Q) When am I allowed to take medication on Shabbos?
A) Chazal instituted an issur d’rabonon (rabbinic prohibition) of refuoh (healing) on Shabbos. The reason for this issur was because people are generally anxious about their health and wellbeing. Were one allowed to become involved in taking medication in a situation of medical necessity on Shabbos this may lead to violating an issur d’orayso (biblical prohibition) of grinding herbs in order to produce medication[1].
What is included in Refuoh?
The issur of refuoh includes taking medication to heal, relieve pain or to generally strengthen the constitution[2]. Not only are all types of medication forbidden; even physical activities that have a healing effect (e.g. exercise or physiotherapy) are prohibited if the same effect can be achieved through medication[3].
Who does the Issur Refuoh apply to?
The issur of refuoh only applies to one who has a michush (minor ailment) or is mitzta’er (in moderate pain)[4]. However, one who is termed a choleh (ill person) may take (oral[5]) medication on Shabbos normally[6]. The definition of a choleh is one who is either bedridden, incapacitated (i.e. cannot function as normal – unable to go to Shul, go for a walk etc.), or experiencing severe pain (even localised)[7]. Some examples of choli would be flu, migraine, a raised temperature or a very painful burn.
The needs of a baby or young child are also classified tzorchei choleh[8]. This is because young children are generally of a weaker constitution and their slight pain or minor ailments can affect them more severely.
Exceptions
There are several other instances where taking medication on Shabbos is allowed – even when one is not a choleh:
- Will become a choleh – someone who is not a choleh now but feels that they will become a choleh later on may take medication now and need not wait until the choli develops[9]. For example, one who has a mild headache and knows that this will develop into a migraine may take medication now.
- Preventative – someone who is currently healthy may take medication to prevent even a minor ailment from developing[10]. For example, one may take antacids before eating to prevent heartburn later on.
Similarly, when Tisha B’av is on Sunday, on Shabbos Chazon one may take “Easy Fast” drops/tablets – as this is a preventative measure[11].
- Foods eaten by healthy people that have medicinal qualities (ma’achal bri’im) may be eaten[12]. For example, someone who has a cold may drink tea, or eat foods that are high in vitamins. The same applies to physical actions that are also performed by healthy people – for example one who has a heart condition may take a walk, and someone with a stomach ache can use a hot water bottle[13].
- A course of medication (even for a condition that is termed michush or mitztaer) that one has started before Shabbos may be continued on Shabbos[14]. However, this is only permitted if the dose must be taken on Shabbos, and by not taking the dose on Shabbos the entire course will be ineffective.
- Indiscernible medication – one may prepare medication before Shabbos by mixing it into food or drink to make it invisible[15]. Since the medicine is unnoticeable to the observer; and the patient himself has prepared it before Shabbos, it may be taken on Shabbos.
(Obviously the food item containing the medicine must be clearly marked for safety reasons.)
[1] גמ’ ע”ז כח. החושש בשיניו ורש”י שם ד”ה לא יגמע; גמ’ שבת נג: בהמה שאחזה דם ורש”י שם; שו”ע או”ח שכ”ח ס”א
[2] מג”א ס”ק מ”ג; מ”ב ס”ק ק”כ
[3] שו”ע שם ס’ מ”ב; מ”ב ס”ק ק”ל; שש”כ פל”ד כ”ב; אורחות שבת פ”כ קנ”ט ובהערה רכ”א
[4] שו”ע שם ס”א וס’ ל”ב; מ”ב שם ס”ק א’
[5] כתבנו דרך הפה לאפוקי פתילה [suppository] שצריך להכניס את זה בשנוי דווקא (שכ”ח מ”ט)
[6] מ”ב שם ס”ק קכ”א
[7] שו”ע שם ס’ י”ז; מ”ב שם ס”ק א’; שש”כ פל”ג א’; חוט השני פ’ פ”ט ס’ כ”ו
[8] רמ”א ס’ רע”ו ס”א וס’ שכ”ח סי”ז; שו”ע ס’ רע”ו ס”ה
[9] שש”כ פל”ד ט”ז; אורחות שבת פ”כ קכ”ה מהא דמותר להמשיך לשתות מי חלתית בשבת (גמ’ שבת קמ.) כדי שלא יחלה (רמב”ם פכ”ב ה”ז)
[10] שו”ע שם ס’ כ”ז ומ”ב שם; אג”מ ח”ג ס’ נ”ד ענף א’; חוט השני ח”ד פפ”ט סוף ס”ק כ”ח; וכן שמעתי ממו”ר הרה”ג ר’ פאלק שליט”א
[11] גם שמעתי ממו”ר הרה”ג ר’ פאלק שליט”א. ואין לאסר משום הכנה – הואיל וזה מוגדר “שמירה” ולכן מותרת
[12] שו”ע שם ס’ ל”ז
Halochos of Refuah on Shabbos (R’ Pinchos Bodner) p. 26 note 68[13]
[14] ספר החיים להגר”ש קלוגר ס’ שכ”ח פ”ו; חוט השני פפ”ט סוף סכ”ז בשם החזו”א; שש”כ פ’ ל”ד י”ז
[15] שו”ע שם ס’ כ”א ע”פ גמ’ שבת קח: (וע’ רש”י שם); שש”כ פ’ ל”ד ו’ בשם הגרש”ז (וע”ש שס”ל דדווקא אם זה שנוי מדרך הרגיל מהני)