Thursday, November 25, 2010

Treating a Gentile on Shabbos

I am really sorry that I have not posted in the last few weeks, but I want the readers of the blog to know that I have been working hard on this next topic.  This is a subject that has been bothering me for quite some time.  Let me share with you my personal history of my quest for an understanding of the halachos of treating non-Jews on shabbos.  I am sharing this with you only because I believe that it will help you appreciate the full force of my arguments that I intend to put forth.

As a yeshiva graduate, newly armed with semicha and a few years of kollel behind me, I decided to go to medical school.  I knew that treating patients on shabbos was going to be an important halachic issue so I made it my business to study the topic thoroughly so I would be ready to handle whatever situations I would encounter.

So I started by reading some articles and teshuvos, mostly in the Tzitz Eliezer and Igros Moshe to familiarize myself with some of the basics.  I threw in a little bit of Nishmas Avrohom, Shemiras Shabbos Kehilchasah, and other seforim, and reviewed a few contemporary halacha books that were available then.  This was the beginning.  I also had some long conversations with some contemporary poskim, who shall remain nameless only because I don't want it to sound like I am claiming that any of them would endorse my ideas that I will be expressing in this blog.

In my final year of medical school I had the opportunity to take off a few months to do some "electives", so i chose to learn in kollel (under the guise of studying "Jewish medical ethics") for a few months to study the relevant sugyos in shas, the rishonim, acharonim, and ultimately the shulchan aruch and acharonei haposkim on the topic of treating gentiles on shabbos.  So I thought that I at least had a handle on the relevant issues, i had poskim to call if I needed help, and I was ready to go.

However, I wasn't really prepared at all for what eventually became the real issue for me.  Stepping out into the "real world" forced me to think seriously about what moral and ethical messages the Torah had to teach me, my colleagues, my patients and indeed the entire world about what it means to be responsible to take care of people's lives.

There is SO much in the Torah to draw strength from, and starting with Verapo yerapey, veahavta lereiachah kamocha and on down, there was so much in the Torah for me to draw strength from and teach others. But I kept on hitting a big bump, nay, a big brick wall.  Everywhere I turned, I hit a brick wall.  what I believed in my heart, and what I learned in shulchan aruch kept on crashing into each other like a game of chicken where both contestants "win".

In my heart I knew that treating and saving a human life is the highest calling.  In my heart I knew that Hashem wants me to do everything I can to take care of all human beings with equal compassion, equal concern, and treat everyone appropriately no matter who they may be.  I knew it in my bones, I knew it in my heart.  So why then does halacha distinguish between caring for a Jew and a non-Jew on Shabbos?

The more I spent my life caring for others, doing what i know Hashem wants from me, the less I was able to reconcile these two seemingly contradictory lessons that the Torah was teaching me.

Let me now be really honest.  I have went through many stages before I came to the conclusions that i will be arguing in this series of blog posts.

Stage One) Not willing to God forbid throw out the Torah, I first thought that maybe my priorities were messed up.  If the Torah teaches me something, then my set of values must be wrong!  Maybe I am just absorbing foreign non_Torah values, and I need to learn the Torah-true values and accept them as the word of God.  But I couldn't accept it.  Sure, on many levels I know that we cannot accept every whim of modern society as a proper value system.  Things like premarital sex, abortion on demand, and other issues shouldn't become acceptable to me just because modern society says so!  But  this issue was different.  Something deep down inside of me told me that this value system was right.  God would not want me to treat a goy or jew differently on shabbos.

Stage two) So maybe the Torah is wrong?  Maybe i should get with the program and join the modern world!  As scary as this thought was to me, I would be dishonest if I claimed that such thoughts never entered my mind.  If God were to ask me why I rejected the Torah, my answer would be, because I believed that all of your children were created equal!  If I burn in hell for that conviction, then go ahead and let me burn!  As such thoughts percolated in my head, I was disgusted.  It can't possibly be that the Torah really believes this way! It is too beautiful, too wonderful, too peaceful, too loving, and I just KNOW that what Hashem wants from me is to treat everyone with the same respect.

Stage three)  So I spoke with people to whom I could trust my inner thoughts, and I studied numerous seforim which entertained these types of doubts.  I turned to thinkers that I knew had grappled with these issues honestly, and remained faithful to the Torah.  Thinkers like the Rambam in the sefer Moreh Nevuchim.  Thinkers like Rav Kook and Rav SR Hirsch.   Poskim like the Seridei Aish. I spoke with people who dealt with these issues openly and honestly, and eventually I realized that with study, discussion, honesty, and openness, the true beauty of the Torah will always shine forth.

Armed with this new approach, I learned something both wonderful and scary.  I learned that what shines forth from the Torah may be something new and refreshing to me, but others often seem to find it difficult to accept.  The famous "Slifkin Affair" was a watershed event for me.  That is because R' Slifkin was a person who also was grappling with the same difficulties that I was, and he seemed to find a path that both satisfied his rationalistic personality , and remained faithful to the Torah.  His area may have been  zoology, the age of the universe and so on, while my area was medical halacha, but the issues were the same to me.  When he got "shot down" by the chareidi establishment, I was "shot down" as well.

I have made it clear in this blog that I have set out to revisit the entire field of medical halacha in a rationalist way, and I have determined to do this unapologetically, and rely on the research that I have conducted.  I will do this because I am a frum Jew, and i will always love the Torah.  For the sake of God, for the sake of my children, and for the sake of every Jew and every human being who uses his or her own head when they think about these issues, I will offer a way to deal with these very difficult subjects.  I would love to hear your thoughts in the comments.

In the upcoming posts i will attack the following fundamental question. Despite the fact that all contemporary poskim DO allow chillul shabbos to save ANY life, we know that this is generally considered a heter due to fear of reprisal, mishum ayvah or some other heter. If the halacha is an ethical guide to life in addition to just being a book of rules, how could it be that the fundamental principles that underlie the halacha are so contrary to what most of us would consider to be basic ethics? How could it be that the halacha only allows chillul shabbos to save the life of  a Jew but not a gentile?  Does this not run counter to our basic ethical instincts?

If you are not bothered by this ethical problem, then you probably should not be reading this blog.  If it doesn't bother you, then our perspectives are so different from each other, that further dialogue will probably not be very productive.  However, if this problem bothers you, then please read it, listen, and tell me what you think.


  1. I am looking forward to your discussion of this topic. I was worried that since you haven't posted in a while that you had abandoned the enterprise. Glad to know that you are forging ahead. There are many of us grappling with these issues, and I am anxious to hear your approach.

  2. The post is sincere and heartfully-felt and I congratulate you for raising this issue.

    On a practical level, though, I wonder how much significance this has in a Western World setting.

    Given the availability of non-Jewish healthcare practioners, the patient will in any event receive excellent care.

    So, it turns out that in this case, Keddushas Shabbos is upheld and it trumps having the Jewish Physician be mechaleil it, with no loss to anyone.

    The only loss I can think of is to the Orthodox Physician, who now has to rely upon b'dieved heterim to take care of the patient himself rather than arranging for a non-jewish colleague to cover for him.

    I can see, then, how this matter presents a dilemma for the Orthodox physician ("Why can't I be the one to take care of him?"), but fail to see how it presents a moral dilemma as regards to the care of the non-Jewish patient.

    I do not, of course, refer to a situation where no other option is available.

  3. If reference to Shlomo David's comment. I will make the point in the upcoming blogs numerous times that clearly it is best for Orthodox physicians to spend shabbos at home with their families, and arrange for proper care of their patients with their non-Jewish colleagues. I also agree that PRACTICALLY there isn;t much relevance, as virtually all poskim agree that when there is no other choice one is supposed to treat a non-Jew no matter what.

    My problem is not with the practical situation, it is with the principles that underlie the halachos. It should be clear from my post that my concern is not with what I am supposed to do halachically, it is with the laws themselves and their derivations.

    BTW, many Orthodox doctors, emergency service personnel, and other health care providers HAVE to be on call on shabbos at times. Some live in small communities where there aren't that many doctors, others have a private practice where they cannot always have someone else cover for them, others are in organizations such as hatzolah, some have unique subspecialties where there aren't many others with their skills. (There are entire States in the US where there may be only one or two neurosurgeons for example) Orthodox surgeons must be available to take care of their own surgical patients, as it is often not appropriate for a surgeon to sign his/her complicated patients out to a colleague.

    A frum colleague of mine has a unique skill which only he is able to do in our area, and thus needs to be available on shabbos - despite the fact that we live in an area full of large major medical centers.

    Another colleague of mine is one of only THREE lung transplant surgeons in Manhattan! So it is impossible for him to never be on call certain days. (He is not frum BTW, I am just bringing it up as an example).

    So this question is of practical significance even in the western world. While I don't want to, at this point, reveal what my specialty is, let it suffice for me to say that I am called upon to see patients on shabbos often enough that i have this problem myself. It is not always possible or ethical for me to hand over my patients to others.

    Regardless, I needed to finally have the guts to question the fundamentals. Practically, I know what to do, but that isn't what is bothering me. I hope that is clear from my post.

  4. Although you don't wish to discuss the practical implications at this point, I would suggest that the situation I described (which applies to perhaps 90% of all frum physicians in the US) means that there very much is practical halachic issue, as it might be highly questionable whether the historic heterim of the past apply today.

    In other words, if the heterim are b'di'eved (which they are), then I don't see it as a given that one may l'chatchilla join a medical practice that will ultimately require one to rely upon a b'di'eved heter.

    As for the moral issue, why stop at this one?

    Should we discuss as well our discomfort with the situation of mamzeirim and agunot? What about that we must kill every man, woman, and child from Amalek?

    At least in the case of the non-Jew, there's no practical consequence of the strictures of halacha. For the mamzer, agunah, woman seeking divorce from a reluctatnt husband, unmarried kohanim who are ba'alei teshuvah, etc, that is very much not the case.

  5. R' Shlomo David, the point you raise about the permissability of joining or practice suituation that would require chillul shabbos is a very valid one. I will have to put that on the table to discuss in the future.

    As far as your question "why stop at this one?" I don't plan on stopping at this one. I presume that you have noticed that I have made a concsious decision to tackle these issues regardless of how uncomfortable they may be. That is why I am writing this blog. I tell my children all of the time, "Judaism encourages questions", "don't be afraid to ask difficult questions....." Well, if we are allowed to ask them, we need to be allowed to answer them as well.

    Your first point regarding the heterim which are b'dieved is also important. I plan ion dealing with this issue. I started it in today's halachic review but will get into much more detail.

    Agunot, Mamzeirim, etc... are all important issues, but they are not within my "specialty" so I will leave them to others. I will attack only my area of interest. But I will say this. I will do my utmost to avoid apologetics. I am searching for an approach that is both real, acceptable, and based on the Torah.

  6. I would add, by the way, that one is not allowed to be mechaleil Shabbos D'Orayssa for sakanas eiver -- even for a Jew.

    Does this not make us uncomfortable as well, that a child should go without a finger
    for the rest of his life?

    (Of course, as with the case of the non-Jew, there is little practical consequence, given the ability to take care of the situation through non-Jews or through reducing things to Rabbonons.)

    Perhaps the lesson to be learned is the extent to which we are insufficient sensitive to the holiness of Shabbos. In other words, these laws are not to be seen as moral judgments, but as testimony to Keddushas Shabbos.

  7. R Shlomo David, I really like your comments. Thank you for engaging me in this discussion. Sakanas Aiver is something that illustrates a similar point. Practically speaking, most poskim today allow medical intervention for sakanas aiver under the guise of it being a potential sakanas nefashos. So we have another case of an area where pratically there is less of a problem, while the underlying principles may be morally problematic.

    I definitely keep in mind your idea that we don't really appreciate the extent of kedushas shabbos. These are exactly the types of conflicts which led me to research these topics. This is what we have to grapple with, and we will all come to different conclusions. I hope to hear from you what you think about the conclusions that i will make, and I am ready to listen and learn from anyone sincere enough to take these topics seriously.

    It happens that I am right now stuck in the hospital taking care of two patients (non-Jews) as shabbos approaches. It is looking less and less likely that i will be home on time. Ironic, I guess. Good shabbos to you.

  8. TMHR: love the post, please keep them coming

    Shlomo David, im very confused by your "practical issues" with this question. The Gemara is filled with issues that have ZERO "practical" relevance to our daily lives yet people in yeshiva spend thousands of hours learning them. Its all Torah and if practicality was the only forum for discussion then maybe we shouldn't learn any halachos of the beit hamikdash, and then we should skip learning about mitzvot that are not possible to do in galus. That should erase about half of shas. This scenario is far more "practical" in our daily dealings with halachik law and if it will educate us about the ethical issues one encounters, why undermine the issue based on practicality?