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Rather, she herself has decided that unless her request for an abor-
tion is fulfilled she will commit suicide. How do we know that even
such a situation is considered piku’ach nefesh which sets aside Torah
prohibitions?

Now, were this young woman to be classed as a shotah [imbecile]
and mentally deficient, it would be permitted to perform the abortion.
So we learn in the Magen Avraham (554:8): “A mentally impaired in-
dividual who is improving daily is allowed to eat meat and drink wine
during the week of Tisha B’Av and should not fast on Tisha B’Av be-
cause fasting entails a risk of danger for him.” The Pri Megadim adds
that not only is he allowed to eat on Tisha B’Av [which is a rabbinic
fast] but whenever there is danger that by fasting he might relapse
into his former state of idiocy he should not even fast on Yom Kippur
because an imbecile is liable to kill himself or others and is therefore
considered a dangerously ill patient.

The same response can be found in responsa Chavalim Bane’imim
(4,13):“A shoteh who is on the road to recovery but fasting will trigger
a relapse into his state of imbecility, is exempt from fasting because
mental derangement is included under the rubric of piku’ach nefesh.”
The author of Teshuvos Pri Haaretz (Yoreh De’ah 3, 2) was asked
about the case of a Jew who had lost his mind to the point where
he had to be restrained with iron chains. Someone then said that a
remedy for the condition was to take a dead hen i.e. a carcass, to cook
it and feed the patient the broth. This was a well known, tried and
tested remedy that had been used on a similar patient who had been
cured. The beis din of Salonika ruled that it was permitted since the
shoteh is considered to be in mortal danger and the cure was known
[in those days]. This ruling is also cited in the sefer Shiurei Berachah
(Yoreh De’ah 155,3) and is also evident from the gemara in Taanis
(22b): “The Rabbis learned…‘A person being pursued by gentiles, by
robbers or by an evil spirit, in all these cases [he] is allowed to afflict
himself by fasting.” Rashi writes: “‘By an evil spirit’ means that the
spirit of a demon entered him and he is running and walking, lest he
drown in a river or fall and die.”

So too writes the Igros Moshe (Even Ha’ezer 1,65): “…If the physi-

352 1 Medical-Halachic Responsa of Rav Zilberstein