Prevention vs. Treatment: How Do We Allocate Scarce Resources from Jewish Ethical Perspectives?

Casuistry has been suggested as the optimal methodology to analyze modern bioethical dilemmas and this methodology can used to develop a Jewish ethic towards preventive care. A number of Biblical precepts are clearly life and health promoting. These include the law forbidding the putting of others at risk, mandating constructing a parapet around one's roof to prevent individuals from falling and the law forbidding the placing of a stumbling block in front of a blind person. The Talmud is full of specific public measures to protect people's health, again interpreted quite broadly to include not only specific health hazards, but also pollution by foul smells, and excessive noise. These edicts emphasizes the role of man as a guardian of their body, which has been given to them in stewardship by the Lord. Man is thus commanded to be vigilant in preventing damage, in the form of ill health to one's body. When a physician is confronted with a sick patient, Jewish tradition places an impressive array of immediate demands upon the prospective provider of services. However with respect to societal decision making, Jewish law expects the "elders" of the community to set priorities that go beyond the immediate heart-rending demands of the suffering individual and to allocate resources in a rational and responsible manner.