W hen Sarah Palin charged that Obamacare would result in “death panels” she was widely ridiculed. But in the broader sense she was surely right. As government assumes an ever-larger share of health-care funding there will inevitably be issues of health-care rationing especially since the government purse is not unlimited. And with rationing come assessments of the quality of life and decisions about who will live and who will die.

The “quality of life” mentality which does not view life as an infinite good but as a commodity to which a price can be assigned has permeated our societal thinking and perhaps most of all that of doctors. A religious neurologist with whom I maintain an e-mail correspondence recently shared with me a horrifying case involving a neighbor of his — an 80-year-old Auschwitz survivor. She developed a benign brain tumor that soon confined her to a wheelchair and left her speechless.

Her children took her to three of the top neurosurgeons in New York each of whom told them that surgery was impossible at her age. As an afterthought her children decided to show the X-rays to their neighbor my friend. What he saw shocked him. The benign tumor was located very close to the scalp and was easily operable. He confirmed that judgment with a local neurosurgeon.

In the end the woman had surgery at Sloan-Kettering. She was speaking and walking again almost immediately after surgery and released to a rehabilitation clinic within a day of the surgery.

My friend contacted two of the three surgeons who had recommended against surgery. They did not tell him as they had the family that the tumor was inoperable. Rather they justified their advice: “She’s so old;” “I wouldn’t subject my mother to this;” “Just let her go.”

How many times a day my friend wondered does a doctor who has taken the Hippocratic Oath make his own independent value judgment that the life in question is no longer “worth it” in terms of the expense and effort required to save the patient?

A WELL-PUBLICIZED CASE FROM ENGLAND points to another corollary of the “quality of life” mentality: If the quality of life is subject to objective determination then end-of-life decisions will inevitably be consigned to “experts” and not family members.

The fate of Charlie Gard an 11-month-old infant born with a DNA defect that prevents his body from producing enough of the mitochondria that provide energy to the muscles and brain does not directly present any rationing issues. His parents have raised close to $2 million to bring him from London for treatment in America.

Charlie’s parents know that none of the previous 16 infants identified with his condition have survived. And they know that no treatment regime has even gone through preliminary testing on animals and that the chances of success are virtually nil. Yet they still want to give their son “a chance ” and have moved heaven and earth to do so.

The hospital in which Charlie is currently on a ventilator however determined that the best thing for Charlie would be to die as soon as possible and thereby avoid any further pain. (He suffers from seizures but there is no evidence that he is in pain.) Both the highest court of England and the European Court of Human Rights told Charlie’s parents the same thing: We sympathize with your grief but the hospital knows what’s best for Charlie and the doctors have determined that the best thing for him is that he die straightaway. (Great Ormond Street Hospital for Children is now reconsidering the possibility of allowing treatment in America.)

We are not talking about government intervention to override a parental decision to withhold medical treatment in order to save a child’s life but the exact opposite — overriding a parental decision to proceed with highly speculative and very expensive treatment on the slight chance that their son can be saved. To the Gards’ claim of the right to make the decision the European Court of Human Rights has answered: The experts know better than you what is best for your son and they say it is best for him to die.

PERHAPS THE MOST IMMEDIATE THREAT to Orthodox Jews however comes in the form of a Canadian law entitling patients to assisted suicide and an Ontario statute pursuant to that national legislation requiring doctors and nurses to assist in the suicide if requested. (We have written previously about the statute.)

Now Mary Jane Martin a registered nurse was told by her government-run employer that she needed to sign an oath of loyalty to the laws of Canada including that governing euthanasia and assisted suicide. Failure to do so would be treated as an automatic resignation her employer explained.

Martin resigned rather than refer patients to other providers to discuss with them the availability of assisted suicide. “I entered nursing to help the vulnerable and struggling ” she said "not to be a link in the chain leading to death."

In a letter to a Canadian parliamentarian Martin lamented that patients would be deprived of her “training experience and commitment to compassionate care for the elderly disabled and vulnerable.” The required oath that led Martin to leave the profession now hangs like the sword of Damocles over every Orthodox health-care provider in the province of Ontario including Toronto.

Alex Schadenberg executive director of the Euthanasia Prevention Coalition made a trenchant point about Martin’s case which also applies to controversial decisions like that of the US Supreme Court in Obergefell. Those advocating for various “rights” are taking an ever more aggressive stance: Their rights they claim include never being exposed to anyone who finds the practices in which they engage to be immoral. It is not enough that euthanasia is permitted and same-gender marriage recognized; they must become normative and anyone who thinks otherwise silenced.

NO TWO SIDES

Sometimes you read or see something that makes you want to stand up and cheer. The speeches of US Ambassador to the United Nations Nikki Haley would fall into that category.

Often it is not that the speaker or writer has said something that is remarkable. But rather that they have said something obvious with complete clarity and without qualification of any kind.

I had that feeling recently after the burning of a soldier in effigy in Meah Shearim. Rabbi Avraham Edelstein responded immediately.

Rabbi Edelstein is quite likely the most knowledgeable person on the subject of kiruv worldwide by virtue of his long years traversing the globe on behalf of the Horn-Wolfson Foundation. Today he runs the English-language department of Neve Yerushalayim. As a consequence of his prominence in the world of kiruv his postings have a wide following.

In the wake of the event in question he wrote: “There are no two sides here two different legitimate opinions within the Chareidi camp. Those who acted in this way acted in a way that is entirely un-Jewish in many respects.” He cited no Torah sources for his opinion: Lama li kra? Sevora hu! — Why would a verse be needed? It’s elementary logic.

Whatever one’s issues with the Israeli government or the IDF’s efforts to use the IDF as a tool of socialization toward one national culture the individual IDF solider is not our enemy. Over a period of three years he may be called upon to risk his life to protect the rest of us at any given moment. It is hard to conceive of someone more worthy of our hakaras hatov than that.

That is not to deny the protective power of Torah learning. But I have never heard a Torah authority quoted for the proposition that Israel does not need an army to protect it and could rely exclusively on Torah scholars. Even the Dor Deiah required an army to conquer the Land of Israel. Yes of the 2 000 from each tribe who went out against Midian one thousand devoted themselves to tefillah but still another thousand went to battle.

I do not know a single person in the chareidi community who would be willing to live in an Israel without an army and I very much doubt such a person exists.

I’D LIKE TO TAKE Rabbi Edelstein’s condemnation one step further to encompass the attacks both verbal and physical against religious soldiers in uniform in several chareidi neighborhoods. It is the ugliest phenomenon in the chareidi world in recent years.

Religious soldiers are also protecting us. And in addition whether acknowledged or not each young man educated in chareidi institutions who goes into the army helps fill the IDF’s various targets for chareidi enlistees and lessens the future pressure on those who seek to remain in full-time learning.

When I see a religious soldier I have no idea what his story is or why he has chosen to enlist. Perhaps he fully subscribes to the view that Torah learning is the greatest protection but feels that his learning is not of the highest quality or that he is not pushing himself with the same mesirus nefesh as a combat soldier is and therefore he is not entitled to the deferment from enlistment.

When I was appointed the editor of the English Yated Ne’eman many years ago I was told by the business manager that Rav Schach was insistent that all the male employees had to inform Vaad Hayeshivos that we were no longer entitled to a deferment. (I was still learning two sedorim a day.)

When I see a religious soldier I also usually have no idea what unit he is in and what are the spiritual threats he faces. Nor do I know what dangers he was exposed to prior to enlisting.

My preeminent concern at that moment is to increase the likelihood of his remaining a Torah-observant Jew. Now which action on my part is more likely to increase his desire to remain affiliated with the Torah community? Which is more likely to strengthen him to resist the temptations and the peer pressure to which he is exposed? Smiling at him and inquiring after his wellbeing or showing my contempt and verbally abusing him?

How sad that such a question even has to be asked. Or that there are those who either don’t know the right answer or don’t care.

Originally featured in Mishpacha Issue 669. Yonoson Rosenblum may be contacted directly at rosenblum@mishpacha.com