Dwelling on the heroic, and patently dangerous, deed of Pinchas, the Keli Yekar asks the following question: How was it permitted for Pinchas to place himself in danger? We are obligated to look after our physical body—to ensure, as best we can, our good health, and to avoid danger. He replies that although it is generally forbidden for a person to endanger himself, in this case, to save Klal Yisrael, it was permitted.
We take the opportunity to discuss the general idea of placing oneself in physical danger, and the specific question of whether it is permitted to do so in order to save another’s life. Is one obligated to endanger oneself to save somebody else’s life? Is this forbidden? Is there a distinction in the level of danger involved? And what is the halacha concerning a physician treating a contagious disease?
These questions, among others, are discussed below.
“Guard Yourselves Very Carefully”
The obligation to look after our health is derived, by many Poskim, from the verse in Devarim (4:5): “Guard yourselves very carefully.” Though the simple reading of the verse refers to preventing ourselves from doing an aveirah, however, based on the Gemara (Berachos 32b), the verse is often interpreted as an exhortation to look after one’s physical wellbeing.
The Kitzur Shulchan Aruch (32:1) thus writes: “Because possessing a healthy body is among the ways of Hashem, for a sick man cannot know or comprehend anything of Divine knowledge, therefore a person must distance himself from things that damage the body, and cling to ways that heal and maintain the body. Of this the verse states, ‘Guard yourselves very carefully.’” The obligation to guard ourselves from danger, as based on the Pasuk, is also mentioned by the Pri Megadim (Orach Chaim 328:6).
Responsa material also includes several authorities who imply that the instruction to preserve our bodies is a Torah obligation. For instance, Rabbi Yehudah Asad (Shut Mahari Asad, Orach Chaim 160) discusses the question of a sick individual who was ordered by doctors to refrain from eating matzah or maror on Pesach. His question was whether it was nonetheless permitted for him to partake of matzah and maror, and whether he could recite a beracha over their consumption.
The response was that it was forbidden for him to eat matzah or maror, because of the biblical injunction: “You shall guard yourselves very carefully,” and because it says (Vayikro 18, 5) “One should do the mitzvos in order to live” If he nonetheless eats, no mitzvah is fulfilled and no beracha may be recited (see also Tosafos, Shevuos 36a; Rashbash 1; Chavas Ya’ir 163; Chasam Sofer, Yoreh De’ah 241; and many other sources).
The Prohibition of Injuring Oneself
Another source, in which the above verse is not mentioned (both by the Mishnah and Talmud themselves, and by later commentators) emerges from the prohibition of self-injury.
The Gemara in Bava Kama (91b) cites a dispute between the Mishnah and a Beraisa concerning whether a person may cause himself bodily harm. The Mishnah (Bava Kama 90b), quoting Rabbi Akiva, states that it is forbidden for one to injure himself. The Beraisa, however, also quoting Rabbi Akiva, states that it is permitted for a person to harm himself physically.
It is noteworthy that the case mentioned by the Mishnah implies that financial gain is not sufficient to permit a person to cause himself bodily harm. The Mishnah tells the story of a man who removed a woman’s hair covering in the marketplace, thereby causing her shame. Rabbi Akiva found him liable to pay four hundred Zuz as compensation for the shame he caused the woman.
The man, who was not pleased with the decision, connived to show that he should be exempt from a penalty by demonstrating that the woman did not care about her own shame. This he did by breaking a jug of oil in the market in front of the woman, at which the woman revealed her hair and began to gather the spilling oil and soak it up in her uncovered hair. The man brought his proof before Rabbi Akiva, stating: “To this woman I should pay four hundred Zuz?”
Rabbi Akiva, however, was not convinced: “One who injures himself, even though it is prohibited, is exempt. If another injures him he is liable.”
The Rambam, followed by the Shulchan Aruch and other Poskim, rule in accordance with the Mishnah: One may not injure himself. As Tosafos point out (91b, s.v. elah), and as implied by the Mishnah, this prohibition applies even for a need (such as the financial need of the Mishnah).
It can thus be suggested that the general obligation to look after one’s health, and to avoid the unhealthy and damaging, is a derivative of the prohibition of causing self-injury which this Gemara derives from a pasuk (Bereishis 9, 5).
Endangering Oneself to Save Others
Having established the obligation to guard one’s personal health, the question we wish to dwell on is endangering oneself to save others.
The Torah instructs us that, “You must not stand upon your fellow’s blood.” Based upon this Pasuk, and on the mitzvah of returning something that is lost, the Gemara (Sanhedrin 73a) states that a person who sees his fellow in danger of death is obligated to save him. This obligation is ruled as simple by the Rambam (Rotze’ach 1:14) and the Shulchan Aruch (Choshen Mishpat 426:1).
At the same time, we know from another Gemara (Bava Metzia 62b) that according to Rabbi Akiva (which is the normative ruling), if two are walking in the desert and only one has a flask of water, it is his prerogative to drink the water and save himself, even if this means that his fellow will die. “Your life,” says Rabbi Akiva, “takes precedence over the life of your friend.”
The issue, then is whether a person is obligated to endanger himself in order to save his fellow from death, or whether, just as a person is not obligated to sacrifice his life for another, so he need not endanger himself. Moreover, perhaps it is even forbidden for a person to endanger himself, given that, as seen above, there is a full obligation to avoid danger and care for one’s physical wellbeing.
The Beis Yosef (Choshen Mishpat 426) and the Kessef Mishnah (Rotze’ach 1:14) note that according to the Yerushalmi, as understood by Hagahos Maimoni, a person is obligated to place himself in possible danger (safek sakana) to save a person from death.
However, this halacha is not mentioned in the Shulchan Aruch itself, nor is it mentioned by other leading early authorities, leading the Sema (426:2) to state that we do not rule in accordance with it. The Pischei Teshuva (426:2) explains further that a Gemara in the Bavli indicates that one need not endanger oneself even to save a life, and the Bach (426) suggests that the wording of the Rambam (a person is obligated to save another if “he can save him”) indicates that if saving involves personal danger, there is no obligation to do so.
Thus, the Shulchan Aruch HaRav (Nizkei Guf 7) states that although some rule that one must endanger himself to save another, the halacha is that one is not obligated to do so. The Pischei Teshuva (426:2) adds that although there is no obligation, one must exercise care in the matter, and not callously say that it is a sofeik sakono for him when there really is no danger. The Mishna Berura (329, 19) rules like the Pischei Teshuva.
The Minchas Chinuch (237) suggest that the obligation of vechai bahem, from which we derive that a person’s own life takes precedence over his fellow’s, seems to apply even concerning placing oneself in danger. This seems to imply that just as one must not give up his life for another’s, so one must not endanger himself.
However, Rav Moshe Feinstein (Shut Iggros Moshe, Yoreh De’ah 2:174:4) writes that it is in fact permitted to endanger oneself to save others. Although one is not obligated to enter a state of danger to refrain from passive transgression of the prohibition of “standing upon your fellow’s blood,” it is permitted to do so in order to save a life.
The Radvaz: Distinctions in Danger
An important opinion cited on the subject is that of the Radvaz, who was asked what a person should do if a government officer threatens: “Let me cut off one of your limbs in a way that you will not die, or I will kill your friend!”
After noting several proofs to the matter in case there is no danger to one’s life, the Radvaz (3:627) concludes that if there is a questionable risk of death (safek sakana), one who agrees to lose his limb is acting wrongly and would be considered a fool (chassid shoteh).
Elsewhere (5:218), the Radbaz explains further that the matter depends on the degree of danger. If the danger is only slight, a person is obligated to place himself in (slight) danger in order to save a life. However, if the danger is substantial, or if it is “even” (shakul), then there is no obligation to do so, for “one’s own life takes precedence.”
Based on the Radvaz, Rav Ovadya Yosef (Yecheveh Da’as 3:84) rules that it is permitted for a person to donate a kidney to a family member or somebody else to potentially save a life. The danger involved in a kidney donation is only slight (he writes 1%), and not nearly substantial enough to prohibit doing so.
A Physician’s Duty
The Rambam (ibid.) rules that just as one must rescue a person to save a life, so a physician must treat the sick in order to save their lives by providing the necessary treatment. Sometimes, treating the sick may involve some element of danger to the physician. Must one offer treatment even in such circumstances?
Rabbi Eliezer Yehuda Waldenberg addressed this issue at length (see Shut Tzitz Eliezer Vol. 8, no. 15, 10:13 and Vol. 9, no. 17:5), as summarized by Dr. Avraham Steinberg in his Encyclopedia of Jewish Medical Ethics (Vol. 10, pp. 177-178):
“In principle, a person may not place himself in possibly life-threatening danger in order to save his neighbor’s life. However, when discussing physicians, this law is somewhat modified. It is permitted for a physician to assume the risk of treating patients with any type of contagious disease. Indeed, he is credited with the fulfillment of an important religious duty. When preparing to treat a patient with a contagious disease, the physician should pray to G-d for special guidance and protection since he is endangering his own life.”
Rav Waldenberg added that a military physician is permitted to provide medical care to a wounded soldier in a combat zone, although he is endangering his own life. He adds that this will apply even if it is doubtful whether the wounded soldier will live, die, or be killed. Likewise, another soldier can to place his own life in danger to rescue a wounded comrade from the combat zone.
Physicians, as Rav Shmuel Wosner (Shut Shevet Halevi 8:251:7) explains further, have a duty to heal the sick, even under circumstances of personal endangerment. Like in times of war, the general principles of saving lives are altered for them, since this is their basic duty and mandate. May Hashem help them, and help all of us, to heal and to assist others whenever we can.