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Shabbat Parashat Pekudei| 5766
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Question: Is a Jewish physician permitted to give his parent an injection, such as of insulin or a flu shot?
Answer: Shemot 21:15 lists striking one’s parent as a capital offense, and the gemara (Sanhedrin 84b) says that that is when he causes a chabura (wound). The gemara then asks whether one is permitted to let blood (a medical practice at that time) for his parent. Two derivations from the Torah are brought to show that when the action is done in a positive context, it is permitted. Yet the gemara relates that Amoraim would not allow their sons to perform certain procedures, fearing that they might accidentally make a wound, which is a serious transgression. Regarding someone other than a parent, where the sin of injuring is less severe, it is permitted to draw blood despite the fear of injury. The gemara’s conclusion seems to be that it should have been permitted for a child to perform medical procedures that include puncturing his parent’s body, but that we instruct him to refrain. The Shulchan Aruch (Yoreh Deah 241:3) rules unequivocally that a child should not let his parent’s blood or remove a splinter. However, the Rama (ad loc.), based on the Rambam, adds that if the child is the only one available to do the procedure, he should do so.
Let us apply this general, halachic background to our specific case. Several poskim discuss injections for parents, including four responsa that open Gesher Hachayim, vol. II. We will summarize the main indicators for leniency and try to come to some conclusion.
The Gesher Hachayim (ibid.) raises the point that, halachically, a chabura must include some spilled blood or blood that accumulates under the skin. The gemara’s conclusion, which was meant to be only a stringency (Bach on Yoreh Deah 241)was concerned about a mistake, but perhaps it was designed for a case of a definite wound, with the mistake being that it went beyond the therapeutic need. If there is only a small chance of a wound at all it is possible that the stringency does not apply (The probability of blood depends on where the injection is done and other factors).
The Minchat Chinuch (#48) claims that if a father asks his son to wound him, the son is not bound by the prohibition of striking a parent. Some (including R. Sh. Z. Ohrbach, cited in Gesher Hachayim, ibid.) raise a possibility that this enables a father to say he agrees that his son treat him, even if it includes unnecessary damage. This suggestion is problematic on a few grounds. The Rivash (#484) says that permission only exempts someone from damage payments but cannot permit causing bodily damage. Igrot Moshe (CM II, 64) says that one can ask someone to cause a non-medical but helpful wound, but he cannot ask his child to do so. Furthermore, it is unlikely that the parent does not mind if the child injures him unnecessarily. His main intention is, even if he says otherwise, to permit a proper job, and halacha is concerned that he may not. It is also quite clear that the early authorities did not accept the Minchat Chinuch’s approach.
Ashkenazim can rely on the Rama’s ruling that if no one else can do the treatment, then the child may. It is unlikely that no one else can do injections. However, poskim discuss the parameters of availability in this context. Some suggest that the prospect that the child can do it for free, whereas others will charge, may be sufficient (see Gesher Hachayim ibid. and Chelkat Yaakov, YD 131). (This point is too complex and dependent on particulars to do justice in this forum.) Sometimes the chance of reliable treatment is improved by the child’s ability to provide the service himself (see Minchat Yitzchak I, 27).
In summation, Sephardim should make every effort to find an alternative to a child injecting his parent. For Ashkenazim, one should do whatever system is best for the patient’s welfare, but the child should avoid doing injections when comparable alternatives exist. One should consult a local rabbi in borderline cases.
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