Halachaהלכה

Maimonides on Physicians' Duties and Life-Saving

Maimonides establishes the physician's religious and legal obligation to preserve life, remove dangers, and provide care even when it requires violating other commandments. His rulings ground medical ethics in the biblical duties to save the endangered and refrain from enabling harm, and clarify that medical oaths hold no halachic force when they conflict with Jewish law.

כָּל הַיָּכוֹל לְהַצִּיל וְלֹא הִצִּיל עוֹבֵר

9 sources · 7 verified

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What the sources say

The most direct answer comes from Sefer Puah (Family and Purity IV, Laws of Medical Examination 23:116), which rules that the physicians' oath has no status as a halachic oath, so it creates no barrier to disclosure when there is a halachic reason to reveal information, and any such commitment is void to the extent it contradicts halacha.

Tzitz Eliezer (16:4) applies this directly to a concrete case: a physician must disclose a prospective bride's major reproductive deficiencies to the prospective groom even without being asked and despite her request for confidentiality, because withholding the information violates the prohibition of standing idly by another's blood and prevents rescuing someone from harm; he takes up whether the physicians' general oath of confidentiality requires formal annulment before such disclosure, concluding that the disclosure is at least permitted and likely obligatory.

This conclusion rests on the broader duty articulated in Mishneh Torah (Murderer and the Preservation of Life 1:14), that one who can save another and fails to do so transgresses "lo ta'amod al dam re'echa," a duty extended in Mishneh Torah (Murderer and the Preservation of Life 11:4) to an affirmative obligation to remove any hazard to life, and in Mishneh Torah (Murderer and the Preservation of Life 12:14) to the prohibition against giving someone improper guidance or placing a stumbling block before one who cannot see the truth.

Mishneh Torah (Sabbath 2:1) shows the weight given to a physician's medical determination in halacha, ruling that Shabbat is set aside for a dangerously ill patient on the word of a local expert physician, and even on the word of one physician against another's dissent, because any doubt about danger to life overrides Shabbat.

Igros Kodesh (letter 6244) likewise invokes the Rambam's teaching and the verse "Venishmartem me'od lenafshoseichem" to press someone refusing medical advice to consult and follow a physician's counsel, underscoring that halacha expects deference to medical guidance rather than disregard of it.

Modern poskim have addressed this question directly, and our research indicates that Tzitz Eliezer (16:4) is relevant.

Source 1 · Rishonim
Verified

Mishneh Torah, Sabbath 2:1

משנה תורה, שבת פרק א א והלאה פרק ב א, וראה שם עוד

Mishneh Torah, Sabbath 2:1

Rambam states that Shabbat is overridden by danger to life, so all necessary care is provided on Shabbat based on a local expert physician’s judgment, and even uncertainty or disagreement between physicians warrants violating Shabbat.

דְחוּיָה הִיא שַׁבָּת אֵצֶל סַכָּנַת נְפָשׁוֹת כִּשְׁאָר כָּל הַמִּצְוֹת. לְפִיכָךְ חוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה עוֹשִׂין לוֹ כָּל צְרָכָיו בְּשַׁבָּת עַל פִּי רוֹפֵא אֻמָּן שֶׁל אוֹתוֹ מָקוֹם. סָפֵק שֶׁהוּא צָרִיךְ לְחַלֵּל עָלָיו אֶת הַשַּׁבָּת סָפֵק שֶׁאֵינוֹ צָרִיךְ. וְכֵן אִם אָמַר רוֹפֵא לְחַלֵּל עָלָיו אֶת הַשַּׁבָּת וְרוֹפֵא אַחֵר אוֹמֵר אֵינוֹ צָרִיךְ מְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת שֶׁסְּפֵק נְפָשׁוֹת דּוֹחֶה אֶת הַשַּׁבָּת:

Source 2 · Rishonim
Verified

Mishneh Torah, Murderer and the Preservation of Life 1:14

משנה תורה, רוצח פרק א יד וטו

Mishneh Torah, Murderer and the Preservation of Life 1:14

Maimonides discusses the obligation to save a pursued person, including the prohibition against standing by while blood is shed. It supplies a direct preservation-of-life paradigm relevant to medicine.

כָּל הַיָּכוֹל לְהַצִּיל וְלֹא הִצִּיל עוֹבֵר עַל (ויקרא יט טז) "לֹא תַעֲמֹד עַל דַּם רֵעֶךָ". וְכֵן הָרוֹאֶה אֶת חֲבֵרוֹ טוֹבֵעַ בַּיָּם. אוֹ לִסְטִים בָּאִים עָלָיו. אוֹ חַיָּה רָעָה בָּאָה עָלָיו.

Source 3 · Rishonim
Verified

Mishneh Torah, Murderer and the Preservation of Life 11:4

משנה תורה, רוצח יא ה, וראה שם עוד

Mishneh Torah, Murderer and the Preservation of Life 11:4

Maimonides codifies the duty to remove dangerous obstacles and preserve life. The law supports the physician's responsibility to prevent harm and protect patients.

וְכֵן כָּל מִכְשׁל שֶׁיֵּשׁ בּוֹ סַכָּנַת נְפָשׁוֹת מִצְוַת עֲשֵׂה לַהֲסִירוֹ וּלְהִשָּׁמֵר מִמֶּנּוּ וּלְהִזָּהֵר בַּדָּבָר יָפֶה יָפֶה. שֶׁנֶּאֱמַר (דברים ד ט) "הִשָּׁמֶר לְךָ וּשְׁמֹר נַפְשְׁךָ". וְאִם לֹא הֵסִיר וְהֵנִיחַ הַמִּכְשׁוֹלוֹת הַמְּבִיאִין לִידֵי סַכָּנָה בִּטֵּל מִצְוַת עֲשֵׂה וְעָבַר בְּ(דברים כב ח) "לֹא תָשִׂים דָּמִים":

Source 4 · Rishonim
Verified

Mishneh Torah, Murderer and the Preservation of Life 12:14

משנה תורה, רוצח יב יד

Mishneh Torah, Murderer and the Preservation of Life 12:14

Rambam states that one may not sell to an Israelite who is a bandit what may not be sold to a non-Jew, because this supports transgressors and causes them to stumble; similarly, giving improper advice or enabling wrongdoing violates “Before the blind do not place a stumbling block,” whereas one who seeks advice should be given suitable counsel.

כָּל שֶׁאָסוּר לִמְכֹּר לְעַכּוּ"ם אָסוּר לִמְכֹּר לְיִשְׂרָאֵל שֶׁהוּא לִסְטִים מִפְּנֵי שֶׁנִּמְצָא מַחֲזִיק יְדֵי עוֹבְרֵי עֲבֵרָה וּמַכְשִׁילוֹ. וְכֵן כָּל הַמַּכְשִׁיל עִוֵּר בְּדָבָר וְהִשִּׂיאוֹ עֵצָה שֶׁאֵינָהּ הוֹגֶנֶת אוֹ שֶׁחִזֵּק יְדֵי עוֹבְרֵי עֲבֵרָה שֶׁהוּא עִוֵּר וְאֵינוֹ רוֹאֶה דֶּרֶךְ הָאֱמֶת מִפְּנֵי תַּאֲוַת לִבּוֹ הֲרֵי זֶה עוֹבֵר בְּלֹא תַּעֲשֶׂה שֶׁנֶּאֱמַר (ויקרא יט יד) "וְלִפְנֵי עִוֵּר לֹא תִתֵּן מִכְשׁל". הַבָּא לִטּל מִמְּךָ עֵצָה תֵּן לוֹ עֵצָה הַהוֹגֶנֶת לוֹ:

Source 5 · Rishonim
Verified

Mishneh Torah, Foundations of the Torah 2:2

משנה תורה, הלכות יסודי התורה ב׳

Mishneh Torah, Foundations of the Torah 2:2

Maimonides teaches that contemplating creation and the human body can lead to love and awe of God. For a physician, this connects clinical knowledge with religious wonder and responsibility.

בְּשָׁעָה שֶׁיִּתְבּוֹנֵן הָאָדָם בְּמַעֲשָׂיו וּבְרוּאָיו הַנִּפְלָאִים הַגְּדוֹלִים וְיִרְאֶה מֵהֶן חָכְמָתוֹ שֶׁאֵין לָהּ עֵרֶךְ וְלֹא קֵץ מִיָּד הוּא אוֹהֵב וּמְשַׁבֵּחַ וּמְפָאֵר וּמִתְאַוֶּה תַּאֲוָה גְּדוֹלָה לֵידַע הַשֵּׁם הַגָּדוֹל. וּכְשֶׁמְּחַשֵּׁב בַּדְּבָרִים הָאֵלּוּ עַצְמָן מִיָּד הוּא נִרְתָּע לַאֲחוֹרָיו וִיפַחֵד וְיוֹדֵעַ שֶׁהוּא בְּרִיָּה קְטַנָּה שְׁפָלָה אֲפֵלָה עוֹמֶדֶת בְּדַעַת קַלָּה מְעוּטָה לִפְנֵי תְּמִים דֵּעוֹת. וּלְפִי הַדְּבָרִים הָאֵלּוּ אֲנִי מְבָאֵר כְּלָלִים גְּדוֹלִים מִמַּעֲשֵׂה רִבּוֹן הָעוֹלָמִים כְּדֵי שֶׁיִּהְיוּ פֶּתַח לַמֵּבִין לֶאֱהֹב אֶת הַשֵּׁם.

Source 6 · Rishonim
Verified

Mishneh Torah, Foundations of the Torah 5:4

משנה תורה, יסודי התורה פרק ה ד

Mishneh Torah, Foundations of the Torah 5:4

Maimonides discusses martyrdom and the limits of religious self-sacrifice. Although not medical in subject, it may illuminate the hierarchy of life, coercion, and ethical limits in a Maimonidean framework.

כָּל מִי שֶׁנֶּאֱמַר בּוֹ יַעֲבֹר וְאַל יֵהָרֵג וְנֶהֱרַג וְלֹא עָבַר הֲרֵי זֶה מִתְחַיֵּב בְּנַפְשׁוֹ. וְכָל מִי שֶׁנֶּאֱמַר בּוֹ יֵהָרֵג וְאַל יַעֲבֹר וְנֶהֱרַג וְלֹא עָבַר הֲרֵי זֶה קִדֵּשׁ אֶת הַשֵּׁם. וְאִם הָיָה בַּעֲשָׂרָה מִיִּשְׂרָאֵל הֲרֵי זֶה קִדֵּשׁ אֶת הַשֵּׁם בָּרַבִּים כְּדָנִיֵּאל חֲנַנְיָה מִישָׁאֵל וַעֲזַרְיָה וְרַבִּי עֲקִיבָא וַחֲבֵרָיו. וְאֵלּוּ הֵן הֲרוּגֵי מַלְכוּת שֶׁאֵין מַעֲלָה עַל מַעֲלָתָן.

Source 7 · Hasidic
External

Igros Kodesh, letter 6244

אגרות קודש — ח"יז אגרת ו'רמד

Igros Kodesh letter 6244

The passage urges someone who fasts excessively and refuses medical advice to heed “Venishmartem me’od lenafshoseichem,” consult and follow a physician, and maintain a healthy body for serving Hashem, citing the Rambam and rulings permitting medical treatment and cautioning against excessive fasting.

ו'רמד ב"ה, י"ד אייר, תשי"ח ברוקלין. שלום וברכה! נמסר לי ידיעות אודות כ' ואופן סדר חייו. ומובן שמצטער אנכי באם הידיעות מתאימות, כוונתי, שסיפרו לי אשר מרבה הוא בתעניות וכן שאף שב"ב שי' מבקשים אותו ומפצירים, לשאול דעת רופא בהנוגע לבריאותו, אינו שם לב לדבריהם ואינו ממלא הוראת רופא ואפילו אינו רוצה לשאול עצת רופא. והנה בודאי למותר להאריך על הציווי שנצטווינו, ונשמרתם מאד לנפשותיכם, ולבאר דברי המורה הגדול הוא הרמב"ם בספרו יד החזקה הלכות דיעות, שאי אפשר שיבין וישתכל בחכמות והוא רעב וחולה וכו' (כי צריך)

Source 8 · Modern
Verified

Sefer Puah, First Volume; Family and Purity, IV Laws of Medical Examination 23:116

ספר פוע"ה, כרך ראשון; משפחה וטהרה, חלק רביעי; הלכות בדיקת רופא כ״ג:קט״ז

Sefer Puah, First Volume; Family and Purity, IV Laws of Medical Examination 23:116

The passage states that a physicians’ oath is not halachically defined as an oath, does not prevent disclosure when there is a halachic reason to reveal information, and has no validity when it conflicts with halachah.

מג. שבועת הרופאים אינה מוגדרת כשבועה מבחינה הלכתית, ואין בה משום מחסום כשיש סיבה הלכתית לגילוי פרטים. כמו כן אין תוקף להתחייבות כזאת אם היא עומדת בניגוד להלכה.

Source 9 · Modern
External

Tzitz Eliezer 16:4

ציץ אליעזר, חט״ז סי׳ ד׳

Tzitz Eliezer 16:4

The passage rules that a physician must disclose a prospective bride’s major reproductive deficiencies to the prospective groom, even without a direct inquiry and despite her request for confidentiality, because withholding such information violates “לא תעמוד על דם רעך” and prevents the rescue of an endangered person; it discusses whether the physicians’ general oath of medical confidentiality requires prior annulment, while advising that such disclosure is at least permissible and likely obligatory.

Tzitz Eliezer 16:4 — page scan on HebrewBooks
Page 19

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