Medications on Shabbos - Part 2
Question: We previously mentioned that to avoid excessive pain or distress the Rabbis established guidelines as to when one is permitted to take medications on Shabbos. What are those guidelines?
Discussion: The Rabbis suspended many of their decrees for a person who can be classified as “ill,” even if not dangerously so. Thus, for example, it is permitted to instruct a non-Jew to do anything which an ill patient may require on Shabbos, since instructing a non-Jew is a rabbinic prohibition. Since taking medication on Shabbos is a rabbinic prohibition, it is suspended when the patient can be classified as “ill.” The poskim agree that when one has a fever, feels weak all over or feels bad enough to require bed rest, he can be classified as a “patient not dangerously ill” and he is permitted to take medications.81
Since “requiring bed rest” and “weak all over” are subjective terms, it is up to each individual to determine his personal pain threshold. Consequently, one who feels that he must lie in bed for his condition may take medication on Shabbos even though other people in the “same” condition would not go to bed. There is no requirement to be overly stringent when judging the degree of illness.82
In addition, healthy infants and babies until the age of three83 (and according to some poskim even older children till the age of six84 or nine85) are also halachically classified as “patients not dangerously ill,” which means that the rabbinical prohibition against taking medication is suspended. It is permitted for their parents to give them all forms of medicine,86 provided, of course, that no Biblical prohibitions are transgressed.
Question: Nowadays, when medicine is always prepared at a pharmacy, there is no longer any fear that using medicine at home will lead to Grinding. Why, then, is this rabbinic prohibition still in effect?
Discussion: Although some contemporary poskim debate whether nowadays we can be more lenient with taking medication on Shabbos because of the change in technique,87 the consensus is to reject this argument. Some of the reasons offered are as follows:
- In general, a rabbinic decree, once enacted, is not repealed even when the reason behind it no longer applies.88
- There are several homeopathic remedies, such as natural herbs and spices, which are still prepared at home and require grinding. In fact, these types of medications are gaining popularity.
- In underdeveloped countries, people have never stopped preparing medicines in their own homes.
- Some modern-day medication may lead to other Biblical Labors, such as Smoothing, Kneading, Cooking or Carrying.
Despite the above, there are some poskim who feel that nowadays we can be somewhat more lenient when interpreting the rabbinic decree. Although all the poskim agree that we may not do away with the rabbinic decree altogether, we may, nevertheless, find some room for leniency in case of severe distress or pain (even if the pain is localized and would not require bed rest).89
Note: Many poskim maintain that although one who is not classified as “ill” may not begin taking medicine on Shabbos, one who requires daily medication for an ongoing condition may continue doing so on Shabbos as well.90 Some poskim go even further and permit continuing taking medicine on Shabbos, even of the patient is not medically required to take the medicine daily.91
81. Entire paragraph based on O.C. 328:17 and 37 and Mishnah Berurah, ibid. [Note that although Shulchan Aruch rules that a shinui is required for rabbinic prohibitions to be suspended, the consensus of the poskim is that this restriction is waived when taking oral medication. When using other medications, however (such as ointment), it is proper to employ a shinui; see Mishnah Berurah 328:85 and 130.]
82. See Tzitz Eliezer 14:50-7 and 17:13.
83. Chazon Ish, O.C. 59:3, Rav S.Z. Auerbach, quoted in Nishmas Avraham 328:54, and Rav Y.S. Elyashiv in Eis Laledes, pg. 57, quote the age of 2-3.
84. Tzitz Eliezer 8:15-12.
85. Minchas Yitzchak 1:78; Shemiras Shabbos K’hilchasah 37:2. Practically speaking, it all depends on the strength and maturity of the child.
86. Rama, O.C. 328:17. Note, however, that not all of a baby’s needs are exempt from the prohibition against medication; see, for instance, Mishnah Berurah 328:131. See Tehillah l’Dovid 328:24 and Minchas Yitzchak 4:124 who deal with this difficulty.
87. The complex preparation that manufacturing modern medicine entails is another reason for leniency, since it may be argued that the Rabbis were fearful that “simple” and quick Labors such as Grinding would be transgressed; they did not fear that someone would engage in the lengthy and involved processing required today.
88. See Igros Moshe, O.C. 2:100 for a general explanation of this rule.
89. See Minchas Shabbos 91:9; Ketzos ha-Shulchan 134:7; Chelkas Yaakov, O.C. 153; Tzitz Eliezer 8:15-15 and Minchas Asher 3:23
90. Chazon Ish (oral ruling, quoted in Imrei Yosher on Moed 97); Rav S.Z. Auerbach (Shemiras Shabbos K’hilchasah 34, note 77). See a dissenting opinion in Igros Moshe, O.C. 3:53.
91. Rav S. Kluger (Sefer ha-Chayim 328:10 and Shenos Chayim 1:152); Minchas Shabbos 91:9; Tzitz Eliezer 8:15-15:15; Rav Y.S. Elyashiv (Koveitz Teshuvos, O.C. 1:40, and oral ruling, quoted in Refuas Yisrael, pg. 14).