TORONTO — In the middle of an Ebola scare that has recently found its way to North America, many Canadians have questions.
For instance, should health-care workers be endangered by going to the front lines and battling the epidemic? Can a government make quarantine mandatory for those suspected to have had close contact with the disease? And, once vaccines and drugs are available, who should get the treatment first?
According to Jewish law, it is the duty of doctors to first treat those who can survive over a long period, meaning the young and the healthy, before those who are sick or elderly.
Of course, bringing religious views to an issue of medical ethics can only spur more debate and discussion. Two public health experts and one noted rabbi came together at Shaarei Shomayim Congregation in Toronto on Nov. 2 to discuss how to treat Ebola according to Jewish law.
The public health experts were Dr. Barry Pakes, program director for the Global Health Education Initiative, and Dr. Brian Schwartz, the chief of emergency preparedness at Public Health Ontario.
Joining them was Rabbi Mordechai Torczyner of Toronto’s Yeshiva University’s Torah MiTzion Beit Midrash Zichron Dov, who shared halachic insights in response to their questions and concerns.
In theory, those who need the most help to try to cure them should get the vaccine first. Unfortunately, the people who often get treatments to stave off viruses such as the flu are those who can afford it instead of those who need it the most, Pakes said.
However, Rabbi Torczyner said that long-term life is of greater value, meaning those with the better and longer chance of survival must be treated first.
“All life is valuable, but it is not necessarily equal,” he said. “One is indeed entitled within Jewish tradition to risk temporary life for the sake of long-term life.”
A trickier situation occurs when two patients arrive at a hospital at the same time. Who should the doctor see first? Rabbi Torczyner used halachic teaching to explain that it is also the one whose life has greater value, meaning who will likely live the longest from that day.
Since debate rages on whether a government can impose quarantine time on people returning from West Africa, Schwartz cited how quarantine was often used in Ontario during the SARS outbreak in 2003. However, taking a healthy person off a plane and isolating him or her for weeks infringes on privacy and human liberty, he argued.
“Whatever you do to reduce the spread of an illness has to be proportionate to the threat of the illness,” Schwartz said. “You don’t take a quarantine and enforce it on everyone who comes back from West Africa, unless there’s a good reason.”
Schwartz added that there is almost no risk of a Canadian patient getting Ebola in the near future. Since Ebola is not as contagious as some believe – the disease cannot spread through the air like the flu or SARS – the risk is not as high.
The Ebola epidemic that began in Liberia, Guinea and Sierra Leone has already killed nearly 5,000 people. The disease can be spread through bodily contact with fluids such as sweat, tears, saliva and blood.
A major debate comes up when one realizes that many of the people who have died of Ebola are health-care workers. Pakes said two-thirds of Liberia’s doctors died in the wake of the disease’s outbreak.
It is a commandment within Judaism to help save people’s lives and not stand by while someone’s blood is shed, Rabbi Torczyner said. However, an argument from Rabbi Akiva sheds a different light.
“You can make the argument that the health-care worker can say, ‘My life comes before the patient’s life. I’m not going to treat him at risk to myself.’” Rabbi Torczyner said. “The trend among those in Jewish law is to say one should treat as long as the risk is manageable.”
In the meantime, no scientifically proven treatments or vaccines are available for Ebola patients. Some of the drugs currently used have not undergone a formal review process to prove their safety or effectiveness.
It may cost more than $1 billion to bring to the market a vaccine to treat Ebola. Vaccines in the pipeline should be ready for testing in 2015.