Shabbat Parashat Haazinu/ Yom Kippur| 5771
Ask the Rabbi: Intravenous Nutrition on Yom Kippur
Question: How does the potential for nourishing oneself intravenously affect the laws of eating on Yom Kippur? May one who has trouble fasting have an intravenous drip? Should someone who needs to eat use intravenous instead?
Answer: We will start with a discussion of whether intravenous nourishment is a violation of eating on Yom Kippur, which will impact on both questions.
Generally, prohibitions of eating are fundamentally violated by swallowing (see Chulin 103b). However, some hold that in order to fully violate the prohibition of eating on Yom Kippur, a requisite amount must be sitting in one’s digestive track (Chatam Sofer, Orach Chayim 127). Therefore, one could claim that it does not make a difference how one is nourished. Nevertheless, besides the Acharonim’s strong questions against the Chatam Sofer (see Achiezer III, 61; Chelkat Yaakov, OC 215), all seem to agree that there must also be some normal process of eating (see ibid. and Tzitz Eliezer X, 22.21). Ingesting in a manner that one does not get normal enjoyment from the eating process is forbidden rabbinically (e.g., the food is scorching hot) (Rambam, Shevitat Assor 2:5). Several poskim treat intravenous ingestion as the same (Teshuvot V’hanhagot II, 290; Chelkat Yaakov, ibid.). However, since not only is it not normal eating but the food does not even go into the digestive track but straight into the blood, it might be even more lenient.
It is true that when pikuach nefesh (efforts to save a life) allows one to violate a Torah law, whether on Yom Kippur or if he must eat a forbidden food, he should do so in a manner that is least severely forbidden (Yoma 83a; Kritot 13a). Nevertheless, poskim do not require one to ingest intravenously instead of eating, and several reasons are given: 1) If one has to insert the catheter on Yom Kippur, this might be as severe a violation of halacha as the eating itself (Igrot Moshe, OC IV, 101.3). 2) It is likely more healthy to eat food through the mouth than through intravenous (ibid, OC III, 91). 3) It is possible that the chemicals, the pain and/or infection could be harmful (see Maharsham I, 123). 4) In general, when pikuach nefesh allows one to violate a Torah law, efforts to reduce the severity of the violation are likely only rabbinic (Kiryat Sefer, Ma’achalot Assurot 14). For this or other reasons, one does not have to find unnatural ways to obviate the need for pikuach nefesh (Minchat Shlomo I, 7). 5) It might even be considered obviating the Divine decree that one is too sick to fast by taking steps that are not medically indicated (Igrot Moshe, III, 90).
The question of whether someone may take intravenous nutrition on Yom Kippur to not be as affected by the fast is a good one and should be broken up into a few parts. We mentioned that many consider it a full-fledged rabbinic violation, which is certainly forbidden, and Teshuvot V’hanhagot (II, 290) makes an interesting (he admits it is unproven) claim that intravenous nutrition violates a Torah positive commandment to afflict oneself (Vayikra 23:29). Regarding a healthy person, then, there would be no justification. Even if there is no violation, it still seems like something novel against the spirit of the law, which would itself be a bad idea in general and certainly on Yom Kippur. However, if he is sick enough to be bedridden, which in general is enough to allow the violation of at least some rabbinic laws (see Shulchan Aruch, OC 328:17), it might be permitted to do so as well. Regarding such a person swallowing medicinal pills without water, such ingestion is indeed permitted (Shemirat Shabbat K’hilchata 39:8). Regarding one who is legitimately but not dangerously sick who may become sicker by fasting, pills or intravenous inserted before Yom Kippur or by a non-Jew might be permitted (Igrot Moshe, III, 91; Teshuovt V’hanhagot, ibid.). Someone who is in that situation or knows that he fasts horribly should discuss alternatives with his personal rabbi, as neither unnecessary “torture” nor improper leniency in this matter is appropriate.
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