Parshas Chukas

Parshas Chukas:
 
In Case of Emergency: Who Pays the Bill?

 
By: Dayan Baruch Rubanowitz
 
 


 

IN CASE OF EMERGENCY:
 WHO PAYS THE BILL?
 

 
Abby Sunderland, the 16-year-old yachtswoman who has a passion to be the youngest person to circumnavigate the world, is sure glad that the International Convention for the Safety of Life at Sea was adopted back in 1914. In response to the Titanic disaster, the Convention mandated safety regulations and dictates that any ship in the area of a distress call will divert to assist that ship. Furthermore, rescues at sea are a no-cost agreement under conventions regarding maritime search and rescue operations.

 

Recently, Abby was stranded in the Southern Ocean. On the first day that Australia‘s rescue agency detected her emergency beacon they chartered a jet to fly over the area where her beacon was activated. The 11-hour flight cost an estimated $94,500 dollars. The second day, after locating her, the agency sent another plane to coordinate her pickup by ships racing toward her damaged and drifting yacht. The Australian military also deployed two Orion aircraft to wait on an Indian Ocean island in case an airdrop or further assistance was needed. An Orion costs about AU$30,000 an hour to operate.

 

In the meantime, the French territory of Reunion Island diverted three ships to Sunderland’s location. The fishing vessel that reached her first lost at least three days of work, and a commercial ship also sent to her rescue had to plan for an additional three or four days of travel time to its intended destination.



 
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Ethically, we as humans did the right thing to create these types of agreements. Much can be said about the wisdom (or lack thereof) in allowing people to embark on these kinds of record-breaking adventure trips. They often end up like Abby’s. Still, even those who might want to say “Who told her to do such a dumb thing like that in the first place!” would have a hard time to justify permitting her to drown.

 

But in the absence of the safety-at-sea regulations who would have been responsible to pay for these rescue costs? What is the halacha?

 

In this week’s Parshah, Hashem asks Moshe Rebbeinu to save the lives of his fellow Jews after venomous snakes bit them. Hashem instructs him to fashion a replica of a snake and place it high up so that all the dying people can gaze at it and thereby survive.[1] Surely there were costs involved. Moshe even considered using gold as the appropriate material but reconsidered and decided to use copper.[2] According to Jewish monetary law should the beneficiaries – the bitten people who were healed – have been obligated to cover the cost of their own care? In fact, the Talmud reads the text as saying that Moshe was to make the copper snake from his own assets and he was not to be reimbursed. If Hashem would have not made that stipulation, could Moshe have demanded payment from the people he saved for the expenses that he incurred in making the copper snake?

 

Let’s ask a more modern version of this same question. According to Halacha, when a person calls for an ambulance to the scene of an emergency, who is obligated to pay for the ambulance company’s fee; the person who made the call or the person who was saved? A proper halachic treatment of this question may not be as simple as you might think.

 

In Sanhedrin 73a, we learn that although one does not have to spend any money to return a lost item to its rightful owner, nevertheless when a person is in a position to save another Jew’s life he must lay out money to do so.[3] The Talmud seems to indicate that along with the mitzvah (Torah obligation) to save lives comes the financial responsibility to pay for the expenses that are incurred in fulfilling the mitzvah. In other words, just as one has to pay for his own esrog because it is his mitzvah, so must one pay for saving a life since it too is his mitzvah. This might explain why the people dying in the desert were not responsible for the cost of the copper snake. Moshe was responsible to cover the costs of the copper snake because it was his mitzvah to do.

 

However, the Rosh (ibid.) rules that in the cases mentioned in the Talmud (i.e., seeing someone in the process of drowning, being dragged by wild animals or about to be attacked by bandits), if the victim has the funds to pay for the costs of the rescuer’s expenses, he must reimburse the rescuer. If so, the people who had been healed with the help of Moshe’s copper snake should have been required to cover the expenses involved.

 

The Rosh does not offer an explanation as to the halachic rationale for his ruling. On what legal grounds can the rescuer demand compensation for his expenses if the person who was rescued had not requested any intervention? Of course, the person who was rescued will be grateful, but gratitude does not create an obligation to pay.

 

The Maharshdam[4] explains the Rosh based on the laws of yored (the word yored literally means a person who goes down, referring to a person who goes down to someone else’s field and invests his own money in improvements to the field). The law of yored (Choshen Mishpat 375) establishes the general rule that when a person provides an unsolicited and unanticipated service or physical improvement to someone else’s assets at a cost to himself, the person is entitled to some payment by the owner of the asset.[5] This is true except when the unsolicited and unanticipated action turns out to be ineffective or detrimental.

 

The Maharshdam reasons that expenses laid out to save a person’s life should be no different than any other case of yored. The fact that there is a Torah obligation on the part of the rescuer to make those expenses is immaterial to the monetary relationship between the rescuer and the person who was rescued. Since the rescue was successful, the person who was saved benefited and must pay the expenses that were incurred. Accordingly, should the rescue operation fail, the rescuer would not be entitled to any reimbursement for losses or money spent.

 

Were this analysis correct, it would have interesting ramifications. Take the following case. Yehudis sees that Esther is choking and tries to save her by calling an ambulance. However, Esther succeeds in coughing up whatever is blocking her airway before the medics arrive.[6] Naturally, the ambulance company wants to be paid for their services.

 

In this scenario in which the victim did not benefit from the medics, according to the concept of yored, the victim would not have to pay. The bill would then possibly become the responsibility of the person who made the call for help. Of course, that person would surely maintain that the call was made on the victim’s behalf. Nevertheless, since that person was the one who made the call, then effectively the person hired the ambulance and should have to pay.

 

This, however, would make many people think twice before calling for help. Attempting to perform the mitzvah of saving a life could come out costing a significant amount of money. The Talmud (Bava Kama 117b) states that the Sages understood this and made an enactment which provided an exemption for a person who damaged someone else’s property while attempting to save someone. For example, if a baby is locked in a car and a passerby needs to break the window to save the baby, although it is permissible to damage the property, were it not for this special exemption the person would have been required to compensate the owner of the car for the damage. Chazal made this dispensation so that people will not hesitate to act to save someone’s life.[7] It would seem that this exemption would be appropriate for the person who called the ambulance. If he knew that there was a chance that he might be held financially liable for the ambulance call, he might hesitate to respond to the medical emergency.

 

According to the discussion so far, in our scenario the patient is not responsible, nor is the caller. Then, it would seem that if a Jewish ambulance company would try to collect from either party by bringing the case to a Jewish court they would be unsuccessful. However, there is another point which must be made before our understanding of the Rosh mentioned earlier is complete – a point which will yield a different conclusion.

 

Within the laws of yored another distinction exists which is applicable to our case. Halacha sees a difference between cases in which the service or improvement that was provided without prior approval would most likely have been requested by the owner anyway and cases where one would not anticipate that the owner would have ordered those services or improvements. If the circumstances suggest that the yored’s work would very likely have been authorized by the owner had he been asked, then the yored is considered ex post facto to have been hired by the owner. He will then be entitled to a wage equivalent to the standard rate for such work in his industry regardless if a benefit actually accrued to the employer/owner. This is because anytime there is an employment contract (implied or explicit); the contract is specific to the action and not the result.

 

It is reasonable to assume that should any situation arise that looks to most people like an emergency the victim would count on others to act on his behalf to contact the emergency services as his agent.[8] Should someone call for help as an implied agent of the victim, the victim would be responsible for the costs regardless of whether he benefited from the call or not. If, however, the call was made by an overly sensitive person who misread the gravity of the situation, the caller would not have been within his mandate to act as an agent on behalf of the victim. The victim would then not have to pay the medics for the visit since they did not provide him with any benefit. The responsibility for the medic’s bill would then fall on the shoulders of the caller since he would not have a right to the exemption that Chazal gave to someone who incurs an expense in the process of saving someone’s life. That exemption only applies to someone who is proceeding with an appropriate response, not someone who is at fault for his misjudgment of the situation.[9]

 

If we consider the case of Abby the yachtswoman in light of the principles mentioned here we come to the conclusion that she would have been obligated to pay for all the reasonable expenses spent on her rescue. Simarly, according to our analysis, it would seem that under normal conditions anyone who did that which Moshe had done would be entitled to be reimbursed at least by all those saved and perhaps by all who were bitten and dying. Nevertheless, Hashem instructed Moshe to pay for it on his own. The question remains why then did Hashem require that Moshe not be reimbursed? The author will leave that to you, the reader, to contemplate.

 

Summary: When a bystander evaluates a situation that would seem to many people as an emergency requiring intervention, all reasonable expenses incurred to save a life or generated by enlisting emergency services should be borne by the patient, whether the patient benefited from them or not.

 

Note: A more detailed discussion of this topic with complete footnotes can be obtained by contacting Dayan Rubanowitz at mohel@ravbaruch.com


[1] Might this be the source of the Rod of Asclepius as a symbol of medicine and healing? Sources I have seen refer back to Greek mythology and its symbols but no further. This symbol may have nothing to do with Greek mythology, but even if it does, perhaps this aspect of Greek mythology had its root in this scene from the Torah. If the rod and snake together were originally the symbol of medicine and healing, it might refer to the elevated rod on which the image of the venomous snake was lifted. According to the Midrash, however, there was no rod as the copper snake suspended miraculously in the air. The Torah does refer to the image of the snake to be placed by or on a ness (Bimidbar 21:8), which can be translated as a miracle or rod.

[2] Seforno 

[3] Saving a life from danger (e.g., bandits or drowning; cases mentioned in the Gemara) is also included in the mitzvah of hashavas aveidah (returning lost objects) since preventing the body from separating from its soul is considered equivalent to returning the body to its owner. The halachic distinction between saving a life and returning lost items is due to an extra verse in the Torah that requires us to take action and not stand by when a life is at risk.

[4] The Maharshdam’s (Y.D. 204) response is regarding a case where a young man joined a cult. Some righteous people devised a plan to retrieve him from the cult he was in and spent money implementing their strategy. Although they captured the young man, ultimately, their plan proved fruitless and they were required to release the person who then returned to the cult. Still, they approached the young man’s father claiming reimbursement for their expenses. The Maharashdam ruled that since they were ineffective, the father is not obligated to reimburse them since he did not benefit from their efforts. The Maharashdam concludes by differentiating between his case and that of the Rosh who requires the victim to reimburse the rescuer by assuming that in the case of the Rosh the rescuer was successful in his mission.

[5] The amount he is paid depends on a number of factors. If the added value was not only unsolicited but the person was also unjustified in assuming that the owner of the asset would have made the same investment, then the person only deserves to receive either his expenses or the benefit to the recipient, whichever is less. If, however, the person could have justifiably assumed that the owner was interested in doing the type of service or added value that the person ended up doing, he is entitled to the going rate for the service he provided despite the fact that he was not asked to do what he did (See Ch.M. 375:1).

[6] Should medics arrive and perform an exam to ascertain that there is no cause for concern, it appears to this writer that such care should be considered medical care from which the patient benefited (provided that the patient is relieved to have had the confirmation of his good health). Even though no treatment was given, ruling out danger is part of medical care and would consequently obligate the victim to pay the relevant costs, even according to Maharashdam’s interpretation of the Rosh. Similarly, if Reuven harms Shimon and Shimon is taken to the hospital for tests and evaluations, it stands to reason that the attacker should cover such expenses despite the fact that no medication or treatment was administered at the hospital.

[7] The Bobover Rebbe, Harav Shlomo Halberstam, zt”l, used this argument to explain why he was not halachically responsible for repaying loans he took out during the war in order to save Jews in Europe. However, this exemption may not be applicable. Harav Moshe Feinstein, zt”l, told the Bobover Rebbe that he had erred in his interpretation of the Gemara. According to Rav Moshe in Iggros Moshe, Ch.M, chelek 2, siman 63, the only dispensation is for damage to property blocking the way to save a Jew. If one took out a loan or stole in order to save someone, he must pay it back. A person who calls an ambulance is deemed to be employing a service-provider and it would seem that according to Rav Moshe there is no dispensation in such circumstances.

Still, it seems to this writer that the Nesivos in siman 340,s.k. 6, supports the position of the Bobover Rebbe. The Nesivos applies the exemption to someone who borrows a sword without permission (which is akin to stealing) and in the course of battle to save others, the sword is ruined or lost. According to the Nesivos, he is not responsible for paying the owner due to the exemption mentioned above. It would seem to follow that if the Nesivos extends the dispensation to stealing, it may be extended in the case of the Bobover Rebbe and in our cases as well.

[8] Admittedly, The Marhashdam does not have this understanding; namely, that the person who attempts to save someone is seen as an ex post facto employee. However, the Maharshdam himself states that his understanding of the Rosh is problematic. Furthermore, the Rosh in responsa 85:2 seems to contradict the understanding of the Maharshdam and supports our thesis.

[9] This article is meant as a halachic discourse on the subject, not definitive halacha. Should any actual situation arise, the parties are recommended to seek counsel from recognized dayanim and not rely on this article.

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