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What would the Torah say about this scenario? A CEO of a hospital has only 1 machine. This machine can save lives if you put someone in it. However, for some patients, this will not make them live, rather just delay their deaths. Let's say patient A walks in. He is in a very bad situation, he will die within 1 hour if not put in the machine for a 24 hours minimum. If he is put in the machine, he will survive for 1 month. Is it better to put him in the machine and let him live for a month? However, if you do this, you may have to face a situation where patient B, who will die in an hour but will live until his normal life expectancy if put in the machine, will show up. And you have must either take Patient A out of the machine, directly killing him, and put patient B in, saving him. Or you could leave patient A in, let him live for another month, and indirectly kill patient B. What should the CEO do?

P.S. I tried to make this question as clear as possible but it is hard to formulate so please feel free to comment to ask for clarification.

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  • "this will not make them live, rather just delay their deaths": I don't understand the difference. – msh210 Mar 13 at 17:59
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And you have must either take Patient A out of the machine, directly killing him, and put patient B in, saving him. Or you could leave patient A in, let him live for another month, and indirectly kill patient B. What should the CEO do?

The key here is status quo -- is someone currently on the machine? This came up in Spring 2020 with a ventilator shortage in the Covid-19 pandemic. You can find the responsa on KolCorona.

Rabbis Hershel Schachter and Asher Weiss both wrote that you don't take someone off of a ventilator, so long as they're still alive, as that would be an act of murder, even if you could use it to save someone with a much better prognosis. (Now if the patient isn't clearly living ... or if the ventilator needs to be occasionally switched off anyhow ... it gets trickier.) Rabbi Shachter is adamant on this point. Rabbi Weiss assumes this is the case as well. He then notes that R' Zalman Nechemya Goldberg zt"l (who we sadly lost in the past year) would allow the hospital to take a poor-prognosis person off a ventilator to give it to a better-prognosis patient; Rabbi Weiss simply comments -- this requires deeper analysis (pilpul).

If, however, nobody is yet hooked up to a ventilator; it's the middle of a pandemic, and every day for the past two weeks you've maxed out your daily ventilators; it's 7am, you have one free ventilator, and a frail patient already in renal failure comes in -- Rabbi Weiss and Schachter agree that you may triage based on the supposed healthy-other-than-this-virus patient you strongly expect will show up within a few hours. Pandemic circumstances allow one to imagine all the people likely to show up at the ER today, and then triage accordingly. (Rabbi Weiss proves from a thought experiment -- say at 7am a poor-prognosis patient is brought in, and just then you get a call from an ambulance that a good-prognosis-if-ventilated patient should arrive in 15 minutes.)

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  • I think the question was more about whether you should put the first person on the ventilator in the first place, knowing that you either won’t be able to take them off to save the second person, or you will take them off and thus be “murdering” them instead of merely not saving them. – Alex Mar 12 at 21:33
  • @Alex thank you! Same poskim addressed that one too. Added it in. – Shalom Mar 12 at 22:28
  • There was a suggestion some year back to attach the ventilator to a shabbos clock, which would periodically switch off the machine and reactivate it, thereby always allowing the question to be o e of triage, not of murder. simpletoremember.com/media/a/one-ventilator – chortkov2 Mar 15 at 14:34
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There is a concept that you don't skip over a mitzva that is in front of you. You have a mitzvah to save patient A now so you put him on the machine to save his life. What will happen in the future you cant worry about it now you have to what you have to do.

Since we don't know how long patient A will live for could be he will live for a long time and patient B will live maybe he will die tomorrow. That's why we do what's in front of us now and save patient A.

If patient B shows up you CAN NOT remove patient A from the machine it is murder.

In Judaism, we value every minute of life if we can extend life even for a minute we do what e can to so that will happen. On the flip side, someone who is dying and someone closes his eye and he dyes a second earlier he is considered a murder.

Now if both show up together at the same time that a different discussion.

Rabbi Dr. Akiva Tatz has a shuir on it.

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