In the previous lesson, we covered several applications of the melacha of Tochen. One more significant application remains for us to examine – the issue of taking medications or doing any other form of healing on Shabbat.
What's the Issue?
In earlier times, medications were made by grinding herbs, spices and other natural substances into usable forms. As a result, the Sages decided to forbid any act of healing on Shabbat, out of concern that a person might need to prepare a medication from scratch, which would involve grinding (i.e., the melacha of Tochen).1
'Healing' in this context is broader than just the act of taking medicine – it also includes applying ointments or other topical agents; physical therapy and exercise; and any other action which has a "curative effect."2
Today, most medications are already prepared by the time they get to us. So there's little chance of us needing to grind them up. However, the rabbinic prohibition on healing still stands.3 Why? There is a principle in halacha that a rabbinic decree remains in force even when the original reason for the decree is no longer relevant. Understanding this principle is a topic in its own right; the basic idea is that the authority of earlier rabbinic courts continues to bind us today.4
In this lesson, we will set out basic parameters for healing on Shabbat. Of course, every situation is different, and needs to be judged on its own facts. A person should always ask a qualified rabbi before deciding any issue regarding someone's health. The halacha is just as concerned about preserving our health as it is about our keeping Shabbat. As the Talmud explains: It is better to break one Shabbat so that the person will live and be able to observe many future Shabbatot.5
First of All: Saving a Life
A bedrock principle in all of Jewish law is that protecting a person's life (in Hebrew, pikuach nefesh) is of paramount importance. If someone is ill, and there is any question about his life being in danger, then not only are we allowed to violate Shabbat, but we are required to do so.6 All aspects of Shabbat observance may be disregarded so that the patient can get immediate and proper care. (Of course, only what is actually necessary should be done, and if possible, a shinui should be used – but not at the expense of precious minutes or quality of care.)
Sometimes, it is obvious when a person is facing a possibly life-threatening condition – for example, a heart attack. Often, it is unclear. The halacha tells us that we should err on the side of caution if there is any reason to think that someone is in danger.
There are some situations which are assumed, by definition, to be possibly life-threatening, e.g. a diabetic who needs insulin. One which is (fortunately) common is a woman in labor. When in labor, a woman is given several leniencies on Shabbat regarding calling her doctor and traveling to the hospital.7
Within this category, there is a slight distinction:
- If the medical condition might be fatal if not treated, then one could do melacha only to treat the specific condition. A woman in labor is in this category.
- If a person is in a dangerous fatal condition, then anything may be done to improve his overall state of health during Shabbat. For example, one may turn on the radio to calm him, if the nervousness is liable to cause a deterioration in his condition.8
An important point: In life-threatening situations, the breaking of melacha should preferably be done by a prominent, observant Jew – in order to impress upon onlookers the proper guidelines for saving a life.9
Note also that one is required to break Shabbat even when there is only a chance that a life can be saved or lengthened.10
Other Levels of Illness
What if a person is clearly not in danger? The types of actions that may be performed depend on the severity of his medical problem.
Danger to Limb (Sakanat Aver)
What if a person is in danger of losing a limb or the function of a limb – e.g. broken bones, fractures, nerve damage, and the like – yet there is definitely no possibility of danger to life? In such a case, one may break any Rabbinic prohibition (wiithout a shinui). This means that any melacha can be done with a shinui, which lowers the action to a rabbinic-level prohibition. For example, one may spread ointment on a severe burn, using the back of one's hand.11
Fully Sick (Choleh Kol Gufo)
If a person is generally "sick" in the conventional sense – that is, he feels ill all over his body – then he may also take medications. The halachic term for this patient is choleh kol gufo (literally, "his whole body is ill").12 Also, a non-Jew can be asked to do things on the patient's behalf.13
Great Pain / Bed-Ridden (Tzar Gadol)
If a person is ill enough to be bedridden, feels extremely weak, or is in great pain – such as from a severe headache, a severe toothache, or a burn – then one may take medicine to treat the condition.14 For example, one could take aspirin for a severe headache.
It is also permitted in order to prevent the ailment from arising in the first place. For example, one may take an aspirin as soon as one feels a severe migraine is coming up, even though presently one is still feeling fine.15
At this level, a non-Jew can be asked to do only rabbinically-prohibited actions, but not Torah laws. So, for example, the non-Jew can apply ointment, or give an injection to help relieve pain. If no non-Jew is around, a Jew may do the action with a shinui. For example – using your mouth to remove a pill from its protective strip when doing so will tear through letters.16
The litmus test for this category is: Would the person wish to lie in bed as a result of the discomfort?17
Slightly Sick (Michtzat Choli)
What about being 'a little sick' (as our grandmothers might have said)? Say you have a headache, sunburn, mild toothache, or heartburn.18 Here also you may ask a non-Jewish person to do some external act of healing, but taking medication (even aspirin) would not be allowed.19
Acts that are Not Considered 'Healing'
So far, we've been speaking about actions that are considered 'healing' by the halacha. Other actions which have the effect of helping a person who is physically uncomfortable, but are not considered actual healing. These actions are permitted on Shabbat.
Let's look at two categories.
(1) Preventative measures – you are allowed to prevent the onset of physical pain or discomfort. This would include, for example, taking medications that you need regularly because of a chronic health condition, such as high blood pressure.20 By taking the medicine you are preventing the problem from affecting you. A person may also
- remove a splinter21
- remove an insect sting22
- apply [an unmedicated] bandage to a wound or irritation23
These activities do not 'cure' the problem. Instead, by doing these things, you are just preventing a minor condition from getting worse.
(2) Normal behaviors which also have health benefits – It is permitted to do something that healthy people do as well; you just happen to be doing it because it may help whatever your problem is.24 For example:
- eating chicken soup if you're not feeling well
- drinking hot tea for a sore throat
- eating oranges to fight a cold25
- drinking prune juice for constipation
- taking vitamins as a food substitute
With this overview, we've introduced the key points in evaluating healing activities on Shabbat. As we've emphasized, this is a complex area of halacha. The key is that if you know the basics, you'll at least know when and how to ask the right questions.
- Talmud – Shabbat 53b; Orach Chaim 327:1 with Mishnah Berurah 1; 39 Melochos, p. 475; Halachos of Shabbos, XII:D.3 (p. 218).
- Mishnah Berurah 328:120; 39 Melochos, p. 476-77.
- There are various opinions as to the scope of this prohibition today. See the Hebrew footnotes in 39 Melochos, p. 357 of the Hebrew section, note 70.
- This is similar, to some extent, to the concept of precedent in Anglo-American law.
- Talmud – Yoma 85b.
- Orach Chaim 328:2; 39 Melochos, p. 500.
- Mishnah – Shabbat 18:3. See, in brief, 39 Melochos, p. 499-500. Prior to the ninth month, it is a very good idea for the expectant couple to speak with their rabbi to review all of the issues brought up by a Shabbat birth.
- Biur Halacha 278, s.v. "L'Chabot"
- Rambam’s Commentary on Mishnah Shabbat 18:3. Of course, if someone else can do the job better and faster, that takes precedence (Orach Chaim 328:12 with Mishnah Berurah 37).
- Orach Chaim 328:5 with Mishnah Berurah 17.
- Orach Chaim 328:17 with Mishnah Berurah 57.
- Orach Chaim 328:37 with Mishnah Berurah 123.
- Using a non-Jew is less of a transgression of Shabbat than having a Jew do the same action. Non-Jews are not commanded to observe Shabbat, and therefore they can help. As we will learn in future lessons, this is not a blanket solution for all situations (Orach Chaim 307:5).
- Though there are differing opinions as to whether taking medicines is allowed (Shemirat Shabbat K’Hilchato 34:4).
- Rambam (Shabbat 22:7); Shemirat Shabbat K’Hilchato 16:34.
- As we will learn, G-d willing, in the lesson on Mochaik (erasing), tearing through letters is not allowed.
- Orach Chaim 328:17; Shemirat Shabbat K’Hilchato 33:1:2, 3. Again, we must emphasize that determining which halachic category applies is an inexact science. You need to use your best judgment, and should consult with a proper halachic authority when one is available.
- These examples are given in Shemirat Shabbat K’Hilchato 34:1 and 39 Melochos, p. 490.
- Orach Chaim 307:5.
- Mishnah Berurah 328:86; 39 Melochos, p. 483.
- Talmud – Shabbat 122b; Mishnah Berurah 328:88
- Shemirat Shabbat K’Hilchato 35:38.
- Orach Chaim 328:23; Shemirat Shabbat K’Hilchato 35:20; 39 Melochos, p. 478-80. See Lesson #30 regarding the issue of glue on the band-aid.
- Mishnah – Shabbat 14:3
- Whereas taking a throat lozenge would be prohibited, since this is not something that healthy people normally do.