And You Shall Surely Heal The Albert Einstein College of Medicine Synagogue Compendium of Torah and Medicine Wiesen.indb 1 4/28/09 4:08:36 PM Wiesen.indb 2 4/28/09 4:08:37 PM And You Shall Surely Heal The Albert Einstein College of Medicine Synagogue Compendium of Torah and Medicine EDITOR Jonathan Wiesen EXECUTIVE EDITOR Rabbi Alex Mondrow SENIOR MENTORS Rabbi Howard Apfel, M.D. Rabbi Edward Reichman, M.D. CONSULTING EDITOR Judah Goldschmiedt ASSOCIATE EDITORS Daniel Strauchler Josh Kra Raphy Hulkower Wiesen.indb 3 4/28/09 4:08:39 PM Copyright © 2009 Yeshiva University ISBN 978-1-60280-126-4 Distributed by KTAV Publishing House, Inc. 930 Newark Avenue Jersey City, NJ 07306 Email: [email protected] www.ktav.com (201) 963-9524 Fax (201) 963-0102 To submit a manuscript or to subscribe to the Journal, email [email protected] Wiesen.indb 4 4/28/09 4:08:40 PM This publication is sponsored by Dassie and Marvin Bienenfeld Wiesen.indb 5 4/28/09 4:08:41 PM Wiesen.indb 6 4/28/09 4:08:41 PM Dedication to Eli Steinberger, zt”l The Talmud in Masechet Sotah describes the profound sense of hopelessness which the Jewish people felt upon their arrival at Yam Suf. With the Egyptians on one side and a large body of water on the other, B’nei Yisrael were in a state of despair. Moshe Rabeinu threw up his arms in prayer, prima facie the classic Jewish response. Sur- prisingly, however, the Talmud tells us that Hashem was not pleased, “Yedidi tov’im bayam v’atah ma’arich bitfilah—My beloved are drowning at the sea, and you are supplicating with lengthy prayer.” Although somewhat astonishing at first blush, the Talmud’s descrip- tion of Hashem’s response highlights a crucial and critical lesson: Although something may seem insurmountable and unachievable, it may not be. Go out and try. The results may be astonishing. Eli Steinberger, zt”l, embodied and epitomized this message. Eli struggled with what may have seemed to be insurmountable dis- abilities. But, with a smile always shining on his face, Eli did not complain or expect any special treatment. Indeed, it was so telling that even his closest friends did not know the source of his disabili- ties! Rather, b’simcha, with joy, he made it his mission not only to accomplish, but to uplift others as well. Whether analyzing a blat gemara, discussing computer science, studying biology, playing classical music, or analyzing chemical equations—all of which he mastered, Eli’s gifted mind and multitude of talents were easily ap- parent. His way was a synthesis of Torah and science, and his life vii Wiesen.indb 7 4/28/09 4:08:46 PM viii And You Shall Surely Heal was lived to the fullest, always trying to gain more knowledge and understand the wondrous ways of Hashem. Regardless of his limitations, Eli would not settle for mediocrity. He set his goals high and had the perseverance to see them through no matter what seemed to be in his way. He insisted on applying to the top graduate schools in the country regardless of the challenges such decisions might pose in light of his condition. It was with little surprise that he received acceptances from all of the schools he ap- plied to. Never one to complain, a task that for most people would be an impossible obstacle was seen by Eli as a simple opportunity that with effort was “easy” to overcome. And, while for those of us watching from afar his results were indeed astonishing, for him they simply epitomized the message that Hashem gave Moshe by Yam Suf: Nothing is impossible, with effort anything is possible. Eli was a scholar both in Torah study and scientific knowledge. With dreams of attending graduate school and pursuing a career in scientific research, Eli always made it his mission to use his God given talents to help others. Though his professional dreams were not realized, he certainly accomplished his mission of helping oth- ers, leaving a lasting impact on the many who were fortunate to know him. Countless stories have been told of the remarkable rap- port that Eli developed with his rabeim, professors, and doctors. One physician who treated Eli during an unexpected hospitaliza- tion in Miami, Florida, recounted how he insisted on bringing his children to meet Eli, someone with unmatched character, brilliance, charm, and strong will. With Eli’s synthesis of Torah and science in mind, it is fitting that the Einstein shul’s first Torah and Medicine Journal will be dedi- cated in his memory. And, particularly at this special moment, we realize that as much as we—literally and figuratively—may have carried Eli, Eli truly carried us. Noam Salamon AECOM class of 2011 Wiesen.indb 8 4/28/09 4:08:47 PM Contents Editor’s Preface xi Jonathan Wiesen Introduction xv Edward Reichman and Howard Apfel From the Rabbi xix Alex Mondrow Rabbis and Faculty Preservation of Life Pushes Away (Docheh) Shabbos: Clarifications within the General Discussion, and in the Opinion of Rambam 3 Yaakov Neuburger The Study of Medicine by Kohanim 15 Edward Burns Verapo Yerape: Diverse Approaches to the License to Heal 21 Howard Apfel and Avi Apfel Is There Life After Life? Superfetation in Medical, Historical, and Rabbinic Literature 39 Edward Reichman Collaborative Reproduction: Unscrambling the Conundrum of Legal Parentage 57 A. Yehuda Warburg Students Abortion of the Diseased Fetus in Jewish Law 115 Ari Berger Jewish Bioethical Perspectives on the Therapeutic Use of Stem Cells and Cloning 153 Netanel Berko ix Wiesen pgs i-152 rev 3.indd 9 5/4/09 4:43:13 PM x And You Shall Surely Heal Rabbi Shlomo Zalman Auerbach’s Stance on End-of-Life Care 171 Aryeh Deinstag The Division of Scarce Resources and Triage in Halacha 187 Judah Goldschmiedt “It Is Upon Him to Bring the Proof”: A Note on Historiography, Printing, and the Power of Hearsay in a Position of Rabad 201 Yaakov Jaffe and David Shabtai Laws of Medical Treatment on Shabbat 211 Dov Karroll Eye of the Beholder: Ophthalmic Illness in Talmudic Literature 231 Elan Rosenblat The Physician on the Sabbath 239 Julianna Rosenblat Hilchot Niddah and Gynecological Procedures 253 Eliyahu Rosman Concierge Medicine and Halacha 273 Noam Salamon The Rabbi Who Ate on Yom Kippur: Israel Salanter and the Cholera Epidemic of 1848 295 Ira Taub Don’t Judge a Book? Surgical Changes to Anatomical Features in Traditional and Modern Thought 315 Jonathan Wiesen Wiesen pgs i-152 rev 3.indd 10 5/4/09 4:43:13 PM Editor’s Preface This journal came into being long before the articles it contains began to be culled and edited a few months ago. Its beginnings took root four years ago as the idealistic vision of Rabbi Alex Mondrow, the new Albert Einstein College of Medicine rabbi. Rabbi Mondrow saw in the unique AECOM synagogue, composed solely of Jewish medical students and their families, great potential for the dedicated and creative study of medical halakha and ethics. As the first step in cultivating his vision of blending the worlds of Torah U’Mada, the traditional halakha and cutting-edge scientific knowledge, Rabbi Mondrow recruited Rabbi Howard Apfel, M.D., to deliver biweekly medical halakha classes to the students. Drawing upon his vast clini- cal experience and expertise in the area of practical halakha, Rabbi Apfel captivated the students and encouraged continued investiga- tion into the complicated topics covered. Not wanting his congregants to be limited to hearing Torah and medical halakha second-hand, Rabbi Mondrow thought it prudent to not only encourage students’ independent study, but also to put their ideas in print. Hence the idea of publishing a medical journal founded, written, and edited by Einstein students was born. This journal afforded students the opportunity to articulate their ideas in a public forum, and further promised to be the only medical halakha journal published in the English language. However, as students just beginning our medical careers, the prospect of investigating, studying, and publishing complex medical and halakhic topics seemed daunting. An idea taught to us by Rabbi Apfel came to mind that was suitable to address our concerns. The Talmud in Berachot (60a) suggests a prayer for one who is undergoing a medical procedure, in this case blood-letting, the “stan- dard of care” of that time for most illnesses. “Rav Acha states: One who goes to let blood prays, ‘May this be for a cure, may You heal xi Wiesen pgs i-152 rev 3.indd 11 5/1/09 12:54:15 PM xii And You Shall Surely Heal me, for You are a faithful healer, Your cure is a true cure.’”1 Com- mentators note the interesting characterization of God as the “faith- ful healer” who is capable of attaining a “true cure.” Presumably, this formulation is meant to contrast God’s medical proficiency with that of man, who is not considered a “faithful healer,” nor able to de- liver a “true cure.” What exact feature of God’s “medical services,” so to speak, is underscored in this statement by Rav Acha? The Ben Yehoyada explains that human physicians may perform procedures or prescribe medications that, while undertaken with noble inten- tions and even accomplishing beneficial results, nonetheless have unwanted and unpredicted consequences.2 God, on the other hand, is capable of complete and perfect care, such that it will not cause negative side-effects in a different area. Thus, while striving to pro- vide the best medical care, physicians must acknowledge God’s role as the “true healer,” and ultimately look only to Him for a “true cure.” Particularly as students, we are keenly aware of the limitations of our medical treatments as well as the ease with which we as humans can err.