[Avodah] Who decides if someone eats on YK

[Ben Waxman via Avodah]

http://en.calameo.com/read/0016608026a15a69a2c56 (page 70)

Rav Melamed in last week's Bsheva about how to decide if one eats on YK.
In the past the we've discussed the topic and Rav Melamed is very clear:
the doctor decides. In his discourse about determining if someone should
eat he never mentions asking a rabbi, just speak to doctor. He is the
sole determiner if someone's condition demands suspending the fast. The
doctor doesn't have to be dati, just honest and ethical.

Ben

[Cantor Wolberg via Avodah]

I recall learning that if 9 doctors say you can fast and
one says you must eat, you are to listen to the one irrespective
of the religion of the doctor(s).

In another situation, Ben said the doctor doesn?t have to be dati,
just as long as he is honest and ethical. I would think that if he
or she is not dati, they might say the patient shouldn?t fast (out
of convenience or whatever, since the doctor feels no obligation
to fast anyway.

Richard Wolberg

[Micha Berger via Avodah]

On Fri, Oct 03, 2014 at 11:03:20AM -0400, Cantor Wolberg via Avodah wrote:
: I recall learning that if 9 doctors say you can fast and
: one says you must eat, you are to listen to the one irrespective
: of the religion of the doctor(s).

Mishnah Yuma 8:5 says that the decision of whether a sick person
should eat or not goes to the experts, and if there are no experts,
"we feed him on his own word, until he says 'enough'."

The gemara ad loc (83a) explains the mishnah as saying that we
listen to the experts when he says I don't need to eat, or
doesn't / can't voice an opinion. But (R' Yanai says) when he
says he needs to eat, we assume he knows how his body feels
better than the experts.

So, it's EITHER the doctors OR the sick person saying he needs
to eat.

The Y-mi (41a Ridbaz ed.) says this is because if they disagree, it's
safeiq nefashos, and still dokheh.

The Tosefta (Shabbos ch. 15) goes futher WRT chulul Shabbos explicitly
saying that for safeiq nefashos one needn't get permission from beis din.

The gemaa in Kerisus 13a says that a pregnant woman may eat less than a
shiur.

The Magid Mishnah (on Shabbos 2:14, and pasqened in his SA OC 328:4) that
one violates Shabbos for a choleh sheyeish bo saqanah even in ways where
the medical help won't stop the saqanah.

Given the gemara in Kerisus and the MM, R' Chaim Brisker (quoted in Halachic
Man pg 39 and GRYZ haLevi on Shevisas Asor 2:8) rules:

To prevent someone from becoming a choleh sheyeish bo saqanah (like the
pregnant woman in the gemara) feed less than a shiur -- the least needed
to prevent piquach nefesh, but
for someone who already is a choleh sheish bo sakanh, you can feed him
as much as he needs. (As Yuma 8:4 says "until he says 'enough'.")

Ad kan things I learned in part of last week's Shabbos Shuvah derashah.

So I looked up the AhS (OC 618:15). He only allows going beyond the shiur
if the choleh needs it. No mention of a distinction between she'ein bo
saqanah or r"l sheyeish.

Notice that in none of this discussion is there mention of asking a rav,
and the implication from the Tosaefta is that bedavqa that one needn't.

GCT and :-)@@ii!
-Micha

[Ben Waxman via Avodah]

The MB on this subject is very clear - the problem is that modern day
doctors scoff at the idea of YK. While it is true that we go by an idol
worshipping doctor if he says "eat", an atheist doctor is more
problematic. Possibly the idol worshiper respects the idea of fasting,
even if he doesn't fast this particular day.

It would appear that at some point poskim decided that what the doctors
says has to be judged by an outside party. To take this line of thinking
to its logical conclusion, it might better to ask a believing Muslim
doctor than a non-believing Jewish doctor.

Actually this idea (the situation has changed so we need to rethink some
of our assumptions) is actually quite modern.

Ben

Post by Micha Berger via Avodah
Notice that in none of this discussion is there mention of asking a rav,
and the implication from the Tosaefta is that bedavqa that one needn't.
-Micha

[Rich, Joel via Avodah]

I think the real question is what parameters do you give the doctor in asking whether one should fast on Yom Kippur (and IMHO this applies to frum doctors as well, since IIUC the decision should be made based on the patient's poseik rather than the doctor's). For example - if the doctor (and I know they often do not think or articulate in terms of probability) feels there is no "leidat hasafeik", assumedly the patient can't eat (although maybe if the patient feels worried he may?) but what if the doctor says there's a 1% increase in his expectation of mortality for the individual (from a 1% to a 1.01% mortality rate)?Assumedly you go to a poseik (or you already went and asked for a parameter ) Of course this assumes poskim and doctors are numerate.
GCT
Joel Rich
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[Kenneth Miller via Avodah]

Post by Cantor Wolberg via Avodah
In another situation, Ben said the doctor doesn?t have to be dati,
just as long as he is honest and ethical. I would think that if
he or she is not dati, they might say the patient shouldn?t fast
(out of convenience or whatever, since the doctor feels no
obligation to fast anyway.

This is an important point. I would enhance it by pointing out that clear communication between doctor and patient is crucial, even when working with a sincere and well-meaning doctor. I think a good rule of thumb would be that if the doctor says to eat, one should ask, "Why? How terrible would it be to fast?"

In some cases, the doctor would say, "Fasting could send you back to the hospital." But in other cases, the doctor merely has general concerns about the patient's strength, and if the patient would offer to spend the day at home and/or in bed, that would suffice.

Akiva Miller
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