Alternative Medicine – Modern vs. Old World Views
Rabbi Haim Perlmutter
Judaism has always had a special and positive outlook regarding the field of medicine and to medicines. The Jew, with a disposition to hesed, has always tried to help the world by treating and offering relief to those suffering from disease. The Torah (Shemot 21:19) teaches, “Verapo yerape,” from which our sages infer that doctors are authorized to heal the sick. Indeed, many prominent Jews throughout our history, including such towering figures as the Rambam and the Ramban, made their living from practicing medicine.
The special place accorded by Judaism to curing and to medicine manifests itself in halachah in many ways. This article will discuss whether alternative medicine falls under the halachic definition of “medicine,” and the halachic ramifications of this question.
The formal halachic status of “medicine” is relevant for a number of different issues, including that of medical treatment on Shabbat. Halachah permits violating the Shabbat in order to cure a person whose life is in danger, yet halachah forbids taking medicine on Shabbat unless one is sick in bed or needs continuing treatment. Thus, something defined as “medicine” would be permitted for use on Shabbat in life-threatening situations, and would be forbidden for use on Shabbat in other circumstances. Conversely, measures taken that do not qualify as medical treatment would be generally permissible on Shabbat, but would be forbidden if they entail Shabbat violations, even for the sake of a gravely ill patient. Indeed, the Rama rules that one may transgress a Torah violation to treat a gravely ill patient only through procedures that are “proven” to succeed, or which are administered by a qualified doctor.[1]
Additionally, in light of the halachic requirement to care for one’s physical wellbeing, the halachic definition of “medicine” is crucial for determining one’s obligation to avail himself of medical treatments to maintain heath.
Rav Shlomo Aviner
Rav Shlomo Aviner[2] says that the Rama’s definition includes only doctors who are certified according to the conventional medical establishment. Therefore, he concludes that if a patient is told that he will die if he does not use conventional treatment for his disease, he may not elect to refrain from using that medicine and pursue non-conventional treatment. However, Rav Aviner concedes that if there was research indicating that the alternative procedure actually helps, there may be reason to reconsider. Similarly, if the medical establishment changes its attitude to certain alternative medicines, this change would give them more halachic validity. Rav Aviner does not address a situation in which conventional medicine has no solution and alternative medicine claims to solve the problem.
Rav Haim David Halevi
Rav Haim David Halevi, zt”l, (former Chief Rabbi of Tel Aviv) received a letter from someone inquiring about the possibility of using homeopathic medicines on Pesah. These medicines were alcohol-based, and since they were manufactured overseas, it was impossible to determine whether or not they were kosher for Pesah. The patient mentioned that he had previously brought this question to a different rabbi who said, “Homeopathic medicine cannot be regarded as valid or proven efficacious,” and added, “Using medical procedures that do not have a rational basis behind them is contrary to belief in Hashem, and can cause people to be open to all kinds of ideas that originate from idol worship and are in contrast to the way Hashem created his world.”
In an article on the subject[3], Rav Halevi set out to prove this rabbi wrong. He cited, among other sources, the Mishnah in Yoma regarding the case of one who is bitten by a “mad dog.” Rabbi Matya allows the patient to be fed a part of that dog‘s liver (which is obviously not kosher), whereas the other rabbis forbid this practice. Rashi explains that the ancients regarded the biting dog’s liver as an antidote, but since the medicinal value was not proven, the majority among the sages do not allow the patient to violate Torah law by eating the dog’s liver. The implication of Rashi’s comments, as Rav Halevi notes, is that if we were dealing with a kosher substance, it would be allowed to be given to the patient even though there is no rational basis for its medical benefits.[4] Accordingly, Rav Halevi concludes that one may use alternative cures even when no rational explanation for their efficacy exists, as long as no halachic violation is entailed.
Rav Neubert, Rav Shlomo Zalman, and Rav Elyashiv
A similar question was posed to a number of halachic authorities involving a cancer patient who was told there was no cure for his illness. In desperation, he decided he would invest considerable amounts of time, effort, and money to go to an alternative clinic in a different country for treatment. The question that arose was twofold: should one try to dissuade him from going, and should one refrain from giving tzedakah money to help him undergo this treatment?
Rav Yehoshua Neubert, zt”l, ruled that one should not try to dissuade the patient from seeking the alternative treatment, as hope is a vital part of overcoming illness, and the hope of recovery can itself prolong a patient’s life. As for the question of giving charitable donations to help fund the treatment, Rav Neubert ruled that tzedakah money may be donated for this cause, in disagreement with the view expressed by his mentor, Rav Shlomo Zalman Auerbach, zt”l. Rav Shlomo Zalman ruled that charity money may not be used to provide alternative medication, though small amounts may be given for the purpose of bringing the patient a degree of emotional relief. Rav Yosef Shalom Elyashiv, zt”l, reportedly maintained that if the psychological effect of undergoing this treatment could help the patient live longer and with better quality of life, then one should give his charity money to this cause, even if the treatment offers no direct medical benefit.[5]
The Permissibility of “Irrational” Medication
As for the lack of rational explanation for the efficacy of much of alternative medicine, Rav Yehudah Shaviv[6] notes a seeming contradiction in the Rambam’s writings. On one hand, the Rambam codifies the Mishnah’s ruling that one may walk in a public domain on Shabbat while wearing a fox’s tooth or the nail from a crucified person, as these were considered remedies and may therefore be worn on Shabbat.[7] On the other hand, the Rambam elsewhere[8] expresses the view that irrational healing practices may not be used, and doing so violates the prohibition of darche ha’Emori (following the ways of the gentiles). The question thus arises, what justification can there be for walking in public on Shabbat wearing articles such as a fox’s tooth, if halachah forbids using them for medicine?
The Rashba[9], as Rav Shaviv cites, explains that if experience has proven the benefit or effectiveness of non-conventional treatments, then they may be used, even if we have no rational explanation for why they are medically beneficial. The Meiri[10] adds that once the masses attribute medicinal value to a certain remedy, this perception lends the remedy psychological value, which itself justifies its use. In any event, Rav Shaviv himself urges people to reject irrational medicinal procedures and to adhere to scientifically proven measures.
The general consensus among the aforementioned scholars is that one should not violate a Torah prohibition for the sake of utilizing these medical treatments. If one has a particular reason to believe that such a remedy could be beneficial, either in light of research and experimentation, or in terms of the psychological benefit, a competent halachic authority should be consulted.
Changing Attitudes in Medicine
It must be emphasized that the articles cited above were written when very few alternative medicine treatments had any scientific validation. To illustrate how conventional medical wisdom has changed since that time, we should note Rav Aviner’s comment that it is acceptable to follow alternative medicine’s “unproven” belief that white flour and sugar cause health problems – a belief which has since been proven clinically and is widely accepted by the conventional medical establishment. Additionally, conventional doctors are now prescribing homeopathic remedies, and the Israeli health services have introduced non-conventional medicine into their clinics. The halachic response to alternative medicine must therefore be updated in light of the significant changes that we are witnessing in the field of medicine. As Rav Aviner himself said, if the attitude of conventional science changes, then so will that of the rabbis.
I would like to conclude with an anecdote from my personal experience. A number of years ago I suffered from dry eyes, and the conventional eye doctor told me to put in a drop of artificial tears every hour. My cornea was so dry I had scratches on it. A non-conventional natural practitioner recommended that I use castor oil, and I found that if I put it in the eye just once a day, the relief lasted the entire day. When I went back to the doctor, she looked in my eyes and couldn’t believe what she saw. She said, “What are you doing for your eyes? The scratches vanished! Whatever you are doing – continue.”
Disclaimer: This article is not to be used for practical halachic decisions. For practical guidance, please consult your personal rabbi.
Rabbi Haim Perlmutter is a rabbi and educator. He is author of “Tools for Tosafos” and “Grow With Gemara – A Hands on Guide to Improve Gemara Skills”(published by Targum Press).
Footnotes:
[1] Rama, Y.D. 155:3.
[2] Asya, 9, pp. 90-130.
[3] Techumin, volume 3, pp. 72-73.
[4] According to another version of the Mishnah, Rabbi Yossi is the one who allows eating the dog’s liver, while Rabbi Meir prohibits doing so. As halachah follows Rabbi Yossi’s view in his disputes with Rabbi Meir, we may have an even stronger basis for permitting such remedies.
[5] Nishmat Avraham (Y.D. 155). It was obvious to both the questioner and to the rabbi that there was no chance that the alternative medicine would actually cure the cancer.
[6] Techumin, vol. 19, pp. 411-416.
[7] Hilchot Shabbat 19:13. The Rambam clearly followed the version of the text of the Mishnah cited above, note 4.
[8] Guide for the Perplexed, 3;37. See also Hilchot Avodat Kochavim, chapter 11.
[9] Responsa, vol. 1, 413.
[10] Shabbat 66b. It must be emphasized that the Meiri advanced this theory to explain why such practices are permissible; this does not mean that one may violate Torah law for the sake of employing these methods.