Charlie suffers from serious heart problems. His doctor warned him that fasting on Yom Kippur could endanger his life and instructed him to drink fluids. Troubled by the idea of drinking on this sacred day, Charlie asked me if he could use intravenous (IV) hydration instead.
His son Jack, who is generally healthy, had a bout of food poisoning and became severely dehydrated. He asked if he needs to remove his IV before the fast begins in order to observe Yom Kippur properly.
Is IV Hydration Considered Eating or Drinking?
Halachically, IV hydration is not considered eating or drinking. The Torah prohibition on Yom Kippur refers specifically to consuming food or drink through the mouth. Hydration administered intravenously bypasses this and is therefore not technically a violation of the fast.
Hacham Ovadia Yosef
Despite the technical leniency, Hacham Ovadia, zt”l, (Chazon Ovadia Yom Kippur, p. 298) opposed the use of IV hydration on Yom Kippur when not medically necessary. He explains that while IV fluids are not halachically defined as food or drink, they should not be used unless clearly required for health reasons.
He gives three key reasons: Firstly, drinking shiurim (small amounts) provides physical and psychological comfort (ituvei da’at) to a sick person. IV hydration does not offer the same level of satisfaction. The Chachamim were deeply concerned with ensuring the comfort of the ill.
Secondly,halacha already allows eating or drinking when health is in danger. There is no halachic requirement to find artificial alternatives. Insisting on IVs could mislead people into thinking they must use IV hydration rather than eat or drink – potentially putting lives in danger if IVs aren’t available.
Lastly,inserting an IV causes minor bleeding, which constitutes an unnecessary wound – another prohibition on Yom Kippur. Since eating or drinking is already permitted in such cases, this injury is avoidable and therefore unjustified.
Hacham Ben Zion Abba Shaul
In contrast, Hacham Ben Zion Abba Shaul, zt”l,(Or LeTzion 4:15:5) held that IV hydration is halachically preferable. He argued that even drinking in shiurim is still be a biblical prohibition, especially according to the Rambam (Shevitat Assor 2:3). IV hydration, by contrast, is not a normal form of drinking and is therefore permitted. As for the bleeding involved in inserting the IV, he viewed it as an unintended and destructive act (pesik reisha d’lo nicha lei), which does not carry a Torah prohibition and is therefore preferable to drinking in shiurim.
Drinking in Shiurim
When someone must drink on Yom Kippur due to pikuach nefesh, when medically possible they should drink in shiurim (melo lugmav, about 1.3 oz or 40 ml). The required pause between sips varies by opinion, from five seconds to nine minutes. Hacham Ovadia (Yabia Omer, OC 2:31) ruled that a pause of five seconds suffices, especially if longer breaks compromise the person’s health.
When Fasting Becomes Forbidden
If fasting could endanger Charlie’s life, not only is he permitted to drink – it is a halachic obligation. In Yechaveh Daat (1:61), Hacham Ovadia writes unequivocally: “If there is concern of possible danger to his life by fasting, one must listen to the doctor and eat on Yom Kippur, because pikuach nefesh overrides the mitzvah of fasting. If the sick person is stringent and fasts nonetheless, he is not acting righteously – on the contrary, he will be punished for this.”
What Should Charlie and Jack Do?
Charlie must not fast if doing so endangers his life. Ideally, he should drink in measured amounts (shiurim). If that is not possible or safe, IV hydration is permitted. Similarly, if Charlie refuses to drink IV hydration is permitted due to pikuach nefesh. Jack, who is already connected to an IV due to dehydration, does not need to remove it before Yom Kippur. In his case, continuing hydration through the IV is fully permitted.
Some people feel guilt or shame about eating or drinking on Yom Kippur, even when halachically necessary. But we must remember: the same Hashem who commands the healthy to fast commands the very sick to eat. When halacha requires eating or drinking on Yom Kippur, doing so is not only allowed – it is amitzvah. No atonement is needed. In fact, following halacha in these cases is the highest mitzvah.
Rabbi Yehuda Finchas is a worldwide expert, lecturer and author on Medical Halacha. He heads the Torat Habayit Medical Halacha Institute. His latest book is “Brain Death in Halacha and the Tower of Babel Syndrome.” To contact Rabbi Finchas, email rabbi@torathabayit.com.