January 19, 2020

Prevention Is Primary, Jewish Tradition Teaches

Since maintaining a healthy and sound body is among the ways of God — for one cannot understand the Creator if he is ill — therefore he must avoid that which harms the body. He must accustom himself to that which helps the body become stronger.

— from the teachings of Maimonides

Contemporary Western medicine has focused on the treatment of diseases rather than prevention.

Judaism’s historic approach is fundamentally different from that of modern medicine. Although treating sick people is certainly a Torah obligation, Judaism puts a priority on the prevention of disease.

The foundation for the Jewish stress on preventive medicine can be found by considering this verse in the Torah:

“And He said: ‘If you will diligently harken to the voice of the Lord, your God, and will do that which is right in His sight, and will give ear to His commandments, and keep all His statutes, I will put none of these diseases upon you which I put on the Egyptians.’ ”

Rashi explains: “It is like a physician who says to a man, ‘Do not eat this thing lest it will bring you into danger from this illness.’ ”

What are the implications for modern medicine? Just as God’s healing role in the above Torah verse is to prevent illness, so, too, a physician must emulate the Divine role by emphasizing the prevention of illness.

It should not be assumed that the Torah places the entire responsibility of maintaining good health on physicians.

The following anecdote about Maimonides is instructive:

During the period when Maimonides served as the royal physician of the sultan of Egypt, the sultan never became ill. One day, the sultan asked Maimonides, “How do I know that you are an expert physician, since during the period that you have been here I never have been ill, and you have not had the opportunity to test your skills?”

Maimonides concluded that “we learn that the ability of a physician to prevent illness is a greater proof of his skill than his ability to cure someone who is already ill.”

The Torah indicates another moral obligation that might demand physicians take a greater interest in preventive medicine: “Do not stand idly by the blood of thy neighbor.”

The Sages indicate that if one sees a person drowning or being attacked by robbers, he or she should do everything possible to rescue the person.

It would seem, therefore, that physicians should put far greater emphasis on preventive medicine, advising their patients about dangers related to high-fat diets and other lifestyle choices.

It should not be assumed that the Torah places the entire responsibility of maintaining good health on physicians.

Our Sages said the major responsibility falls on the individual.

Rabbi Sampson Raphael Hirsch explains the mitzvah of guarding our health: “Limiting our presumption against our own body, God’s word calls to us: ‘Do not commit suicide. Do not injure yourself. Do not ruin yourself. Do not weaken yourself. Preserve yourself.’

“You may not … in any way weaken your health or shorten your life. Only if the body is healthy is it an efficient instrument for the spirit’s activity. … Therefore, you should avoid everything which might possibly injure your health. … And the law asks you to be even more circumspect in avoiding danger to life and limb than in the avoidance of other transgressions.”

Judaism regards life as the highest good. We are obligated to protect it. An important Jewish principle is pikuach nefesh, the duty to preserve a human life.

Jews are to be more particular about matters concerning danger to health and life than about ritual matters. If it could help save a life, one must (not may) violate the Sabbath, eat forbidden foods and even eat on Yom Kippur. The only laws that cannot be violated to preserve a life are those prohibiting murder, idolatry and sexual immorality.

A longer version of this essay originally appeared in the Fall 1999 issue of Emunah Magazine. Author and activist Yosef Ben Shlomo Hakohen died in 2011. Richard H. Schwartz wrote “Judaism and Vegetarianism” (Micah Publications), the case for vegetarianism from a Jewish perspective.