MISHMERES GUF:
GUARD NOT ONLY YOUR TONGUE, BUT YOUR ENTIRE BODY
R’ Dr. Yehudah Mordechai Gardin
Teaneck, New Jersey
Permission to Heal
The Mishnah (Kiddushin, 82a) admonishes: “The best of physicians deserves Hell…”
This is generally interpreted to mean that physicians who are arrogant and feel
that they are infallible—i.e., they “play G-d” as it were—or refuse to treat the
needy free of charge, deserve an untoward end. So, how do we know that under
Jewish Law, the physician has the right to hang out a shingle and practice
medicine? This is not a trivial question since there are many references to G-d
being the Supreme Healer in the Torah and in our prayers. As an example, in
Shemos Parashas Beshalach, 15:26, it states: “I am G-d your healer.” In our
morning prayers, we refer to Pokeach Ivrim (“He who opens the eyes of the
blind”). In the Amidah (Shemoneh Esrei), we say, Somech noflim v’rofeh cholim,
(“He who lifts up the fallen and heals the sick”) and after we go to the
restroom, we say, as part of the Asher yotzar prayer, Rofeh kol basar umafli
la’asos (“Who heals all flesh and acts wondrously”).
This actually is the subject of a machlokes between the Ramban (Rabbi Moshe ben
Nachman, born 1194, died 1270) and the Rambam (Rabbi Moshe ben Maimon, born
1135, died 1204). Specifically, the Ramban posits that it demonstrates a defect
in our emunah (faith) to rely on earthly healers—i.e., physicians—even though
the Ramban himself is a physician-scholar. The Rambam, a
physician-diplomat-scholar, argued that physicians were empowered by the Torah
to heal their fellows. Sources for the physician’s empowerment to help the
Supreme Healer include the double lashon, rapo y’rapeh—“You shall surely
heal”—in the context of two men quarreling, in which the aggressor strikes the
other with a stone or his fist (Devarim, Parashas Mishpatim, 21:19, as explained
by Tanna debai Rebbe Yishmael [Bava Kama, 85a]); and vahasheivoso lo (“You
should return [a lost object] to him”, Devarim, Parashas Ki Seitzei, 22:2). The
Talmudic explanation (lomdus) is that just as the one is obligated to return a
lost object to another, so too, he is obligated to return his lost health to
him. We are also instructed that we must make efforts to protect ourselves and
not rely on a miracle to save us (Ein somech al hanes). The Torah also
admonishes us that we should “take heed to thyself and take care of thy life” (Devarim,
Parashas Va ‘Eschanan, 4:9) and “take very good care of your lives” (V’nishmartem
me’od le’ nafshosechem [Devarim 4:15]).
The Magnitude of the Problem
Various examples could be cited in which people endanger their health by their
own actions—including the use of excessive alcohol and illicit drugs; smoking;
significant overeating; and a lack of appropriate exercise. In this particular
discussion, I will focus on the threats to health related to smoking. Smoking is
well-known to be associated with an increased incidence of cancer, emphysema,
heart and vascular disease, as well as other ailments. The negative effects
affect not only the smoker, but also others who are exposed to smoke (“passive
smoking”). It was estimated that in the beginning of the 1990s, about 1.1
billion people worldwide were smokers. This represented about one-third of the
world’s population above the age of 15. The annual global death rate at that
time was estimated to be 3 million smokers (Chapman, Brit Med J 1996;313:97).
Although in the Western world, there has been a decline in the number of adult
smokers over the past 20 years (1998 to 2009), from 24.1% to 20.6%, the American
Heart Association estimates that from 2000 to 2004, the number of deaths each
year from smoking was approximately 270,000 among males and 174,000 among
females (Roger, et al. Heart Disease and Stroke Update Statistics 2011 Update.
Circulation. 2011;123;e18-e209.).
Key Modern-Day Responsa
Faced with the evidence of the detrimental effects of smoking, some key poskim
(Rabbinic authorities) have ruled that it is Biblically forbidden to smoke.
These include HaRav Eliezer Waldenberg, a major modern-day Israeli posek (Tzitz
Eliezer, Part 15, # 39 and Part 17, # 21-22; see also Steinberg A. Encyclopedia
of Jewish Medical Ethics, vol 3. Feldhelm Pub. 2003:971-977.). In the United
States, the Gadol Hador of the last generation, HaRav Moshe Feinstein, z”tz”l,
felt there was not a Biblical halachic basis for prohibiting smoking. Reasons
cited by HaRav Feinstein for not declaring that smoking was forbidden
(assur)—despite the fact that it should be discouraged and prevented if
possible—were the following:
• Many holy people in previous generations smoked and they certainly did not
violate Torah law; furthermore, it is forbidden for the Rabbis to enact a law
that will be trampled by the masses (shedashu ba rabim);
• Since some argue that smoking harms only a minority of smokers (a conjecture
now subject to serious question), one cannot include it among the prohibitions
related to the precepts related to Shomer es nafshosechem; and
• Any act which the masses accept the risk of performing—i.e., driving in a car,
flying in a plane, etc.—cannot be forbidden since the masses are protected under
the umbrella of Shomer pesaim HaShem (“The Lord watches out over fools [or
simpletons]”). (Iggros Moshe, Yoreh Deah, Part 2, # 49 and Choshen Mishpat, Part
2, # 76)
It should be noted that more recently, there have been some stronger rabbinic
calls to forbid smoking, including from HaRav Ovadyah Yosef.
Activism of the Gedolim (Torah Sages) in Cases of Dinei Mamonos
Recent examples of important Rabbinic authorities issuing bans related to
excessive monetary expenditures include a ban that was promulgated by the
Moetzes Gedolei HaTorah (Council of Torah Sages of the Agudath Israel), and
publicized in The Jewish Observer, related to excessive expenditures for Jewish
weddings. In particular, the Rabbis put a cap, in most instances, on the number
of courses permitted as part of the wedding meal, the number of attendees at the
wedding, the number of musicians in the band, etc. The idea was to avoid the
squandering of large sums of cash—particularly by individuals who could ill
afford to do so and who put their families in financial distress for many years
in order to “keep up with the Goldbergs.” In a similar vein, a number of years
ago, HaRav Moshe Heinemann of the Star-K in Baltimore set a ceiling on the sales
price for esrogim for use on Succos.
Call to Action
It is our opinion that in order to improve the health of the community and
demonstrate that protecting one’s life and health is as important as protecting
one’s money, the Torah Sages of our age—and other poskim who have not already
done so—should consider issuing proclamations, and publicize them widely, that
include the following points:
• It is their strong advice (eitzah tovah) that men and women stop smoking, or
not start;
• It is imperative that Rebbeim (Rabbis) not smoke in class or in other public
venues; and
• Yeshivos and seminaries must encourage, and provide time in their curriculum
for, regular exercise and menus featuring healthful food.
In our view, Rebbeim should issue a “call to health” from their pulpits and
shtenders for boys and girls and men and women to not only “guard your tongue” (mishmeres
lashon) but also to “take care of your body” (mishmeres guf).
Quotes on
Health