Clashing Values - Rosh Hashanah and Rationalist Medical Ethics

Shana Tova and Ketiva V"Chatima Tova to all Rationalist Medical Halachists.  I wish everyone a wonderful Chag with their families and a healthy and beautiful New Year. May all of our discussions about medical issues remain purely theoretical for all of you, and may you enjoy a year of only health and happiness.  A few words about the upcoming holiday before I start my new topic, one which is sure to challenge you and stimulate some serious thought.

One of the primary themes of Rosh Hashanah is the acceptance of God upon ourselves as our King. This has always been quite a challenge for me, as most of us don't really believe in kings anymore these days.  When I think of a king, I think of an institution that is brutal, dictatorial, and based on hereditary luck.  I'd like to think that this institution will remain in the dustbins of history where it truly belongs. I like democracy. 

It is very difficult for me to imagine God as a king.  Imagine even the most kind, and the most just King.  A King who is as perfect a ruler as a human can possibly be.  He metes punishments only after careful consideration to those who deserve it, and rewards those who are good.  This is the King of the Disney movies, the kind of King we would supposedly love and cherish. But is this God? Is this who I want to make my "King" on Rosh Hashanah? 

The method I use to answer this Rosh Hashanah dilemma is the same method I use to tackle the most difficult Medical Halachic topics when they seem to clash with my Rationalist viewpoint.  I did this when I couldn't understand why some Orthodox Jews wouldn't donate their organs to save the lives of others, and when my soul understood that the right thing to do on Shabbat is to save lives no matter what the religious and ethnic background of my patient happened to be. I will explain.

To answer the question of the type of King we are supposed to accept this Rosh Hashanah,  allow me to quote from the Rambam in Moreh Nevuchim 3:23 (Friedlander Translation):

" ... The description of all these things (the description of Elihu in Job where he describes the wondrous creatures of God's creation - RMH)  serves to impress on our minds that we are unable to comprehend how these transient creatures come into existence, or to imagine how their natural properties commenced to exist, and that these are not like the things which we are able to produce. Much less can we compare the manner in which God rules and manages His creatures with the manner in which we rule and manage certain beings. We must content ourselves with this, and believe that nothing is hidden from God, as Elihu says: "For his eyes are upon the ways of man, and he seeth all his goings. There is no darkness nor shadow of death, where the workers of iniquity may hide themselves" (xxxiv. 21, 22). But the term management, when applied to God, has not the same meaning which it has when applied to us; and when we say that He rules His creatures we do not mean that He does the same as we do when we rule over other beings. The term "rule" has not the same definition in both cases: it signifies two different notions, which have nothing in common but the name. In the same manner, as there is a difference between works of nature and productions of human handicraft, so there is a difference between God's rule, providence, and intention in reference to all natural forces, and our rule, providence, and intention in reference to things which are the objects of our rule, providence, and intention. This lesson is the principal object of the whole Book of Job; it lays down this principle of faith, and recommends us to derive a proof from nature, that we should not fall into the error of imagining His knowledge to be similar to ours, or His intention, providence, and rule similar to ours. When we know this we shall find everything that may befall us easy to bear; mishap will create no doubts in our hearts concerning God, whether He knows our affairs or not, whether He provides for us or abandons us. On the contrary, our fate will increase our love of God; as is said in the end of this prophecy: "Therefore I abhor myself and repent concerning the dust and ashes" (xlii. 6); and as our Sages say: "The pious do everything out of love, and rejoice in their own afflictions." (B. T. Shabb. 88b.) ..."

This is the only type of King we should be accepting upon ourselves this Rosh Hashanah. Forget your silly, human, and mundane conceptions of justice, and certainly get rid of the Disney king image, and take the God that the Rambam is describing and make Him your King.  I can accept that.

So what does this have to do with Rationalist Medical Halacha!?!

That's easy to explain.  In the past 7 or 8 years of my life, I have concentrated my Torah study in areas that the traditional yeshivos I studied in during my youth purposefully ignored.  The study of Nach, and the study of the Moreh Nevuchim have changed my spiritual life in such dramatic ways, that I often feel as if I have discovered a new religion.

Focusing for a moment on the Moreh, the primary lesson that sums up the entire sefer is that one should never take for granted his simple and surface understanding for granted as the truth.  When one takes the simple understanding of almost any concept presented in the Written and/or Oral Torah, one is led to inconsistencies and contradictions that will almost inevitably lead to doubts and and rejection.  The way to come to the truth is to study and investigate to find out what is really the meaning of the Torah, the ma'mar chazal, or the pasuk, that seems to present a difficulty.  If you work at it, and you study it honestly and openly, you will understand, and your search will lead to the truth instead of leading to despair.

The Rambam did this for us with our concept of what we accept upon ourselves when we realize that God is our King.

We need to do this as well when we encounter difficulties in our study of the Torah.

Let us start the new year with a study of one of the most difficult and impossible to understand passages in Chazal (at least for me, and I suspect that many other rationalist medical halachic blog followers will agree).

The Mishna in Horayot, 3:7-8 says as follows:

3:7 - A man comes before a woman to (save) his life, and to return his lost object, and a woman comes before a man to clothe her and to save her from captivity, and if they both are at equal risk of abuse (in captivity) then a man comes before a woman

3:8 - a Kohen comes before a Levy, a Levy before a Yisrael, a Yisrael before a mamzer, a mamzer before a Netin, a Netin before a convert, a convert before a freed slave. when is this true? Only if they are equal, but if the mamzer is a talmid chacham, then a mamzer talmid chacham comes before a Kohen gadol who is an am ha'aretz

This mishna raises so many obvious questions, that it is almost unnecessary to list them, but I will anyway:

1. Why should I save the life of a man before a woman just because he was born with a "Y" chromosome?
2. If the risk of abuse is equal, why does gender give the man precedence over the woman?
3. Do these rules apply nowadays?
4. Where do these rules come from?
5. Why should simple genealogy give a Kohen precedence over a Levy and a Levy over a Yisrael and so on?
6. Why should a convert be one of the last on the list, shouldn't he/she be higher on the list? After all, didn't he/she accept Judaism voluntarily, while the others were just born into it?
7. What about other circumstances that might make one person more "valuable" than another, other than prowess in Torah study?
8. Most importantly: Can one conclude from this mishna that one person's life is more valuable than another simply because of the family he was born into? 

I will not answer these questions today. Indeed, many of you probably have given some thought to this mishna and have done some research yourselves. I am going to take the approach of the Moreh, and begin a lengthy and detailed analysis of this Mishna from many different perspectives.  I ask you to be patient and help me as I wade through this. Please comment as you wish, especially if you have something intelligent to say, but please, don't jump to conclusions until you have done the work and have intellectually honest things to say.

I hope to demonstrate that we can still remain faithful and intellectually honest Orthodox Jews, despite the fact that the Mishna seems to contradict so many of the modern values that we have come to accept and hold dear.  It will take me a while, so please be patient with me.  I also have a day job ;-)