New York – Halachic Analysis: The Case Of Home’s Refusal To Give CPR And The Noahide Laws

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    Shown is the main gate of Glenwood Gardens in Bakersfield, Calif., Monday March 4, 2013, where an elderly woman died after a nurse refused to perform CPR on her last week. The central California retirement home is defending one of its nurses who refused pleas by a 911 operator to perform CPR on an elderly woman, who later died. "Is there anybody that's willing to help this lady and not let her die," dispatcher Tracey Halvorson says on a 911 tape released by the Bakersfield Fire Department aired by several media outlets. (AP Photo/Gosia Wozniacka)New York – It is a case of mind-boggling immorality. The official policy of the “Glenwood Gardens” retirement home in Bakersfield, California, is that staff, even trained medical staff, may not engage in the saving of human life. Yes, you read correctly.

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    This immoral, depraved, and decadent policy may have resulted in the death of an 87-year-old retiree, when a nurse at that facility refused to give a woman CPR. Lorraine Bayless collapsed on Tuesday last week in the dining room of the Glenwood Gardens facility and was barely breathing. The nurse called 911 for help. She explained to the dispatcher that it was against the facility’s policy for staff to give CPR. The heroic dispatcher pleaded, “It’s a human being!” according to the 911 tape released by the Bakersfield Fire Department and aired by dozens of media outlets.

    911 dispatcher Tracey Halvorson continued her plea: “Is there anybody that’s willing to help this lady and not let her die?”

    “Um, not at this time,” was the horrific response of the facility’s nurse. Bayless, 87, was declared dead at Mercy Southwest Hospital later that night.

    The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse and his facility’s morally depraved policy. “In the event of a health emergency at this independent living community our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives,” Toomer wrote in a statement released to the media. “That is the protocol we followed.”

    Glenwood Gardens is a subsidiary of Brookdale Senior Living, which operates long-term-care facilities in 36 states. Worse yet, the tape reveals that the nurse actually complained to someone else about the dispatcher’s moralization. “She’s yelling at me,” referring to dispatcher Halvorson, “and saying we have to have one of our residents perform CPR. I’m feeling stressed, and I’m not going to do that—make that call.” The dispatcher then asked the nurse if she was going to let the woman die. The nurse responded, “That’s why we called 911.”

    All this brings up the question: Is there a halachic and moral obligation incumbent upon all humanity to save human life?

    The answer is that the Torah obligates non-Jews to follow a set of halachic guidelines, known as the Seven Laws of Noah.

    The Sefer HaChinuch points out that these are not just seven individual laws, but seven categories of laws. The Seven Laws are found in the Tosefta to Tractate Avodah Zarah (9:4) and are cited in the Babylonian Talmud (Sanhedrin 56a). They are (1) the obligation to believe in G‑d; (2) the prohibition against murder; (3) the prohibition against theft; (4) the prohibition against adultery and similar forms of immorality; (5) the prohibition against cursing G‑d; (6) the prohibition of the cruelty to animals involved in eating flesh from a live animal; and (7) the obligation to establish a just court of law to enforce the laws.

    As mentioned earlier, these seven laws are categories, and the obligation to save the life of another person is a subcategory of the law against murder. The Talmud (Sanhedrin 72b) explains the moral obligation of defending the life of a victim from one who is pursuing him. There it states that the Torah obligates one to save the life of the victim—even if it may cause the death of the (potential) murderer pursuing that victim. This law and the associated verse—Bereishis 9:6, „שֹׁפֵךְ דַּם הָאָדָם בָּאָדָם דָּמו יִשָּׁפֵךְ כִּי בְּצֶלֶם אֱלֹקִים עָשָׂה אֶת־הָאָדָם“ —apply to non-Jews as well as Jews.

    Since the obligation to save is even when it may cause the death of the pursuer, certainly, there is an obligation to save under other circumstances. Furthermore, Rabbi Dovid Parro in his monumental work Chasdei Dovid on the Tosefta writes (Korbanos 13:1) that each of the seven Noachide laws has an associated positive commandment, and the positive commandment of the law against murder is the obligation to save human life. The Chasdei Dovid writes, however, that one who neglects this obligation does not incur the death penalty.

    How obligatory is the mitzvah of saving a life? The Netziv in his He’Emek Sheilah (Sh’lach 129:4) writes that a person is obligated to undergo any difficulty in the world to save the life of another. The Pischei Teshuvah (Y.D. 157:15) cites a debate between the Maharam Rikanti and the Radbaz as to whether one is obligated to sacrifice a limb to save another. The conclusion is like the view of the Radbaz that there is no obligation to do so.

    What if the saving of the other’s life will incur an expense? Is there an obligation? Although the Yad Rama and Chavvos Yair seem to indicate that the obligation under such circumstances is similar to the view of the Radbaz, Rav Chaim Kanievsky in the work Mishnas Pikuach Nefesh (page 186) compiled by Rabbi Aryeh Lorenz (son of the late R’ Shlomo Lorenz) writes that there is an obligation of spending 20 percent of one’s financial holdings under such circumstances.

    Applying all of this to the Glenwood Gardens nurse, let’s ask the following question: What if she could expect to be fired from her job if she chose to ignore the immoral policy of her employer? Would she still have had the obligation to save the life of the woman? Although technically one can answer that if losing her job would be greater than a loss of 20 percent of her assets she would be exempt, there are times when we must ignore the technical obligations and do what is right and proper. The Glenwood Gardens policy is horrifying and should be changed immediately. The moral fiber of this country is dependent upon the laws and policies that we implement—whether they be government policies or those of a corporation. At the same time, the actions of Tracey Halvorson, the 911 dispatcher, should be lauded and commended by anyone with the opportunity to do so.

    he author can be reached at [email protected].


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    39 Comments
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    11 years ago

    this may be a shock to you but the official policy of the red cross is that if a patient is conscious you must get a verbal or any other kind of consent from them before treating them. even in a case of an emergency.

    kiri49
    kiri49
    11 years ago

    According to some; Sodom was not so barbaric, they just had lots of policies.

    DRE53
    DRE53
    11 years ago

    I understand the policy being in today’s times where lawyers are out their to come up with ideas of how to sue.
    A nurse isn’t a licensed doctor and if somethingf goes wrong, the home will be sued and that’s why they refrain from saving lives.
    However, my question is: did the home clearly state there policy to all residents?

    sechelyoshor
    sechelyoshor
    11 years ago

    Maybe it’s wiser not to air the halachos of this topic in public. If it were not for darchei sholom on Shabbos…. (fill in the rest of the sentence yourself)

    Babishka
    Member
    Babishka
    11 years ago

    CPR if done correctly breaks the ribs. My grandmother at 99 years old went into failure and in spite of a DNR, hospital techs performed CPR and broke all her ribs and then she died in horrible pain 2 weeks later.

    AskNoah
    AskNoah
    11 years ago

    From the 7-Mitzvot halacha sefer “Sheva Mitzvot HaShem,” Vol.. 2, Prohibition of Murder and Injury, Ch. 7: “It is an obligation on every [Gentile] person to save another person from bodily or life-threatening damage … [a Gentile] is obligated to spend money to save another person with the assumption that it will be paid back.” (English translation: “The Divine Code”, 2nd Ed.). By Rav Moshe Weiner, Jerusalem.

    Norden
    Norden
    11 years ago

    It will doubtless come as a terrible shock to many Jewish geriatrics but “DNR” (do not resuscitate) policies are standard practice in hospices and optional in old people’s homes.

    Sorry, Babishka, but what (or where) is your authority for stating that “CPR if done correctly breaks the ribs”, please? You usually are the most sensible correspondent here on VIN.

    Shabat shalom (uberiah!) to everybody.

    Shlomo2
    Shlomo2
    11 years ago

    I believe that Rabbi Hoffman misunderstands the halachic obligations in this case, perhaps because, like many, he is not aware of the efficacy of CPR on the frail elderly.
    Chest compression is extremely violent; in the elderly and frail, it cracks ribs already with the first compression. By the end, perhaps all the ribs and likely the sternum will be cracked.
    SHould the patient survive (only a tiny percentage will, in the nursing home population), she will likely spend the rest of her life intubated and heavily sedated in the hospital, in agony with each breath.
    There is a difference between treatment that effects a cure and one which does not. In the case at hand, the woman was dying of organ failure and will soon afterwards die again
    One need not know the patient’s wishes, as the majority of normal people would not want this.
    That is why the dying are permitted to decline painful surgeries that will not cure them, but only add to their pain as it prolongs their dying process.
    I refer Rabbi Hoffman to “End of Life Issues in Halacha: DNR, Feeding Tubes, and Palliative Care
    Rabbi Y. Dovid Kaye”
    http://goo.gl/cdGdX

    11 years ago

    Correct me if I’m wrong but when CPR is necessary isn’t the patient already unconcious? The argument regarding consent would then be a moot point.

    11 years ago

    I would be careful with this issue. I can infer that it is and obligation to donate organs to save lives, perhaps?

    DavidCohen
    DavidCohen
    11 years ago

    The halachic discussion is an important one. But the outrage over this case is completely misplaced as the patient had signed a DNR as has now been confirmed by the family. Tying this conversation into mass hysteria does the subject a disservice.

    Rabbi Yair Hoffman
    Admin
    11 years ago

    Actually there was no DNR signed as the institution readily admitted.

    RobertS
    RobertS
    11 years ago

    We can argue mitzvot and Halacha all we want but it’s moot because the goyim and writers of civil law do not feel obligated to keep any aspect of Jewish law. This is not EY; the majority here are goyim. You think this is a bad situation? Just wait for worse treatment under ObamaCare.

    1ROYTOVOLAM
    1ROYTOVOLAM
    11 years ago

    who is roy tov

    Shlomo-1
    Shlomo-1
    11 years ago

    1) CPR may crack ribs even when practiced well
    2) Many nursing homes and assisted living centers have policies in place to not routinely perform CPR. The survival rate is very, very low in that population and many have DNR orders in place.
    3) The person involved was not a nurse.
    4) CPR does not “save lives.” It only buys time to get a defibrillator and then trained personnel to the scene.

    Buchwalter
    Buchwalter
    11 years ago

    I was starved and taken to the SS Wache in Pelzer Hasag in Czenstochau beaten and resulted in broken ribs. Better broken ribs than tachrichim and 6 ft under

    lazerx
    lazerx
    11 years ago

    shev v’al ta’aseh is different, states the gemora. Here the person did nothing. It is hard to believe that she would be chaiyev on this tragic death. However to claim she is a decent person, I would not claim this either.

    Rabbi Yair Hoffman
    Admin
    11 years ago

    The article said that she is not chayav – just that she was mechuyav to do it

    chavaz
    chavaz
    11 years ago

    Something that has been overlooked in all the prior posts-You don’t perform CPR on someone who is still breathing as it clearly said she was (on the 911 dispatcher’s recording). What should have been done, if it was available, was to put oxygen on her and to position her with her upper body elevated. If someone has died, i.e. stopped breathing and no heart rate, one is not under any obligation to try and bring them “back”. Also, isn’t there a halacha that says if a person is near death you are not supposed to touch them in fear that you might hasten their demise?