Tuesday, December 7, 2010

Is it "Only a B'Dieved?"

I started this discussion of treating a goy on shabbos with a description of my learning and research throughout my career, and the moral dilemmas that I faced. What happens when I have to be in the hospital on shabbos, and I have to face an actual, real live, gentile?  How do I treat him/her?

The halacha, is clear, no matter what I am supposed to treat the patient, so does it really matter why?  The bottom line is, yes, it does matter.  If the reason why I am supposed to treat him is because I am afraid of the repercussions, then it is a bedieved.  I should do everything I can to NOT be in the situation.  This type of attitude really does make a difference to my patients. Maybe it is intangible, maybe it is unmeasurable, but it does matter.  Being a doctor takes devotion, compassion, and empathy.  To be an effective physician, you have to be more than a scientist, you actually have to care about your patients. More importantly, you have to believe in the importance and value of what you are doing!

Now that you have seen and read my analysis in this blog, you know that it is the Torah from which I derive the incredible value and importance of treating this person, this human being.  And yes, this importance is such that it even transcends the prohibitions of shabbos.  Once we have given all human beings that live in and take part in a moral and righteous society, the status of a ger toshav, we can apply the words of the Ramban (Sefer HaMitzvot Mitzvah 16 - my own translation)

That we have been commanded to support and maintain the lives of the ger toshav, to save him from his enemies, so that if he were drowning in a river or if he was stuck underneath rubble, that with all our strength we will involve ourselves in saving him, and if he were sick, we will heal him ... and this is considered pikuach nefesh that supersedes the Shabbos, and this is what God meant when He said in His Torah ..."When your brother is destitute ... and you shall support him and the ger toshav, and he shall live amongst you ..."

To say that this reflects the true sentiments of the Torah would be the understatement of the century, as anyone who has ever read the Bible would tell you.

This of course does not mean that Jewish doctors should go out of their way to be in the hospital on shabbos to work.  Of course the Torah wants us to keep shabbos.  Of course the Torah wants us to spend shabbos at rest with our family, in our shuls and communities.  Of course we should try as much as we can to let our competent and caring gentile colleagues take hospital calls on Shabbos while we take their Sundays etc....  But once we are there, it is not at all a bedieved to take care of people. It is doing the work of the Ribbono Shel Olam, and it should be done properly and with enthusiasm.

Now I am sure that many of you are looking forward to my next topic.  I still have some more to say, and I was going to write a post about how the five principles of Rationalist Medical Halacha have been applied with my analysis of this issue.  However, I am eager to start with a new topic, so I will leave that one out for now.  So let me conclude with an invitation to say whatever you want in the comments.  I begged you before to reserve judgement until I finished.  Thank you so much for your patience, and now we can take our discussion into the comments section, and all holds are off, say whatever you think.  The next topic will be abortion.  Please give me some time to get my thoughts together, but I promise to do my best to start that subject asap.


  1. I am 100% in line with you here. Shkoyach.

  2. This type of thinking is sorely lacking in large segments of the orthodox world. (Just look at this week's edict signed by 4 dozen rabbis in Israel against selling/renting to non-Jews.)

    Thank you for giving "teeth" to something I, and many of friends, consider to be a critically important message in today's world.

  3. Really interesting topic. I've been following since you started (recommended by Natan Slifkin) and your blog is top-notch. Thanks a lot.

  4. Great series - very thought provoking. I would like to read the essay of the Maharatz Chajes that you mentioned ("tifferes l'yisrael"). Where can I find it? I did not find it on a search of hebrewbooks.org.

    There are many practical problems with being in the hospital on shabbos besides the issue of treating non-Jews. I would be interested for example, to hear how you write notes on shabbos (much of what's written in the chart is NOT needed for pikuach nefesh, and is repetative stuff that has already been documented); how do you discharge patients? Do you sleep in the hospital or return with a non-Jewish driver? To me, these practical concerns are more of an issue than treating non-Jews, which is at least mutar m'shum eivah (at least the d'rabanans according the chumrah of the mishna brura).

  5. Daniel shain; I found it it the back of a two volume sefer "Kol Kisvei Maharatz Chayas" in a shtibel I was davening in. I assume you could find it in a good seforim store. The topics that you mentioned regarding shabbos in the hospital are very important, and they are dealt with extensively in the sifrei halacha. So while they are of course interesting to me for practical reasons, I don't have that much to add from the "rationalist medical halachic" perspective I do have some comments to make though, although it is very true that not everything one writes in a note are`really necessary for care, sometimes it is important to maintain a standard of consistency in note writing to make sure you always "cover all your bases" and don't miss important things. This is an issue which many poskim don't quite understand when they discuss note writing on shabbos. Medical routines and habits (assuming they are GOOD habits) can sometimes be lifesaving. also with eloctronic note writing as many hospitals now have, there are more heterim, as typing on a keyboard may not be kesivah midoraysah. However, that it way out of the scope of this forum