잠언 3:17의 Halakhah

To the latter question Radbaz responds that the Torah, "whose ways are ways of pleasantness" (Proverbs 3:17), could not possibly demand the sacrifice of a limb even for such a noble purpose.¹⁹Radbaz’ interlocutor informed him that he had “found it written” that sacrifice of a limb is obligatory in order to save the life of another person. That view is espoused by R. Menachem Recanati, Piskei Recanati, no. 470, and is cited by R. Yehudah Ashkenazi of Tiktin, Be’er Heiteiv, Yoreh De‘ah (Amsterdam, 5529), 157:13, who declares that “some say” that it is indeed obligatory to sacrifice a limb in order to preserve the life of another person; cf., Naḥal Eitan, Hilkhot Ishut 21:11. See also Hagahot Mordekhai, Sanhedrin, sec. 718, who states that a person may cut off the limb of another in order to save his own life. Nevertheless, a person who is willing voluntarily to make such a sacrifice without endangering his own life acts in accordance with the highest traits of piety and merits approbation. If, however, the procedure involves self-endangerment, Radbaz dismisses the act as that of a "pious fool."²⁰The term “pious fool” would appear to denote a person who is foolhardy in his pursuit of pious deeds and assignment of this appellation certainly implies that such acts should not be encouraged. However, in context, the term does appear to connote that the act performed by the individual is forbidden. Although the verse “and your brother shall live with you” (Leviticus 25:36) is cited by R. Akiva, Baba Meẓi‘a 62a, as establishing that one dare not give preference to the life of another over one’s own life, that discussion serves only to prohibit the sacrifice of one’s own life on behalf of another but not to prohibit acceptance of a measure of danger in order to save the life of another. To be sure, as explicitly stated by Teshuvot Radbaz, III, no. 1,052, the principle expressed in the dictum formulated by the Gemara, Sanhedrin 74a, “Why do you think that your blood is sweeter than the blood of your fellow?” is valid in the converse as well, viz., “Why do you think that the blood of your fellow is sweeter than your own blood?” However, application of that principle would require passive nonintervention only when the danger to one’s own life is greater or equal to the danger to the person in need of rescue. In a situation in which the danger to the endangered person is significantly greater than the danger to the rescuer that consideration does not appear to be applicable. Hence, although the Torah does not demand self-endangerment even under such circumstances, the act of rescue, when posing a hazard to the rescuer, should be regarded as discretionary, albeit foolhardy, rather than as prohibited.
Nevertheless, Ẓiẓ Eli‘ezer, IX, no. 45, sec. 13, cites Radbaz’ use of the term “pious fool” in ruling that self-endangerment is forbidden even for the purpose of preserving the life of another. That position is reiterated in Ẓiẓ Eli‘ezer, X, no. 25, chap. 7, secs. 5 and 12 and no. 25, chap. 28. See also R. Chaim David Halevi, Sefer Assia, IV (5743), 256–257, and R. Shemayah Dikhovski, Ne’ot Deshe, II, 155–156. An identical view is also espoused by R. Moshe Hershler, Halakhah u-Refu’ah, II, 123. However, in the course of resolving the contradiction between Teshuvot Radbaz, III, no. 1,052 and Teshuvot Radbaz, V, no. 1,582 (see supra, note 10), Rabbi Hershler limits the prohibition to situations in which the potential danger to the rescuer is equal to, or greater than, the danger to the person to be rescued since he regards Radbaz as requiring intervention when the danger to the victim is disproportionate to that of the intervenor. Ẓiẓ Eli’ezer’s discussion is rather confusing since he also resolves the contradiction in a manner similar to the resolution presented by Rabbi Hershler (see supra, note 10), but in his definitive rulings does not seem to apply the principle that arises therefrom. Most striking is his ruling in Ẓiẓ Eli‘ezer, XIII, no. 101, to the effect that blood donations cannot be compelled because of the attendant danger. See infra, note 28. As will be shown shortly, Ẓiẓ Eli’ezer’s rulings with regard to kidney transplants are also inconsistent with this principle. Moreover, Ẓiẓ Eli‘ezer, IX, no. 45, sec. 5, himself states that Resh Lakish’s self-endangerment did not reflect a controversy with Rav Yonatan but represented an act of piety. That statement is inconsistent with the view that self-endangerment is prohibited.
A number of authorities explicitly declare that, under such circumstances, self-endangerment is discretionary but permissible. Teshuvot Minḥat Yiẓḥak, VI, no. 103, declares that the controversy between Hagahot Maimuniyot and Radbaz is limited to whether or not there is an obligation of rescue when there is a hazard to the rescuer but that all agree that “it is permissible if he so desires.” Minḥat Yiẓḥak, however, qualifies that statement with the caveat that self-endangerment is permitted only if such self-endangerment will “with certainty” lead to the rescue of the victim. See supra, note 8. R. Moses Feinstein, Iggerot
Mosheh, Yoreh De‘ah, II, no. 174, anaf 4, explicitly permits a person to risk his own life in order to save the life of another provided that he does not expose himself to “certain death.” Similarly, R. Samuel ha-Levi Woszner, Teshuvot Shevet ha-Levi, V, no. 119, reprinted in Halakhah u-Refu’ah, IV, 139–142, finds no transgression in endangering oneself in order to preserve the life of another provided that the probability of survival is more than fifty percent. R. Moshe Dov Welner, Ha-Torah ve-ha-Medinah, VII–VIII (5715–5719), 311, also regards self-endangerment for purposes of rescuing another person to be permissible. See also Jacob Levy, No‘am, XIV (5731), 319.
The hazards involved in donation of a kidney are not insignificant. See infra, note 109. Accordingly, the propriety of transplantation of a kidney from a living donor is directly related to the resolution of the issue of whether or not a person may risk his own life in order to preserve the life of another. Despite his earlier cited comments in resolving the contradiction found in Radbaz’ responsa, in Ẓiẓ Eli‘ezer, IX, no. 45, sec. 13 and Ẓiẓ Eli‘ezer, X, no. 25, chap. 7, secs. 5 and 12, Rabbi Waldenberg asserts that, pursuant to the opinion of Radbaz, such donations are prohibited. Although in Ẓiẓ Eli‘ezer, IX, no. 45, sec. 13, Rabbi Waldenberg concludes that such transplants cannot be sanctioned unless it is medically determined that “the matter does not entail possible danger to the life of the donor,” in Ẓiẓ Eli‘ezer, X, no. 25, chap. 7, he incongruously cites his earlier discussion of this topic and rules that such transplants may be permitted “where the danger is not certain and medical science states that it is reasonable [to assume that as a result both will remain alive.” That conclusion is inconsistent not only with his earlier ruling but also with his discussions in the same chapter. R. Pinchas Baruch Toledano, Barka’i, III, 26 and 32, similarly understands Radbaz as prohibiting self-endangerment and rules that donation of a kidney by a living person is forbidden. R. Saul Israeli, Barka’i, III, 35, notes 1 and 2, takes no definitive stand with regard to whether self-endangerment constitutes a transgression but opines that Radbaz’ negative view regarding self-endangerment is limited to situations involving a significant immediate danger. He also suggests that Radbaz’ comments are limited to the danger experienced in the loss of an external organ that would render the donor a cripple. However, neither qualification of Radbaz’ position is supported either by the text of the responsum or by an analysis of the underlying position.
The earlier cited authorities who permit self-endangerment for the purpose of preserving the life of another would certainly sanction transplantation of a kidney from a live donor. Such procedures are also permitted, at least under usual conditions, by R. Ovadiah Yosef, Dinei Yisra’el, VII, 41–43; idem, Yeḥaveh Da‘at, III, no. 84 and Halakhah u-Refu’ah, III, 61–63; R. Shlomoh Zalman Auerbach, as cited by Nishmat Avraham, II, Yoreh De‘ah 157:4 (sec. 2), s.v. akh katav li; R. Moshe Hershler, Halakhah u-Refu’ah, II, 124; R. Saul Israeli, Barka’i, III, p. 35, note 1 (cf., however, idem, p. 36, note 2); R. Moshe Meiselman, Halakhah u-Refu’ah, II, 119–125; R. Chaim David Halevi, Sefer Assia, IV, 257; and Ne’ot Deshe, II, 156.
It is certainly clear that Radbaz himself not only permitted amputation of a limb in order to preserve the life of another but also lauded such a sacrifice as an act of inordinate piety and voiced such approbation despite his observation that loss of blood resulting from perforation of an earlobe has been known to result in loss of life. Radbaz explicitly maintained that even the relatively high risk associated with amputation of a limb, particularly in his day, did not rise to the threshold of risk acceptable only to a “pious fool.” The comment of Ẓiẓ Eli‘ezer, IX, chap. 45, sec. 11, stating that, “since the multitude has trodden thereupon,” the surgical amputation of a limb does not rise to the halakhically significant threshold of danger is both empirically incorrect and contradicted by Radbaz’ comments concerning perforation of an earlobe. See Jacob Levy, No‘am, XIV, 322. Accordingly, contrary to the comments of Ẓiẓ Eli‘ezer and others, prohibition of a kidney transplant from a living donor cannot be sustained even according to their understanding of Radbaz. Cf., Ne’ot Deshe, II, 156.

Among other reasons, Radbaz writes that the Torah is by definition “pleasant and peaceful” (“deracheihah darchei noam v’chol netivoteha shalom,” Mishlei 3:17) and would not compel a person to sacrifice a limb. However, one who sacrifices a limb to save another’s life fulfills a great mitzvah, as long as it does not involve a fifty percent or higher risk of death. Our bodies belong to Hashem and we have no right to place our lives at such great risk.