Tuesday, April 14, 2020

Moral Dilemmas Then and Now

by Victor Rosenthal

Dario Gabbai died last month, aged 97. Gabbai was a Sonderkommando, a Greek-Jewish prisoner at Auschwitz-Birkenau who was forced to help herd new arrivals to the German death chambers and remove their bodies to the crematoria a few minutes later. Very few of them survived the war, and Gabbai may have been the last of them.

Gabbai, who was often interviewed and appeared in several documentaries about the Holocaust, described shutting down his brain in order to survive in that hellish place. There were things that he had seen, he said, that he could neither talk about nor get out of his mind.

His situation raised moral dilemmas in the purest possible way. He had a choice: he could help the Germans or they would kill him immediately. Should he sacrifice himself in order to avoid becoming an accessory to murder? It would be pointless: there was no shortage of prisoners who would take his job in order to stay alive a bit longer. The Germans killed all the Sonderkommandos every few months, anyway (Gabbai arrived near the end). Maybe they simply stopped being able to do the soul-destroying work, or maybe the Germans were afraid of a revolt; there were at least three bloody but unsuccessful revolts of Sonderkommandos in Treblinka, Sobibor, and Birkenau. These were men – boys, actually – who had nothing to lose, and who knew in the most graphic and painful way they had nothing to lose.

One day, the transport included two of Gabbai’s friends from Salonika. “I told them they were going to die,” he recalls. “My cousins and I gave them whatever food we had, and we told them where to stand so the gas would kill them in two minutes instead of five.”

The cousins scooped the men’s ashes from the oven and buried them outside the crematoria. “We said ‘Kaddish’ for them,” Gabbai says. “But we were already so ice-cold [emotionally]. Nothing was penetrating. That is the only way we could survive.” – Naomi Pfefferman, “Job of Infinite Horror”

Gabbai was apparently not religious, but he indicated that it gave him some comfort to be told that his actions were permitted as pikuach nefesh, a doctrine that permits violating almost any of the commandments when it is necessary to save a human life.

I rarely write about the Holocaust; I’m not happy with the uses to which it is sometimes put. But I’m thinking about it today because the worldwide coronavirus pandemic has again posed hard, though different, moral questions. There are simple (but not easy) ones, such as that faced by the doctor with an inadequate number of ventilators at his disposal. And there are the more complicated ones, like finding a balance between shutting off economic activity in order to reduce the rate of transmission of the virus, and preventing an ensuing economic catastrophe.

This is a very difficult question from a scientific standpoint, since getting a good answer depends on predicting the effects of social distancing, quarantines, and lockdowns on the spread of the virus, something which as yet is only partially understood. We are better able to predict the economic consequences of these measures, although even then there is uncertainty about possible feedback effects that could make a downturn more severe.

There are moral questions too. As an extreme example, suppose it were decided to impose no restrictions at all on workplaces and schools, and let the virus run its course. Because of the nature of the illness, the greatest number of those seriously affected would be the elderly. It might be possible to mitigate the imbalance by isolating only older people – many of them are retired, after all – but there would still be a much greater opportunity for them to be exposed if movement and commerce weren’t restricted. And if the healthcare system became overloaded, as happened in northern Italy, then they would be much more likely to die, even if care were not apportioned according to age.

If, on the other hand, a society succeeded in “flattening the curve” by reducing normal activity, then everyone who was sick would be more likely to receive the best possible care, which would disproportionately reduce the death toll among the older patients.

A straightforward utilitarian argument can be made for letting the virus run its course. Older people are on balance consumers and not producers. They have a negative effect on the economic life of a society. Economically speaking, they wouldn’t be missed. The virus would just be a small blip, with a small number of productive individuals becoming seriously ill and very few dying.

Sweden seems to be doing something like this. They are taking some social distancing measures and trying to isolate older citizens, but they have not shut down workplaces and schools. At some point there will be herd immunity, and at some point a vaccine.

This strategy could not possibly be adopted in Israel, where even secular people are imbued with Jewish ethical principles, according to which every human life is equally valuable. The tradeoff that is being made in Israel between economic activity and suppressing viral transmission leans in the direction of protecting people from the virus, a policy of pikuach nefesh. And I think this is a humane policy, a morally better one, even if it is less rational by some standard than strictly minimizing economic damage.

Somewhat less admirably, people in assisted living facilities here have been more or less abandoned. Staff have passed the disease to residents, and then essentially fled. No one has picked up the ball.

There are other factors in dealing with the epidemic. I haven’t mentioned the attempt to track and isolate carriers of the disease before they can transmit it. In this respect, Israel could do much better if she would (could?) increase the number of tests done daily. This is a win-win activity, because it only isolates those who need to be. In addition, research is proceeding on various treatments that may be efficacious. The slower the virus spreads, the more patients will be able to receive these treatments in time.

There are (naturally) political problems. There is a struggle between the Health Ministry and the Defense Ministry over who should be in charge of coordinating the overall response to the epidemic, although we do not see the kind of political controversies about the efficacy of this treatment or another which seem to exist in the US. On the other hand, the lack of a permanent government and the specter of a possible fourth election may have serious effects on the ability of Israel to deal with the economic fallout from the epidemic.

The corona pandemic is not like the Holocaust in many ways. There is no Auschwitz-Birkenau and there are no Sonderkommandos. But the campaign against it is much like a military campaign, involving logistics, foot-soldiers, and orders that must be followed. And I suspect that some medical personnel, like Dario Gabbai, will be left with memories that will be very hard to erase, much as they would wish to.

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