One of the Rabbinic prohibitions on Shabbos is the prohibition on acts of Refuah. This includes medical treatments, other types of healing and the use of medication. Chaza”l forbade acts of Refuah on Shabbos because of a concern that it may lead to the Torah prohibition of crushing or grinding herbs, which was a standard in making medications at the time.
Whilst this concern does not apply to most medications today which are bought is ready-made tablet or liquid form, Rabbinic Gezeiros remain in force even if the reason behind them is no longer applicable. Further even today there are a variety of natural remedies are still made in this fashion.
The scope of this Gezeira can apply to all forms of healing treatments including; medications, ointments, massage and compresses. This article will focus specifically on the taking of oral medication.
In cases of Pikuach Nefesh, life-threatening situations or illness, the laws of Shabbos are overridden. Medication may be obtained however necessary and taken without question. This is true even in possible or doubtful (safek) life-threatening situations.
If not medicating now will potentially lead to a life-threatening situation later (e.g. risk of spreading infection), all treatments are also permitted as above.
What about non-life-threatening conditions?
Incapacitating Illness
Chaza”l did not apply their Gezeira for someone who is in the category of חולה שאין בו סכנה. This is defined as an incapacitating illness that affects the entire body and the sufferer would normally have to go lie down. Weakness of the entire body is also included. Severe pain even when localised which would necessitate lying down likewise falls into this category.
Even if the person remains active but would in normal circumstances go and lie down they are considered a חולה שאין בו סכנה. Examples would include; Migraine headache, severe cramps or severe muscular pain.
Generally, the Shulchan Aruch rules that treatments for a חולה שאין בו סכנה must be done either by a non-Jew or with a Shinui.
of employing a Shinui even when taking medication. However based on the Alter Rebbe a Shinui is not required when taking oral medication. If medication is not available, one may send a non-Jew to travel to acquire it being that this too is only Rabbinically forbidden.
Ailments
A person who has pain which is localised and not so intense as to weaken the entire body, or if they suffer from מיחוש בעלמא (discomfort or ailment) may not take medication. This is where Chaza”l applied their Gezeira. Examples would include a runny nose, headache or stomach ache, stiff neck, muscle pain, hay-fever.
Note: If the pain or ailment is significant enough then it can fall under the category of חולה שאין בו סכנה and medication will be permitted as above.
Whether one’s condition is classified as חולה שאין בו סכנה or מיחוש בעלמא is personal and subjective and will very from person to person. One need not be overly-strict in assessing their condition.
Children are always considered in the category of חולה שאין בו סכנה and medication may be taken even for minor ailments. Many Poskim apply this leniency only up to the age of 3. Others extend it until the age of 6 or 9.
A woman within 30 days of childbirth is also automatically considered in the category of חולה שאין בו סכנה and medication may be taken as necessary.
Other
When medication is permitted and for when it is prohibited, there is no difference between liquid medication or tablet or capsule form.
If necessary, pills may be cut or crushed. This is because the medication has been previously crushed and אין טוחן אחר טוחן. Care must still be used when removing the pills from their packaging so as not to tear writing. No Torah prohibition may be violated unless in case of Pikuach Nefesh.
Vitamins and Sleeping Pills
There is much discussion in Poskim whether vitamins fall under the Gezeira against Refuah on Shabbos or not. Rav Moshe Feinstein maintains that since their use is not to heal but rather to increase or enhance nutrients, they are not subject to the Gezeira unless taken specifically for healing. Rav Shlomo Zalman Auerbach argues and classifies vitamins as medication. One can be lenient with children especially since the tablets are flavoured and can be eaten as a “candy”.
Sleeping Pills: Tzitz Eliezer considers sleeping pills to be a Refuah for a medical condition. This view is also held by Rav Moshe Feinstein. Rav Shlomo Zalman Auerbach maintains that since they do not actually treat any illness, they are not subject to the Gezeira. If a person suffers greatly from insomnia to the extent that they would be categorised as a חולה שאין בו סכנה all authorities would permit their use. The same argument would apply to diet pills.
Oral contraceptives (being used with the permission of a competent Rav) may be taken on Shabbos.
Ongoing Treatment
If a condition requires ongoing medicating and treatment began on a weekday, some Poskim permit the continuing on Shabbos. Many Poskim take a stricter approach and do not allow this for a מיחוש בעלמא.
A Practical Tip
Medication or pills may be mixed into food or drink before Shabbos and then taken on Shabbos in all cases even for a מיחוש בעלמא. This is because it is not recognisable as being done for the purpose of Refuah but rather looks like eating or drinking.
