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1 AnsweR

In Tractate Yoma (83a) it states: If the patient claims that he needs
to eat on Yom Kippur but the physician says he does not need to eat,
we listen to the patient because “the heart knows the bitterness of the
98 A NON-DANGEROUS soul” (Mishlei 14:10). The Shulchan Aruch (Orach Chaim #618:1) rules
DISEASE THAT MAY
likewise. The Shiltei Gibborim asks in Tractate Shabbos (Ch. 18, p. 144b
#
DEVELOP INTO A
in the pages of the Rif :2): Does this apply only in reference to eating
DANGEROUS DISEASE
on Yom Kippur? What about if the patient complains of pain in a
specific organ and claims he is in danger and one should desecrate
Shabbos for him? If the physician feels there is no danger, do we also 9
say that “the heart knows the bitterness of the soul,” and pay heed to
the patient’s words?
1 Question The Bi’ur Halacha (#328:10, s.v. verofe) states three general princi-

pals about the matter:
A patient is not currently in danger, but his disease is liable to develop
into something that can endanger his life. Is he allowed to eat on Yom 1. If the patient claims to feel weakness in a specific organ or limb,
Kippur and to desecrate Shabbos in order to be healed and prevent and requests a certain medication that is beneficial for that
the danger from occurring, or, since at the moment there is no actual illness, we certainly pay heed to his request. The dictum that
danger, is he prohibited to do these transgressions? “the heart knows the bitterness of the soul” applies in this case.
Therefore, even if the physician says there is no need for the
1 AnsweR medication, we still administer it.
2. If the disease is well-known and there is no dispute about how
The Iggros Moshe writes (Orach Chaim, Vol. 3 #91): A patient who to treat it, then if the physician says that a certain medication
is not in danger, but is liable to become endangered, is permitted to will not help, we abide by his opinion even if the patient feels
swallow pills with water on Yom Kippur in order to be healed, if he otherwise. It is most probable that the physician is a greater
cannot swallow the pills without water. Since if he is not healed, he expert on the topic.
will be in danger, his present disease is already viewed as dangerous.
Proof for the above is in Tractate Avodah Zarah (28a) where the 3. If the patient knows the nature of his body to be healed by a
Gemara wants to prove that diseased gums and teeth are viewed as specific medication, while the physician disagrees, perhaps one
an internal wound, for which one desecrates Shabbos, based on the should heed the words of the patient. This is because it is prob-
disease called tsafdina. The Gemara rejects this proof, since tsafdina able that a person is more of an expert on his own body than
is a disease which begins in the mouth but ends up in the intestines. one-hundred physicians.
This seems to indicate that although the disease at present is only in My father-in-law, Rav Y. S. Elyashiv zt”l, believed that the words of
the gums and teeth, it is considered a dangerous illness because it will the Bi’ur Halacha were only referring to a situation where the patient
end up affecting the intestines. complains of pain in a specific organ and the physician does not find

250 1 Medical-HalacHic Responsa of Rav ZilbeRstein Physician discounts possible danger of back-pain 2 267