The Torah’s Position on Proactive Medicine

Medical Intervention in the Torah – Part 1

This week’s double parsha, Tazria-Metzora, provides an excellent introduction into the Torah’s perspective on doctors. It should disturb us, but not surprise us, that the Torah’s perspective is quite different from what is generally accepted today. This leaves two options for those who desire at least the pretense of following the Torah: contort the Torah to support our desired outcome (what most people do), or recalibrate our perspective (what winners do).

Those with suspected cases of tzora’as are commanded to consult not a dermatologist, but a Kohen. The treatment for this skin disease is spiritual rehabilitation. Not only that, it is forbidden to cut out or deface the affected skin to circumvent the purification process (Devarim 24:8). One who violates this prohibition may well sabotage his chances of ever becoming pure (see Rambam Hilchos Tum’as Tzara’as Chapter 10).

The naysayers are already gearing up to argue that this is an exceptional case, and we cannot compare it to natural illnesses. The naysayers had best be still. While it is true that tzora’as is a spiritual-based illness from start to finish, it is also true that every illness has a spiritual cause. In fact, everything has a spiritual cause and effect. The fact that the Torah permits – and even, to a certain extent – obligates us to pursue physical treatments for other illnesses does not negate the fact that the root cause of both the illness and the healing is spiritual.

Chazal teach that in the olden days people did not normally become sick. When their time in this world was up, they would suddenly drop dead without warning. Yaakov asked Hashem to make people ill for two or three days before they died, in order that they should be able to settle their affairs. Hashem was pleased by this request, and started with Yaakov himself. Until the time of King Chizkiyahu, people did not become seriously ill and then recover (Bereishis Rabba 65:9).

The Maharzu notes the apparent discrepancy with Elisha, who lived earlier, becoming ill on three separate occasions, and explains that recovery from illness did not become an established norm until Chizkiyahu’s time.

The Yefeh To’ar similarly explains that the illnesses of Avimelech and his household centuries earlier were special divine decrees to chastise them. However, people did not become ill in the ordinary course of affairs until much later. He further explains that the medical intervention referenced in the Torah in Shemos 21:19, “ורפא ירפא”, refers to injuries, not illnesses affecting the entire body. This view is echoed by the Ibn Ezra on that pasuk.

This distinction is critical for understanding the Torah’s perspective on medical intervention. Illnesses are portrayed throughout Tanach as the direct effect of a spiritual cause, which can therefore only be healed through spiritual intervention. There is not a single case in Tanach of a doctor curing an illness. At best their services were complementary, but they had no power to heal without divine assistance, which the patient was expected to seek. Failure to seek God in a time of illness is a sin, which compounds the original spiritual cause of the illness itself (see Divrei Hayamim II 16:12).

The doctor’s position in the Torah is quite marginal, which stands in stark contrast to the vaunted position of doctors in later times to this day. The role of a doctor in the Torah is to facilitate healing from injuries, offer guidance on healthy living, tend to the sick, and provide proven remedies for illnesses when possible.

The Kli Yakar on Parshat Metzora 14:4 writes as follows:

לפי ששמירת הבריאות אינו צריך סם רק שהרופא מלמדו להועיל שיהיה נשמר מן הדברים המזיקים שלא יבא לידי חוליאבל מי שכבר נפל אל החולי אז הוא צריך לסמים

To guard one’s health there is no need for a drug, only that the doctor should teach him positive measures so that he can protect himself from the things that cause harm, in order that he should not become ill…but one who has already fallen ill, then he has a need for drugs.

The “drugs” referenced here and in other sources are almost invariably natural remedies, with some unusual exceptions found in the Gemara. Although we have become used to artificial drugs in recent generations, and I am not suggesting we eliminate modern drugs, we should nevertheless recognize that this method of treating illness is a radical departure from everything the human race knew and learned from time immemorial. In light of this, it is absolute madness to rush headlong into any artificial treatment that has not been thoroughly proven, unless in truly extreme circumstances.

The Kli Yakar makes a point that is desperately needed in our time: A healthy person has no need for drugs, only for guidance on maintaining a healthy lifestyle. The notion of injecting a perfectly healthy person with an artificial drug – all of which have side effects and can cause severe harm – to prevent a potential illness would have been unthinkable.

Granted, the technology did not yet exist, but the Torah’s perspective on medical intervention is reactive, not proactive. Even reactive intervention needed to be explicitly permitted by the Torah (Bava Kama 85A). We have a hands-off policy until otherwise demonstrated, and leave it to God to bring healing without drugs getting in the way, which they so often do. (See https://www.sefaria.org.il/sheets/26290?lang=bi, where some of the previous sources and others on the subject can be found.)

The claim that the Torah obligates the healthy masses to inject themselves and their children with artificial drugs as a proactive medical treatment is an incredible stretch. The Torah’s default position is that proactive medical interventions, with the risks they necessarily entail, are forbidden until proven otherwise. Even reactive interventions must be proven through transparent, thorough, unbiased studies, and have benefits that clearly outweigh the risks. Speculation, even by those with plaques on their walls, is no substitute for this.

In light of this, how can anyone declare that healthy people must undergo experimental gene treatments, especially with all the doubts and obfuscation surrounding the illness they are intended to alleviate – not even prevent – and with safer alternative treatments available? I defy them to provide clear Torah sources that even permit this, let alone obligate this for everyone or anyone. The general instruction to “guard our lives” is hardly a halachic argument, let alone one that favors this radical position. On the contrary, it is a clear warning to refrain from dubious medical treatments on healthy people that offer minimal, highly speculative benefits at best.

(In part 2 I will discuss Chizkiyahu’s illness, the book of cures that he hid away, and the implications for our views on doctors and medical intervention.)

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