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September 1, 2015 | 17th Elul 5775

Who Shall Live...

January 12, 2003
Marc Rosenstein

1. Two years ago, a coworker of my wife, afflicted with cancer, sought treatment with an experimental chemotherapy regime not covered by the government-funded HMOs, nor by her supplementary health insurance. So, friends and neighbors and coworkers pitched in to mount a fund drive by personal contributions and various local benefit activities, and raised the money.

2. Last year I received a letter on behalf of a colleague and friend from Tel Aviv, with whom I am not regularly in touch, notifying me that his wife urgently needed a heart transplant in the US, and that $1 million was needed to fund it. I recently learned that the funds were raised, and the operation was successfully completed.

3. Several residents of our part of the Galilee have needed such extreme care in the past two years, and their friends, families, and communities have run a constant series of benefit performances, races, walks, auctions, etc., to fund their medical expenses, with of course lots of supportive coverage in the local newpapers.

4. Now a neighbor, a young mother here on Shorashim, has been told that her brain tumor can only be treated in the US, at a cost of tens of thousands of dollars not covered by her HMO or insurance. Her neighbors have begun to act; the proceeds of our annual Hanukah tzedakah auction were designated for her fund, and the auction of course broke all records for success. Now a committee of Shorashim members is busy planning more events -- an art sale, a women's evening, etc.

What is wrong with this picture? On the one hand there is something wonderful about the human phenomenon of communities pulling together to save the life of a member. Here at Shorashim, and I'm sure this is typical, this project has brought out activists who have never shown any involvement in any other project in the community. There are meetings of the various subcommittees every other night; we have been galvanized into action in an unmistakably worthy cause; it's an exciting and important challenge, the kind that brings people together. On the other hand, how has it happened that people with lots of friends and a strong community get to live, while those who lack these resources don't? And how does one decide how much is appropriate to donate to save the life of a neighbor? What is capability giving in this context? And suppose the folks who are the neighbors of one of the patients described above are more resourceful, aggressive, and/or well-connected than we are, and succeed in making their campaign a major media event in the area while ours remains a modest local effort; are we at fault for not putting forth more energy? What does it mean to live in a constant barrage of requests for such individual life-saving contributions? And what happens when we get saturated with them? How does one decide among them?

And what is the alternative? What kind of national policy could prevent this life-and-death marketplace? What's it like in other countries? Is it that in Israel our knowledge of the possibilities of sophisticated treatment -- and hence our expectations -- are high, while as a small, isolated country with limited resources our ability to fulfill those expectations is limited? Or is this just a local manifestation of a global phenomenon? I know that the issue of allocation of scarce resources as medical treatment becomes increasing sophisticated and expensive is a complex and difficult one about which ethicists and doctors and economists write learned papers. But that doesn't help me feel better about the reality around me. We have Hadassah, and the Weizman Institute; we have Jewish values and Jewish brains; we have a man in space this week, doing esoteric scientific experiments that cost millions. And we are baking brownies for a bake sale to pay for our neighbor's brain surgery.


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