Sunday, February 5, 2012

So much for Shabbos Shirah

We put out a bird-feeder bell before Shabbos, as part of our Shabbos Shirah celebrations. No birds braved the freezing cold over Shabbos, but we had hopes for the rest of the week...

...Until just now, when I heard a thump outside and got this picture:



Those are evil-looking eyes.

I don't suppose raccoons ate the manna left out on Shabbos by Dasan and Aviram?

Now that we're discussing Shabbos Shirah and leaving food for birds, here's a halachic note on the subject:

May I feed wild birds on Shabbat Shirah?

There is an old custom of leaving grain or bread for birds on Shabbat Shirah. Some suggest it is a reward for their song at the Sea; others link it to the way the birds ate the false manna dispersed by Dasan and Aviram on Shabbat.

Some oppose this practice, insisting that food be left out before Shabbat. This is because the sages forbade feeding wild animals on Shabbat (1) because there may be strain involved and (2) because one might forget the laws of Shabbat and trap these creatures. They permitted only feeding domesticated animals which depend on us for food.

Other authorities defend the practice of putting out food on Shabbat Shirah, arguing that there is no strain involved and that the birds are beyond trapping when the food is placed outside. Further, we are doing it not for the birds' sake, but for the sake of our own custom.

(Maharam Lublin to Beitzah 23b; Magen Avraham 324:7; Tosefes Shabbos 324:17; Mishneh Berurah 324:31; Aruch haShulchan Orach Chaim 324:3; Tzitz Eliezer 14:28)

Saturday, February 4, 2012

Refusing medical treatment

This week I'll be presenting a campus Medical Ethics class on "May a patient refuse medical treatment?" We'll talk about:
  • The Torah's license to heal and whether that obligates patients to seek healing;
  • The arguments in favor of compelling a person to pursue certain activities, and against;
  • The question of whether a patient is required to trust a doctor who prescribes a given treatment.

Here's the source sheet. Of course, there are many more sources to consider, but this is a relatively quick "lunch and learn" session:

Cases

A. Jim, 25, is in a car accident. A large vein in his leg is severed, and Jim loses a great deal of blood. Jim's religious beliefs prohibit blood transfusions. Is Jim entitled to refuse the transfusion?

B. Susan, 89, has emphysema, cataracts, dementia and trigeminal neuralgia, and is diagnosed with Stage 2 breast cancer. Her doctor says the tumor is treatable with chemotherapy. Is Susan entitled to refuse the cancer treatment?

C. Jason and Sally have a 6 year old son who is scheduled to have a tetanus vaccination, but they have heard that vaccines are dangerous. Are they entitled to refuse the vaccination on behalf of their son?

Physicians are permitted to heal

1. Talmud, Berachot 60a

אמר רב אחא הנכנס להקיז דם אומר יהי רצון מלפניך ד' אלקי שיהא עסק זה לי לרפואה ותרפאני כי אל רופא נאמן אתה ורפואתך אמת לפי שאין דרכן של בני אדם לרפאות אלא שנהגו אמר אביי לא לימא אינש הכי דתני דבי רבי ישמעאל ורפא ירפא מכאן שניתנה רשות לרופא לרפאות

Rav Acha said: One should recite the following prayer when he enters to have his blood let: “May it be Your will, my Gd, that this activity should be a cure for me and heal me, for You are a faithful healer and Your healing is true. It is not the way of humans to heal; it is simply what we do.”

Abayye said: One should not say this, for we have learned from the yeshiva of Rabbi Yishmael, “The Torah says ‘and heal him,’ from which we learn that the doctor is given permission to heal.”

2. Ramban, Torat haAdam, Illness: Danger

ומסתברא דהא דאמרינן נתנה רשות לרופא לרפאות לומר שאינו אסור משום חשש השגגה. א״נ שלא יאמרו הקב״ה מוחץ והוא מרפא שאין דרכן של בני אדם ברפואותאלא שנהגו... האי רשות רשות דמצוה הוא לרפאות ובכלל פקו"נ הוא

"The Torah gave the doctor permission to heal" means that healing is not prohibited due to concern for error. Alternatively, it is lest people say that Gd strikes and this person comes to heal, and that it is not the way of humans to heal, but simply what we do… This permission is a mitzvah, for it is a mitzvah to heal and it is part of saving lives.

Am I obligated to go to a doctor, or not?

3. Ramban to Vayyikra 26:11

והכלל כי בהיות ישראל שלמים והם רבים, לא יתנהג ענינם בטבע כלל... עד שלא יצטרכו לרופא ולהשתמר בדרך מדרכי הרפואות כלל, כמו שאמר כי אני ד' רופאך. וכן היו הצדיקים עושים בזמן הנבואה...

The principle is that when the Jews are complete, the laws of nature will not govern them at all… They will not need a doctor and will not need to be careful about therapeutic activities at all, as it is written, ‘For I am HaShem your healer.’ And so the righteous did in the prophetic era…

Am I obligated to follow the doctor's advice?

4. Talmud, Bava Kama 90b

החובל בעצמו אף על פי שאינו רשאי - פטור, אחרים שחבלו בו - חייבים

Although one who illegally harms himself is exempt from liability, others who harm him are liable.

5. Shulchan Aruch Orach Chaim 618:1

חולה שצריך לאכול, אם יש שם רופא בקי אפילו הוא עובד כוכבים שאומר: אם לא יאכילו אותו אפשר שיכבד עליו החולי ויסתכן, מאכילין אותו על פיו... אפילו אם החולה אומר: אינו צריך, שומעים לרופא

If a patient needs to eat, and an expert doctor – Jewish or not Jewish – says that without eating his illness may worsen and he may be endangered, we feed him… Even if the patient denies needing it, we listen to the doctor.

6. Shulchan Aruch Choshen Mishpat 3:1

אין בית דין פחות משלשה. וכל שלשה נקראים בית דין, אפילו הדיוטות... והם דנים את האדם בעל כרחו

There is no such thing as a court of fewer than three judges; any set of three, even untrained people, are a court… and they can judge a person against his will.

7. Talmud, Sanhedrin 73a

מנין לרואה את חברו שהוא טובע.. שהוא חייב להצילו תלמוד לומר לא תעמד על דם רעך והא מהכא נפקא מהתם נפקא אבדת גופו מניין תלמוד לומר והשבתו לו אי מהתם הוה אמינא הני מילי בנפשיה אבל מיטרח ומיגר אגורי אימא לא קא משמע לן

How do we know that one must save a person he sees drowning…? The Torah teaches, "You shall not stand by the blood of another." Isn't that "And you shall return it to him," which refers to loss of his body? That would only require doing it personally, but it would not require hiring someone to help.

8. Shulchan Aruch Choshen Mishpat 261:4

המאבד ממונו לדעת אין נזקקין לו

One need not aid a person who destroys his own property knowingly.

9. R' Yaakov Emden, Mor uKetziah Orach Chaim 328

ועוסק בתרופה בדוקה וגמורה ודאי לעולם כופין לחולה המסרב במקום סכנה בכל ענין ואופן שנתנה תורה רשות לרופא לרפאותו, כגון לחתוך בשר חי שבמכה... אפילו בנטילת אבר (כדי להצילו ממות)... ומעשין אותו בעל כרחו משום הצלת נפש, ואין משגיחין בו אם הוא אינו רוצה ביסורין ובוחר מות מחיים אלא חותכין לו אפילו אבר שלם, אם הוצרך לכך למלטו ממות

One who practices tested treatments definitely forces a recalcitrant patient, in a case of danger, to undergo any treatment licensed by the Torah in its permission to heal, such as cutting raw flesh from a wound… or even removing a limb to save his life… And we force him against his will to save his life. We do not pay attention to his refusal of pain and his choice of death over life; we cut even a whole limb if this is necessary to save him from death.

10. R' Meir Simchah haKohen, Meshech Chachmah to Shemot 24:3

לכוף ולרדות על חוקי התורה ונדריה הוא רק מצד ש'כל ישראל ערבים זה בזה', ואם יעבור אחד, הוא מזיק לחבירו ולהכלל כולו. בזה יש לבית דין לכוף ולשפוט העובר את מצות ד' יתברך, דבלא זה אין זה מהראוי שיתערב אחד במה שיש להאדם עם קונו

Compelling people to follow Torah is a product of 'All Jews are responsible for each other'; one who would violate the law would harm others and the entity as a whole. Then the court should compel and judge one who violates Gd's commands. Otherwise, it would be inappropriate to intervene in another's relationship with his Creator.

11. Talmud, Sanhedrin 84b

בן מהו שיקיז דם לאביו רב מתנא אמר ואהבת לרעך כמוך

May a son let blood to treat his father? Rav Matna said: "Love your neighbour as yourself."

12. R' Yaakov Emden, Mor uKetziah Orach Chaim 328

נ"ל דווקא כשרוצה למנוע מהשתמש ברפואה הוודאית (אף הסתמית ע"י רופא מומחה כוודאית חשיבא)... אבל אם נמנע מפני שאינו מחזיקה לרפואה בדוקה אפילו מדעת עצמו בלבד, כ"ש אם מסייעו רופא אחד... אין כופין, וכ"ש אם חושש הוא שמזקת לו אותה טרופה שסידר לו הרופא האומר צריך... רק בחולי ומכה שבגלוי שיש לרופא ידיעה ודאית והכרה ברורה בהם ועוסק בתרופה בדוקה וגמורה

It appears to me that [we compel] only where he wishes to refrain from a definite treatment – and the default assumption regarding an expert doctor is that his treatments are 'definite'… But if he refuses because he doesn't think the cure is tested, even on his own say-so and certainly if another doctor agrees, then we do not compel him. This is certainly true if the patient is concerned that the treatment may harm him… And [we compel] only for a revealed illness or wound, where the doctor has definite knowledge and clear comprehension and is using a tested treatment…

13. R' Yaakov Emden, Mor uKetziah Orach Chaim 328

אבל יש שבוחרין בספק נפשות כדי להציל עצמן מיסורין קשין כאותן שמוסרין עצמן לחיתוך מפני אבן שבכיס ובגיד וחצץ הכליות הכואב אותן מאד בצער קשה כמוות ר"ל. ולאלה מניחין אותן לעשות כחפצם בלי מוחה, מחמת שכמה פעמים נושעים ונרפאים.

Some choose to endanger their lives in order to avoid great pain, like those who undergo surgery for a kidneystone… which pains them like death. They may do so without protest, for they are often saved and healed.

14. R' Shlomo Zalman Auerbach, cited in Nishmat Avraham 2 pg. 47-48

אין לבצע ניתוח כזה נגד רצונו של החולה (או אפילו לנסות לשכנע אותו להסכים לניתוח) כיון שמדובר כאן בניתוח גדול ומסוכן שרק יוסיף לסבלו של החולה בלי סיכוי כל שהוא לחיי עולם.

One may not conduct such a surgery against the patient's will, or even try to convince him to agree, since this is a great and dangerous surgery which will only add to his suffering without any chance of restoring 'eternal' life.

Thursday, February 2, 2012

The Kaddish Rules

[This is my article from this week's edition of Toronto Torah]

On its most basic level, the chazzan's kaddish is a call for the Name of G-d to be elevated, to which we respond with a similar blessing of the Name of Gd. However, our davening is dotted with "half" and "whole" versions of kaddish (aside from the mourner's own varieties of kaddish, which we will not address in this article). What rule determines where the chazzan recites kaddish?

The half-kaddish, also known as "chatzi kaddish", is the basic kaddish, and its role is to separate the various mitzvot we fulfill in the course of our davening. (Raavad, cited in Beit Yosef Orach Chaim 55)

At Shacharit:
The chazzan recites a chatzi kaddish after Yishtabach to show that the preceding paragraphs do not connect to the ensuing amidah, and then another after the amidah to show that the amidah is complete. [The latter chatzi kaddish is delayed until after tachanun because tachanun is meant to be an extension of the amidah.]

An additional chatzi kaddish is recited after the Torah reading on days when we read from the Torah, in order to demonstrate that this Torah reading is a separate mitzvah.

Shema is not followed by a chatzi kaddish to demarcate its separate identity, because this would disrupt the required continuity between Shema and the amidah.

At Minchah:
A chatzi kaddish before the amidah at Minchah demarcates this special mitzvah.

An additional chatzi kaddish precedes the Torah reading on days when the Torah is read, for the same purpose.

At Maariv:
A chatzi kaddish precedes the amidah to identify it as a unique mitzvah. Mateh Moshe 388 notes that this also demonstrates that the amidah at Maariv need not be connected to Shema and the preceding passages describing our redemption from Egypt.

A chatzi kaddish follows the amidah after Shabbat, to mark the amidah as separate from the readings (V'Yhi Noam, v'Yiten Lecha) which follow it.


The whole kaddish, also known as "kaddish shalem", is meant to conclude our formal prayer with its "Titkabel" request that HaShem accept our prayers (Terumat haDeshen 15). Therefore, the chazzan recites kaddish shalem after Uva L'Tzion at the end of Shacharit, and at the end of Minchah and Maariv. When there is Musaf, this kaddish terminating Shacharit appears after Hallel. [When Hallel is recited but there is no Musaf, such as on Chanukah, kaddish shalem is recited in its normal location after Uva L'Tzion, and the chatzi kaddish for the end of the amidah is recited after Hallel.]

What is the role of the listener? Rav Yosef Karo (Beit Yosef Orach Chaim 55) noted that we try to respond to at least seven recitations of kaddish each day, to fulfill King David's declaration, "I have praised You seven times each day." Per Rav Moshe Isserles (Orach Chaim 25:13), we should make sure that our tefillin are on when responding to four recitations of kaddish on weekday mornings, although others contend that the text should read "three recitations" (Magen Avraham 25:28, Mishneh Berurah 25:56). These quotas include recitations of the Mourner's Kaddish.

Tuesday, January 31, 2012

Wanted: An Experimental Yeshiva

No, that title is not meant the way it may sound.

My father likes to note Rashi to this week's parshah (Shemot 16:14), in which he offers a science experiment: If one fills an eggshell with dew, seal her and leave her in the sun, she will rise independently into the air. Based on the pronouns, it certainly seems that Rashi meant the shell would ascend, presumably as a function of the dew's ascension.

Here is the Rashi:
כשהחמה זורחת עולה הטל שעל המן לקראת החמה, כדרך טל עולה לקראת החמה, אף אם תמלא שפופרת של ביצה טל, ותסתום את פיה ותניחה בחמה, היא עולה מאליה באויר. ורבותינו דרשו שהטל עולה מן הארץ באויר, וכעלות שכבת הטל נתגלה המן וראו והנה על פני המדבר וגו':
[For an interesting aside on Rashi's language, see here.]

I was thinking about this the other day, when contemplating experiments yeshivot could perform in order to understand gemara better. Many passages of gemara rely on familiarity with physical realities we don't normally encounter, and these experiments would help us understand what the Rabbis were discussing.

To put it differently: Imagine learning Maseches Succah without ever having seen an esrog before, or Maseches Chullin without the benefit of seeing a cow, or the various modern picture books which illustrate the innards of a cow. It's inconceivable – but that's the way our yeshiva students learn much of the Talmud, including segments which relate to daily ritual. So here are some experiments they could conduct, which would help:

For Maseches Berachos and the discussion of the earliest time for Shma – Go to a place far from urban light pollution, on a clear night, 90 minutes before sunrise, and watch the morning lighten. Set up black, green, blue and white strips of paper, and see when you can discern the difference between them. Time how long the sun takes to cross the horizon.

For Maseches Shabbos and the thresholds of cooking (Maachal Ben Derusai) – Cook a piece of meat 1/3 of the recommended time and test its edibility. Do the same at 1/2 of the recommended time.

For Maseches Pesachim and the discussion of which plants become chametz and which do not – Get wheat and barley kernels, as well as grains of rice, grind them up and expose them to water. Watch what happens, and how long it takes.

For Maseches Beitzah and discussions about the muktzeh status of fruit that has been left to dry, as well as for various halachic discussions which revolve around dried figs – Leave grapes and figs in the sun, and monitor the process as they dry out. Test them for edibility at various stages.

For Maseches Rosh HaShanah and discussions about testimony regarding the sighting of the new moon - Take a field trip on a clear night at the end and start of the lunar month and make observations of the shape and location of the moon.

For Maseches Bava Kama and discussions about tort law and harm caused when items fall into a pit which is ten tefach deep - Dig a pit that deep and experiment dropping various items in.

For Maseches Niddah and the discussion of kesamim (stains which may be blood, but might not be) – Crush lice and examine the quantity and color of the blood produced.

There is much more to do, of course; this is just a start. Some may be more useful, some of more narrow benefit, but this might make the learning experience more 'real' for some students, as well as help them grasp the concepts involved. Some of this is tongue-in-cheek, but not all of it.

Sunday, January 29, 2012

40: The Age of Limits

[This month's Kosher Cooking Carnival is here; enjoy]

40 is coming, in just a few weeks.

This development brings with it many different emotions, on many different levels, but one stands out for me: A sense of limits. Not depressingly, just realistically.

All of us have limits, of course, from the start of our lives, but as we get older and hit certain stages, key limitations become obvious and cannot be ignored. This birthday is drawing my attention to them.

We encounter llimits in terms of mortality. This varies from person to person, but we hit gray hair, no hair, reading glasses, a bad back and muscle pain, etc.

We encounter limits in terms of career. We realize we won't go as far as we had wanted, or enter new careers that we had always hoped to join.

We encounter limits in terms of growth. We recognize we're not going to get around to learning Mandarin, or getting a really good handle on materials sciences, not because we have too little time left but because we can see how our lives are going and how we make our decisions.

And so on.

The gemara (Avodah Zarah 19b) identifies the age of 40 as the minimum age for offering serious psak [legal rulings], or, as the Beis Yosef (Yoreh Deah 242) renders it, the deadline past which a capable person may not stall offering serious psak. What is so special about 40? Why isn't it a matter of what you have learned, as opposed to the years you have lived?

I posed the question in a recent class, and one person said it's because people will listen to you at 40. Another suggested this is an age when one has had life experiences which prepare him to handle a situation properly. Another suggested that people are more stable and responsible at this stage in life.

These are all valid answers. I wonder, though, if it isn't also that by the age of 40 one is forced to accept a certain humility, in the awareness of his limitations.

Interesting.

Thursday, January 26, 2012

Burning your sink?

Last night, during a shiur on common Kashering questions, I was asked about a unique method of kashering a sink. My sense is that this approach does NOT work... but it does sound entertaining.

Normally, we kasher a sink by heating water to a high boil, and then pouring it all over the surfaces of the sink. Some authorities also place a heated stone on surfaces of the sink while pouring the water, because the water cools off between the time it leaves the pot or kettle and the time it strikes the sink's surface. The process is tedious and messy.

So the new method (new to me, anyway) is this: Spread brandy or whiskey over the surfaces of the sink, and light it on fire. Essentially, flambe the sink.

Definitely a guy's way to kasher.

Again, my impression is that this does NOT work, from a kashrut perspective; as I understand it, the heat from this fire is directed outward, and the material beneath the alcohol layer is not heated. [Watch the video I linked on "flambe" above; the crepe certainly doesn't show any sign of singeing. On the other hand, perhaps it does get hot enough to reach the level needed for kashering.]

Have you heard of this? From a reputable source?

Tuesday, January 24, 2012

Moshe's death begins again

I write the post below 4 years ago, as a reaction to Parhas Shmos. It still rings true for me, on many levels.

I cannot stand Parshat Shmot. I fear reading it. It drives me berserk – and especially this year.

Call this hubris, but I overly identify with Moshe Rabbeinu. It’s because of my field of work, it’s because I love his “I can’t stands no more!” declaration to Gd in Bamidbar (Numbers) 11:11-15, it’s because I was born on his birthday (the 7th of Adar)… his struggle just resonates with me.

In particular, I am struck by the way Moshe is stopped at the goal line, blocked from entering Israel after putting himself through 41 years of absolute Gehennom to get there. This man exposed himself to hatred and ridicule, slaved day and night for a nation that often rebelled against his leadership, separated himself from his family, braved the mighty Pharoah and defeated Amalek and fought wars against Emorite kings, you name it – and G-d would not allow him to enter Israel. Sorry, no entry.

Of course, Moshe didn’t complain; after his appeal was rejected, he still did everything he was told to do, up to and including dying. What an outsized tzaddik we’re looking at here.

It all starts in Parshat Shmot, at a time when Moshe would give anything not to have to take this job. He doesn’t want the power, he doesn’t want to lead, he doesn’t want anything other than to be a simple Jew, but Gd won’t take no for an answer.

“They won’t believe me.” No. “Send someone else.” No. “Pharoah won’t listen.” No. “I don’t speak well.” No. You’re taking this job, Moshe, end of discussion.

And he takes the job. And Gd tells him Aharon will help him out, and Gd gives him a staff to use to engineer miracles, and Gd tells him, “Don’t worry, Moshele, it’ll be all right.”

And so the clock starts on Moshe's death.

“MOSHE, IT’S A FRAUD!” I want to yell at him as I read the parshah. "It’s not true, Moshe, run the other way! You’re going to spend the next forty-one years doing this, only to be prevented from reaching your goal! Turn around while there’s still time!"

But he doesn’t. He picks up the staff and heads to Egypt, expecting that Gd will be there with him every step of the way. Which Gd will be – until the cruel end of the story, when Moshe will be given one last order: Sure, you can go up the mountain and see Israel. Then Die.

This has been the story for so many Jewish leaders; so many well-meaning, committed rabbis and community leaders have given their lives for this stubborn nation, only to perish short of the mark. I know; I’ve buried some of them.

And this year, the story has special resonance for me. As I think about taking a new job, in a new community, where I am told by so many people that I could lead and accomplish great things, I wonder: How far short of my own mark will I die and be buried?

[Note, as I said at the start: I wrote this post 4 years ago, at a time when it became clear I was going to be taking a new position. This is not relevant now!]

But I am comforted by two points:
1. True, Moshe dies short of the mark – but he has a great ride along the way. He speaks to Gd. He rescues the Jews from Egypt. He wins wars. He teaches a nation the way of Gd.

2. And, of course, Moshe must die short of the mark, and this is perhaps his greatest lesson for leaders. Moshe must die short of the mark because the sign of a great leader is that he always has a ‘mark’ in front of him: When he achieves one goal, he sets the next.
Moshe takes the Jews out of Egypt; time to go to Sinai. He reaches Sinai, time to get the Jews on the road to Israel. He gets the Jews on the road, time to teach them the Torah. His life is one long string of Dayyenus, and it never ends because it never can end.
The true Moshe will always die short of the mark, because there will always be another mark, drawing him forward.