Of מקרה and Medicine

My weekly halachah column for this past parashas Behukosai:

Parashas Bechukosai begins with Hashem’s promises that if we obey His statutes and commandments, He will bestow upon us all manner of worldly good fortune. The Ramban (26:11) explains that when the Jewish people conduct themselves worthily, “their affairs will not be arranged by nature at all … and He will remove all disease from their midst, to the extent that they will not need a physician”. He goes so far as to declare that “one who seeks Hashem via a prophet will not seek physicians”, and that the practice of the righteous in the era of prophecy was to consult solely prophets, and not physicians, when they fell ill.

The Rambam (Commentary to the Mishnah, Pesachim 56a) seems to vehemently reject this perspective. He argues that one who consumes bread as a remedy for his hunger is surely not guilty of any lack of reliance upon Hashem! Just as we acknowledge and thank Him when we eat for providing us with our sustenance, so, too, do we do so when utilizing medical remedies. [In a similar vein, the Akeidas Yitzchak (#26) sharply critiques the view of the Ramban as theologically unsound, but see Michtav Me’Eliyahu (Part 3 pp. 170-73) who argues that the Rambam and the Ramban do not actually disagree, but are referring to people on different spiritual levels.]

Furthermore, the Ramban himself elsewhere (Toras Ha’Adam, Sha’ar Ha’Sakanah) expresses a much more positive view toward the practice of medicine, declaring that anyone knowledgeable in this field is obligated to practice, “and if he refrains, he is a murderer”.

The consensus of later authorities is that the Ramban’s comments to our parashah notwithstanding, in our generation “it is virtually a strong obligation upon the ill individual and his relatives” to seek medical treatment, and those who decline to do so but simply rely upon Hashem to deliver a miracle are misguided and sinful (Shevet Yehudah (Ayash) Yoreh De’ah beginning of #336). Of course, the medical treatment should be accompanied by fervent prayer (Birkei Yosef ibid. #2, and cf. Shut. Tzitz Eliezer Vol. 5 Ramas Rachel 20-2).

[We have previously discussed this topic here.]

My weekly lecture for Behukosai discussed the general question of the scope of individual Divine Providence and the possibility of the existence of מקרה – random, meaningless occurrences. [We have previously discussed this topic here, and see also here.]

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