Vaccination Vacillation

Should I leave limited flu vaccine for needier people?

Q. Authorities have requested that healthy people pass on flu shots to leave enough vaccine for old and sick patients. Am I obligated to listen?

A. Of course the question of how to allocate scarce medical resources is hardly a new one. Jewish law and tradition provide an instructive ethical approach to this delicate question.

Jewish law does establish that there is an obligation to heal others and protect their health. The source for this obligation is a commandment of the Torah — perhaps a surprising one. The sages of the Talmud explain that we learn this obligation from the commandment to return a lost object! The Torah teaches, “Don’t see your brother’s ox, or his sheep, wandering in the way, and ignore them; surely return them to your brother” (Deuteronomy 22:1). The very next verse reiterates “return it to him;” from this the Talmud infers that there is another kind of return — restoring a person to himself.1 A person’s well-being, including his health, so to speak “belong” to him; when a person is ill, he has lost something precious. Others are required to do their best to restore him to health.

By the same token, we are obligated to help others maintain their well being in the face of a threat. This is learned from the verse “Don’t stand idly by the blood of your brother” (Leviticus 19:16). We are required to take active steps to protect others from harm.

What happens if I found someone else’s lost object but I also have a lost object of my own?

Here the Talmud provides us with a law and a lesson. First, it states clearly that we may give preference to our own status: This also has a fascinating source. The Torah commands us to make a release of debts in the Sabbatical year; but then it reassures us, “However, there will be no needy among you, for the Lord will surely bless you in the land which the Lord your God gives you as in legacy to inherit” (Deuteronomy 15:4). The simple understanding is that of a blessing: when we carry out God’s will, poverty will be eliminated. But the unusual wording hints also at a commandment: “There should be no needy among you” — you yourself should not become needy. This is part of a general ethical principle in Judaism: while generosity is obligatory, at all times a person should take care that he himself is not reduced to penury, so that he should not himself become a burden to the community. Therefore, we may first take care of our loss to make sure we avoid poverty.

Yet the very next line of the Talmud cautions us: “Anyone who scrupulously fulfills this for himself will ultimately come to this very state.”2 In other words, anyone who is ultra-cautious for his own well being at the expense of others will ultimately find himself dependent on others.

The Torah intends for us to exercise reasonable caution; it legitimizes prudent self-interest, not callous indifference to others. Disregard for others endangers the Divine blessing which is after all the ultimate source of wealth, so an overly selfish person is actually damaging rather than helping his fortunes.

Let us apply this insight to the case of flu vaccine. A person who has a reasonable concern that he might contract the flu and that the illness might be a serious health concern, rather than a minor inconvenience, is permitted to give precedence to his own well being and exercise his legitimate right to obtain a vaccination.

However, a person should consider carefully if he is being excessively cautious at the expense of some other patient who may really need the vaccination much more.3 The average healthy person will probably conclude that his health will be better protected by the Divine blessing towards those who show concern for the needy than by getting a flu shot a few weeks earlier in the season.

SOURCES:
(1) Babylonian Talmud Bava Kamma 81b.
(2) Babylonian Talmud Bava Metzia 33a.
(3) See Pitchei Teshuva on Shulchan Arukh Choshen Mishpat 426.