Derekh Eretz, Jewish Medical Ethics and the Vaccine

Oasis Songs: Musings from Rav D
Friday, February 12, 2021 / 30 Shevat 5781

Summary: In this week’s Oasis, I wanted to look at this period of vaccination roll-outs, particularly because it brings up all sorts of feelings for people. While I previously wrote about an individual mandate in Judaism to get vaccinated, today I want to discuss issues of fairness and how our religion encourages us to behave during a time like this, as well as include contact information for our Covid team.

Reading Time: Five minutes

Anger. Frustration. Anxiety. Resentment.

As some people begin to get their inoculations, other people who are in a higher risk group or otherwise eligible are feeling frustrated that they can’t find a place to get the vaccine. Signing up is primarily done by computer, and not all of our older neighbors have computer access or feel comfortable navigating the sites. That’s pretty frustrating.

Because of that, our Covid response team (CNSCOS) is here to assist with many Covid-19 related questions or issues, including helping seniors secure a vaccination appointment. If you need help setting up an appointment, please email them at or call the hotline at 971-990-5652.

If you do want help over the phone, please provide them with your phone number and a good time for one of the team members to call. If you can’t use email, you can call one of our tam members in the morning betwen 8am-12 pm, and again from 4pm-7pm. It is a small team, but Galia, Stephanie or Alex will get back to you as soon as they are able. Finally, if you know of someone who won’t get this message because of computer limitations, please reach out to them with the information.

In addition to the complexities of getting vaccinated, some people are feeling resentful that others have already received their shots. While I have heard of only a few local incidents, there have been more complaints about this on social media. This concerns me. Most of the people I know who have posted about getting their shots have done so to model and encourage others to get vaccinated. Since herd immunity is essential to help us all get past this pandemic, I am grateful to those who have posted. After all, many people and communities remain suspicious about the vaccines.

Let’s also acknowledge that this period dredges up all sorts of emotions. That’s understandable and natural. So much in our lives has been disrupted. When we are able, we should all strive to hear the complaints that arise from those emotions with as much generosity as we can muster. At the same, even when we might be feeling angry about someone else’s social media post, Judaism asks us to behave with a sense of derekh eretz. Derekh eretz is a rich set of ideas. The pertinent one here concerns treating people politely. We feel what we feel. One of the central goals of Judaism, though, has always been to teach us self-control. Just because a social media post disturbs us doesn’t mean we have to respond with vitriol. Flaming someone is never appropriate.

Some of the anger and resentment that people are expressing, however, comes from a sense that the vaccine roll-out is unfair. It certainly has not been well-organized. Others feel that someone has “jumped the line” and shouldn’t have gotten a shot yet. In a period where we are all increasingly aware of systemic inequities, I wanted to provide general Jewish insights about the ethics of triage, or how and to whom we provide medical care and supplies when demand (patients) exceeds supply (doctors, hospital beds, vaccinations).

Triage falls under the ethical category of distributive justice. When medical resources are insufficient or scarce, doctors and societies have to make excruciating decisions regarding who gets treated first. What is a fair way to do that?

In an ideal situation, Judaism forbids us to sacrifice one life for another. Someone can’t be removed from a ventilator, for instance, in order to provide it to another person, because our tradition teaches us that “no one’s blood is more red.” In other words, all human life is of equal worth.

Such a pure ideal, however, can’t really be applied in a world with limited resources. That’s why Dr. Abraham S. Abraham, one of the leading experts on medicine and Jewish law writes in his book Nishmat Avraham, that we must give priority to certain classes of people when we don’t have sufficient treatment for everyone. That priority must not be arbitrary nor must it favor rich over poor, or the powerful over the weak. Rabbi Tendler, another important figure in Jewish medical ethics, highlights that triage is a decision making process in which one set of goods is pitted against another set of good, rather than good versus bad.

For example, our society has decided to provide the vaccine first to medical professionals and then to the oldest members of society. If we don’t have healthy doctors, nurses and physician’s assistants, we won’t be able to provide for others. Similarly, the elderly are statistically most likely to suffer the most severe cases of Covid that lead to death and that also require more of those scarce medical resources. Providing care first to the elderly is a good. A different society might allocate resources in another way, providing vaccines to those most likely to survive, or those with longer expected life-spans. That is a different set of “goods” and values. Teachers are toward the front of the list because our children can’t yet be vaccinated, and it is a societal value to reduce mental and emotional anguish in the young by getting them back into school.

What is important for us all to remember is that in the world of triage or distributive justice, we don’t have the luxury of providing perfectly equitable treatment to everyone simultaneously. Whatever distributive model we develop trades off one set of goods for another. We are, however, obligated to develop systems that are as fair and color-blind within our resource limitations. Unfortunately, this pandemic has highlighted that our communities of color have been disproportionately impacted. Such discriminatory behavior can’t be considered ethical under any fair system of triage.

Finally, it is worth remembering that even if someone gets an inoculation before me, and that seems unfair, society as a whole still benefits. The more arms we get needles into, the better for everyone.

It’s always darkest before the dawn goes an old saying. It also seems that the greatest emotions arise when there’s a light at the end of the tunnel. It’s been 11 months since we closed down. There’s a path in front of us. Let’s try to keep our chins up and our attitudes positive. We need to maintain our discipline, continue to wear our masks, reduce exposure, and get vaccinated when we can.

May we embrace this moment of hope with optimism rather than rancor.

Shabbat shalom,

Rav D

Shabbat Table Talk

  1. If you had to make decisions about how to distribute a limited resource, such as a new vaccine, who would receive it first, and who last? Why?
  2. What values are reflected in your decisions? Which values are you ignoring by your choice?
  3. What can you do to encourage the people in your circle to get vaccinated? Which strategies might best move someone who doesn’t want the vaccine to get inoculated (assuming no medical reasons prevent this).

If you’d like to continue this discussion, follow this link to CNS’s Facebook page to share your own perspectives on the topics raised in this week’s Oasis Songs. Comments will be moderated as necessary.

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