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Jewish Perspectives on HIV/AIDS
From AJWS Education Module on The Global HIV/AIDS Pandemic (November, 2005)
Pikuach Nefesh- The Value of Human Life
Mishna, Sanhedrin 4:5
Jewish tradition is unequivocal on the value of human life, to the extent that each human being is equated with an entire verse, as it says:
Because each person is the potential progenitor of all his or her descendants, the loss of any one person deprives the world not only of that person, but of all his or her potential descendents. For Jews, there is no greater tragedy than the loss of a human being and the generations that he or she would have brought into the world.
Integrally linked to this infinite valuation of human life is a corresponding intense obligation to protect life. We find:
This Divine charge forbids us to be passive if our fellow human beings are in mortal danger.
Babylonian Talmud, Yoma 82a
And what is phrased in the Torah as a negative prohibition becomes a positive obligation, where is says:
These few exceptions, in a legal system filled with seemingly infinite obligations and prohibitions, simply underscore the absolute priority accorded to saving lives.
The implications of pikuach nefesh in the context of the HIV/AIDS Pandemic are obvious and straightforward. We cannot remain passive or disinterested while millions of people are at immediate risk of death. And while there may have been some ambiguity about this question in the early days of the pandemic when treatment options were unclear, the existence now of effective treatments to prolong the lives of people living with AIDS makes our obligations clear. We must do all that is in our power to insure that HIV positive people receive adequate medical care and treatment and that effective prevention programs are employed to reduce as much as possible the rate of new infections. Each person killed by HIV/AIDS is an entire universe and we cannot stand idly by and accept that loss with indifference.
Shmirat Ha-Guf- Protecting the Body
Shulchan Aruch, Choshen Mishpat 427:8
Beyond saving lives, there is an additional Jewish obligation to anticipate potential dangers and protect against them. This principle is derived from two separate verses in Deuteronomy. In the first, Deuteronomy 4:9, we find a requirement that people take care to protect themselves from danger: "Protect yourself and guard yourself."
The Shulkhan Arukh extrapolates from this verse an obligation to protect others:
The second verse from the Torah, Deuteronomy 22:8, expands this obligation to protect so that it encompasses other people:
Rambam, Laws of the Murderer and Protecting Life 11:4
Rambam builds on this narrow case to create a more universal and wide-ranging obligation:
Now the charge is that every person has an obligation to anticipate and remove "any obstacle which could cause mortal danger." Again, the implications in the context of HIV/AIDS are clear. To the extent that lack of access to resources- education, condoms, clean needles, money, refrigeration for AIDS drugs, food, clean water, etc.- is a life-threatening challenge for people living with AIDS, or for people at risk for AIDS, we are bound to work to rectify the situation and make those resources available.
Bikkur Cholim- Visiting the Sick
Babylonian Talmud, Sotah 14a
Finally, Jewish tradition articulates an obligation to maintain social relationships with people suffering from illness. This reflects a deep understanding of the kind of social isolation that the ill can experience- not only are they often limited from social activity and restricted to home by their illness, but the stigma and fear of contamination that accompany illness may keep the community from maintaining connections and providing critically important emotional, physical, and psychological support.
This value is enshrined in the Babylonian Talmud where visiting the sick is included among a short list of ethical actions.
Babylonian Talmud, Nedarim 39b-40a
The text puzzles at R. Dimi's claim that one who does not visit the sick person cause him/her to die, but then arrives at a remarkable conclusion. The crime in failing to visit and care for the sick person is not an act of killing. It is an act of profound indifference to human life. "He who does not visit the sick prays neither that he may live nor die."- he is indifferent and to the rabbis, indifference to human suffering is perhaps even worse than active malevolence.
Among these three values discussion here, bikur cholim is perhaps the one most directly linked to HIV/AIDS. Because it is an infectious and (thus far) chronic illness, and because it remains ruthlessly lethal, and because it has historically struck already vulnerable populations, AIDS carries a history of stigma and social discrimination that we must transcend if we are to respond to the pandemic and its victims with compassion and solidarity.
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