Rabbi Dr. Shalom Carmy’s response to Noah Feldman has been widely praised (and widely anticiapted) perhaps because Carmy is today what Noah Feldman might have become had he stayed frum. Personally, I was a little disappointed by it, because of the straw-man syndrome that it too falls prey to, like many other responses from the Orthodox movement:

In settling his scores with his alma mater, Feldman ascribes to his high school rebbi the claim that a doctor who treats a Gentile on Shabbat violates the day unless his explicit intention is to do so only in order to avoid animus. Though this sounds like nonsense, I am informed that a high school teacher actually said it.

The insinuation that religious Jewish doctors cannot be entrusted with the care of non-Jewish patients was, as we all know, part of the arsenal of 19th century European anti-Semitism. It was not meant in earnest: as an Orthodox deputy once remarked, during a debate on the licensing of physicians in the Austrian Parliament, several of the most outspoken leaders of the anti-Semitic party used Jewish doctors.

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In any event Feldman presumably knows very well that his high school teacher’s remark is not representative of grown-up halakhic thought, and he knows even better that it is not a guide to the practice of Orthodox Jewish doctors. Nonetheless, in his desire to satisfy himself against those who failed to properly esteem his choices and flatter his vanity, he has resorted to one of the most potent weapons of 19th-20th century anti-Semitism. He has made it easier for individuals or groups in medical schools to sideline or bar Orthodox Jews, in the name of high-sounding universalistic moral ideals, from positions in the medical profession. Whether he intends these consequences or not, and whether or not he envisions, in his wise shrewdness and genteel outrage, further punitive consequences to his classmates and their children, he has employed his power and prestige to those ends. He, and we, must live with the consequences of his decision.

Was Noah Feldman really suggesting that Jewish doctors can’t be trusted on Saturdays? I think that the common denominator to far too many of the Feldman responses is that they all seek to rebut arguments and contentions that are far simpler than those Feldman actually brought up. And to me, Carmy’s attempt to elide the point by saying that we must deal even with Feldman’s unintended consequences is not convincing.

We all agree that saving the life of a non-Jew on Shabbat is ok. Does it matter what your mindset is? According to Rabbi Carmy, it does not, but I am not convinced that his view is the only or final view on the matter. Still, I couldn’t find a single Orthodox doctor who embraced the mindset that he was working to prevent Antisemitism when treating non-Jews on Shabbat. In fact, many of the doctors I spoke to said that they keep their minds on their work, and to do otherwise would diminish their effectiveness. Perhaps this gap between theoretical and practical halacha could be addressed.

Over the last twenty or so years, we’ve seen a rise in shomer-shabbas residencies. Most Orthodox Jews consider these residencies a boon whose primary virtue is freeing observant doctors from grappling with the difficulties of working in a hospital on Shabbat. But it feels to me like there is a disconnect between this idea and the notion that l’maaseh, there is no difference between saving the life of a Jew and a non-Jew on Shabbat.

Moreover, non-Jewish doctors are often quite resentful of the Shomer Shabbas residency programs because they are forced to cover the Shabbat shifts. No doubt, the Jewish residents cover the Sunday shifts, but for doctors who live in a world where Friday night is the primary night for social engagements, having to work many more Friday night and Saturday shifts is a real burden. I’ve been told by some residents that these Shomer Shabbas residencies are often only available at lower-ranked programs, where foreign medical students (who cannot afford to be so demanding) make up the bulk of the non-Jewish staff. Here then is a living, breathing example of animosity directed at Jews for their unwillingness to practice medicine on Shabbat, not just some theoretical meanderings. Yet never have I heard that Jewish residents should avoid Shomer Shabbas residencies ‘mishum evah‘ (i.e. to prevent Antisemitism). That too is a disconnect.

On a personal note, a very close friend of mine declined a prestigious anesthesia residency at Mass General in favor of a ho-hum program that was willing to offer him a Shomer Shabbas residency. This gifted medical student turned down the opportunity to study anesthesia at the very institution where the discipline was founded some 160 years ago, and which remains among the finest places for a young clinician to learn his trade. Did this Jew correctly prioritize Shabbat over saving lives?

These are the types of issues that Feldman raises in my mind, and I would rather discuss them than waste time debating Feldman’s character, intentions or integrity, or those of his respondents.

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