Physicians

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Permission to Heal

TALMUD

The rabbis assert that a physician’s healing is not an intervention against the will of God. The Gemara in Bava Kamma discusses the obligation to pay medical costs and interprets Exodus 21:19 to grant permission for a doctor to heal.

The Gemara asks: And according to the opinion of the latter Rabbis in the baraita, who say: Anyone who is liable to pay compensation for loss of livelihood is liable to pay compensation for medical costs, and anyone who is not liable to pay compensation for loss of livelihood is not liable to pay compensation for medical costs, why do I need, i.e., how do I account for, the fact that the verse repeated the obligation to pay medical costs? The Gemara answers: It is necessary for that which the school of Rabbi…

Bava Kamma 85a:15

Moral Guidance in Medical Ethics

HALAKHAH

Rav Moshe Feinstein's guidance was crucial in making a life-and-death medical decision, showcasing the intersection of religious authority and medical ethics. Rabbi Chaim Jachter's work, Gray Matter, delves into contemporary halakhic questions, including the ethical complexities of separating conjoined twins.

This situation posed a moral and legal dilemma that needed to be resolved in many venues. Dr. Koop sought and received legal immunity from being prosecuted for the murder of a twin. Catholic doctors and nurses sought the guidance of their theologians to permit their participation in the surgery. The parents of the twins would give their consent to the surgery only if Rav Moshe Feinstein permitted sacrificing one twin to save the other. When Dr. Koop, a deeply religious man who studied Bible every day, was challenged by his staff as to the morality of killing one baby in order to save another…

Gray Matter IV, Medical Issues, Separating Conjoined Twins 3

Skepticism Towards Medicine

CHASIDUT

Rebbe Nachman of Breslov expressed skepticism about the medical profession, emphasizing the limitations and complexities of medicine. In his collection of teachings, Sichot HaRan, Rebbe Nachman advises caution towards medical treatments and reliance on divine providence.

He told us that while he was in Lemberg, home to many great physicians, one of the physicians there told him to keep as far as possible from medicines and people in his profession. This physician said that research into medicine had shown that it is impossible fully undersatand its subject matter.

Sichot HaRan 50:5

The Ethics of Truth in Medicine

SECOND TEMPLE

Philo of Alexandria explores the ethical dilemma of whether physicians should always tell their patients the truth, especially if withholding it might aid in their recovery. Philo, a Hellenistic Jewish philosopher, blends Jewish theology with Greek philosophy to address complex ethical issues.

[65] Thus too in dealing with dangerous sicknesses of the body, the most approved physicians do not allow themselves to tell the truth to their patients, since they know that this will but increase their disheartenment, and bring no recovery from the malady, whereas under the encouragement, which the opposite course of treatment gives, they will bear more contentedly their present trouble, and at the same time the disease will be relieved.

On the Unchangeableness of God 14:3

The Physician and the Rabbi

MIDRASH

The personal and mystical connection between the physician Samuel of Yarchina and Rabbi offers a unique perspective on the roles of medicine and prophecy in Jewish tradition. The early 20th-century compilation, Ein Yaakov, presents a blend of stories, parables, and biblical interpretations from the Talmud, highlighting key figures and their contributions to Jewish law and tradition.

Samuel of Yarchina was the physician of Rabbi. When Rabbi had sore eyes, he said to him: "I shall inject some medicine into them." Rabbi said: "I cannot endure it." "I will smear some salve over it." But Rabbi answered him: "I cannot endure it." He then poured some medicine into a tube, placed it under his head while he was in bed, and he was cured. Rabbi essayed to invest Samuel with the title of Rabbi, but never had the opportunity, and Samuel said to him: "Let the master not be so sorry, for I have seen the book which was submitted to Adam the first…

Ein Yaakov (Glick Edition), Bava Metzia 7:18

Ensuring Professional Medical Care

HALAKHAH

The person who caused the injury must ensure professional medical care for the injured, rather than attempting to heal them personally or providing free treatment. In his monumental 12th-century legal code, the Mishneh Torah, Rambam emphasizes the importance of professional medical care and the responsibility of the injurer to ensure proper treatment.

If the person who caused the injury says: "I will heal you," or he says: "I have a physician who will heal you without charge," his words are not heeded. Instead, he is required to bring a professional physician who charges for healing him.

Mishneh Torah, One Who Injures a Person or Property 2:18

Ethics of Medical Practice

HALAKHAH

The ethical obligation of physicians to prioritize care over profit is a timeless principle. In the 16th-century Shulchan Arukh, Rabbi Joseph Karo explains that while physicians may not charge for their wisdom, they can be compensated for their time and effort.

The physician is forbidden to take payment for his wisdom and learning but he may receive payment for his trouble and lost time.

Shulchan Arukh, Yoreh De'ah 336:2

The Multifaceted Genius of Maimonides

COMMENTARY

Maimonides was not only a physician but also a philosopher and a supreme authority on Jewish law, integrating these fields in a unique and profound way. Rabbi Jonathan Sacks, in his essays, explores the multifaceted expertise of Maimonides, highlighting his contributions to philosophy, natural science, and Jewish law.

Maimonides, the greatest rabbi of the Middle Ages, had already written a systematic commentary to the Mishna as well as the Mishneh Torah, the greatest of all codes of Jewish law, before writing The Guide for the Perplexed. He was internationally recognised as a supreme authority on Jewish law, and was turned to for guidance by Jews from as far afield as Provence, Marseilles, and Lunel in France, to Yemen and Baghdad. He had become a physician in service to the Sultan Saladin in Cairo and was the author of many medical texts…

Covenant and Conversation; Leviticus; The Book of Holiness, Vayikra, Maimonides on Sacrifices 3

The Divine Accountability of Physicians

HALAKHAH

Even if a physician is not liable for payment according to human laws, he is still accountable according to divine laws if he causes harm or death through error. Rabbi J. David Bleich explores Ramban's analogy between physicians and judges, highlighting the ethical and legal responsibilities of professionals in Jewish law.

Ramban's resolution of the problem is startling, to say the least. His solution is novel but seemingly paradoxical. Ramban responds by stating that the situation of the physician is analogous to that of a judge. The dayyan is commanded to sit in judgment and, declares the Gemara, Sanhedrin 6b, "Lest the judge say, 'Why should I seek this vexation?' the verse states '[God is] with you in the matter of judgment' (II Chronicles 19:6)—the dayyan has only what his eyes see." Nevertheless, in some circumstances, the dayyan will be held liable for judicial malpractice…

Contemporary Halakhic Problems, Vol VI, Chapter 5 Medical Malpractice and Jewish Law 31

Balancing Shabbat and Saving Lives

HALAKHAH

Jewish law generally prohibits benefiting from work done by a non-Jew on Shabbat, but saving a life takes precedence. Rabbi Eliezer Melamed’s contemporary halakhic work, Peninei Halakhah, addresses the permissibility of using a non-Jewish driver to transport Jewish medical professionals to the hospital on Shabbat.

The best solution for doctors and nurses in such a situation is to hire a non-Jewish driver to drive them from their homes to the hospital. This way, these doctors and nurses can enjoy Shabbat in their homes, and then when they need to go to the hospital, they can get there with the help of a non-Jew. Even though the Sages prohibited benefiting from melakha performed by a non-Jew on Shabbat (above, 25:1), they permitted this for the sake of a sick person.

Peninei Halakhah, Shabbat 27:10:3

Ethical Fees in Jewish Law

HALAKHAH

The legitimacy of a physician charging fees for both therapeutic and non-therapeutic services, including those necessary for fulfilling mitzvot, is a nuanced and ethically significant issue in Jewish law. Rabbi J. David Bleich, a contemporary halakhic authority, explores the rulings of Maharam Schick and other rabbinic sources to address these ethical considerations.

The physician is obviously entitled to recover the expenses he incurs in conjunction with his practice by apportioning those costs among the patients whom he treats. Teshuvot Maharam Schick, Yoreh De'ah, no. 343, rules that the physician may also legitimately charge a fee for services which are non-therapeutic in nature such as pronouncing death and signing a death certificate. Maharam Schick does, however, raise a problem with regard to accepting compensation for pronouncing death and signing a death certificate on other, although similar, grounds…

Contemporary Halakhic Problems, Vol II, Part I, Chapter III Medical Questions 55

Where is the Balm in Gilead?

TANAKH

The emotional and communal anguish over the lack of healing and the absence of a physician to provide relief is a poignant reflection of societal despair. The prophet Jeremiah laments the absence of a remedy or healer for the suffering of the people, symbolized by the lack of balm in Gilead.

Is there no balm in Gilead?
Can no physician be found?
Why has healing not yet
Come to my poor people?

Jeremiah 8:22

Moral Physicians

JEWISH THOUGHT

Just as a physician heals the body, sages are seen as moral physicians who guide individuals in healing their souls. In his philosophical and ethical treatise, the Eight Chapters, Rambam explores the nature of the soul and the importance of moral and spiritual health.

Likewise, just as when people, unacquainted with the science of medicine, realize that they are sick, and consult a physician, who tells them what they must do, forbidding them to partake of that which they imagine beneficial, and prescribing for them things which are unpleasant and bitter, in order that their bodies may become healthy, and that they may again choose the good and spurn the bad, so those whose souls become ill should consult the sages, the moral physicians, who will advise them against indulging in those evils which they (the morally ill) think are good…

Eight Chapters 3:2

The Divine Role in Healing

COMMENTARY

The ability of a physician to heal is not merely a professional skill but is fundamentally rooted in the permission and decree of the Creator. In the Fourth Treatise on Trust from Pat Lechem, Chaim Avraham Katz explores the theological perspective that both healing and harm are ultimately determined by divine judgment.

(on the 3 terms: permission, decree, judgment) -- To not think that some human being's advice can possibly be beneficial unless it is through the permission and decree of the Creator. For example, regarding the healing of a sick person, the talmud expounds [on the verse shmos 21:19]: "from this we learn that permission has been given to the physician to heal". The power in nature to heal through medicinal means is a permission of the Creator. This is a universal matter. And this is combined with the decree of G-d who decreed that this illness be healed through this specific doctor…

Pat Lechem, Fourth Treatise on Trust 4:8

Healing with Human Tissues

RESPONSA

Jewish law permits the use of human tissues for medical purposes, reflecting the principle of pikuach nefesh, which prioritizes saving a life. This mid-20th-century responsa addresses the permissibility of using bone, skin, and cornea for healing under modern medical conditions.

Thus it is clear that, according to Jewish law, under modern scientific medical conditions (rofey mumcheh and refuah yeduah) it is permitted to use bone, skin, and cornea for all purposes of healing.

Collected Responsa to Chaplains, Use of Bone Fragments in Bone Surgery 17

The Sanctity of Life in Jewish Medical Ethics

HALAKHAH

Jewish medical ethics uphold the absolute sanctity and infinite value of human life, mandating physicians to heal and prohibiting euthanasia. Rabbi Moshe Tendler, in his work on Jewish medical ethics, discusses the obligation to preserve life and the prohibition of euthanasia, referencing the Talmud, Midrash, and rulings by Rav Moses Isserles (Rema).

Judaism never condones the deliberate destruction of human life except in judicial execution for certain criminal acts, in self defense, or in time of war. One may not even sacrifice one life to save another life. The principles of Jewish medical ethics are based on this concept of the sanctity and infinite value of human life. Judaism is a "right to life" religion. The obligation to save lives is both an individual and a communal obligation. A physician is Biblically mandated to use his medical skills to heal the sick and thereby prolong and preserve life…

Care of the Critically Ill, Quality and Sanctity of Life in the Talmud and Midrash Coauthored by Dr Fred Rosner, Treatment of the Dying in Judaism 1

The Ethical Physician

MUSAR

Physicians hold a unique position of power and influence, and their ethical and moral responsibilities are paramount. The medieval ethical treatise Sefer HaYashar emphasizes the importance of altruism, particularly for physicians, who are urged to provide care without accepting payment from the poor and to offer hope and encouragement to their patients.

If he should occupy himself with the healing of the sick and it is in the power of his hand to help, let him not accept a reward from a sick person. Let him keep the high road and not destroy it for the sake of the easy path, for with this he will acquire eternal life. For he is like one who saves those who are doomed to death. Even though everything is in the hand of the Creator, blessed be He, since his intention was for good and to help the sick person and to save him from his misfortune, it is accounted to him as though he saved him from death…

Sefer HaYashar 13:13

The Role of Expert Physicians

COMMENTARY

The expertise of physicians is crucial, especially when making health decisions on Yom Kippur. Ovadiah Bartenura, in his 15th-century commentary on the Mishnah, emphasizes the need for specialized physicians to make informed decisions regarding health on Yom Kippur.

על פי בקיאים – physicians who are specialists in their craft.

Bartenura on Mishnah Yoma 8:5:2

Portrait of Ephraim Bueno, Physician, Rembrandt van Rijn 1647. Etching and drypoint on paper, Gift of Leo Wallerstein, The Jewish Museum, New York.

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