Beit Midrash

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קטגוריה משנית
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  • Yom Kippur
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1. The Mitzva to Fast
It is a positive commandment to fast on Yom Kippur, as we read: "And this shall be to you a law for all time: In the seventh month, on the tenth day of the month, you shall practice self-denial; and you shall do no manner of work, neither the citizen nor the stranger who resides among you. For on this day atonement shall be made for you to purify you of all your sins; you shall purify yourselves before the Lord. It shall be a Sabbath of complete rest for you, and you shall practice self-denial; it is a law for all time" (Vayikra 16:29-31). Someone who transgresses and does not fast not only fails to fulfill a positive commandment, but also transgresses a negative one. Even though self-denial is primarily about refraining from life-sustaining food and drink, the mitzva of self-denial also includes four additional prohibitions, detailed in the next chapter.
On the fast, absolutely nothing may be eaten, nor may even a single drop of water be drunk. Eating or drinking anything at all is a transgression of a Torah prohibition. Someone who intentionally eats the volume of a large date or drinks a cheek full of water is liable to karet, as we read: "Indeed, any person who does not practice self-denial throughout that day shall be cut off from his kin" (Vayikra 23:29). If a person transgresses unintentionally, he is liable to bring a sin offering. These punishments apply only if someone eats or drinks enough to alleviate discomfort somewhat, as then self-denial is no longer experienced. The shi’urim (minimum quantities) specified are a tradition received by Moshe at Sinai and passed down orally. Although these are the minimum quantities for punishment purposes, anyone who eats or drinks anything at all is still transgressing a Torah prohibition.
Someone who eats an item which is not generally considered edible – such as leaves, twigs, an extremely fiery spice, or rotten food – does not transgress a Torah prohibition, as this is not what is meant by "eating." Similarly, someone who drinks a non-potable beverage – such as an extremely sour or spoiled liquid – does not transgress biblically (SA 612:6-8; Rema ad loc. 9). Nevertheless, all the above are prohibited rabbinically. Since this person has chosen to eat or drink them on the fast, he has made it clear that from his perspective they are edible or potable. Therefore, it is forbidden for him to eat or drink them. Even if the quantity being consumed is less than a shi’ur, le-khatĥila this must be avoided (MB ad loc. 15).
2. The Sick
Even someone who is sick and suffering may not eat or drink anything on Yom Kippur, unless the illness is life-threatening. This is because fasting on Yom Kippur is a Torah obligation, overridden only in cases of danger to life. Yom Kippur is different in this way from other fasts. On Tisha Be-Av, sick people are not obligated to fast. On the minor fasts, even pregnant or nursing women are exempt (Peninei Halakha: Zemanim 10:2-4).
Therefore, people who have the flu, strep throat, and the like are obligated to fast on Yom Kippur, since these conditions are not life-threatening. It is better for someone sick to stay in bed all day and not go to the synagogue, rather than drink something to enable him to go. For fasting is the primary mitzva of the day, and thanks to it God purifies the Jewish people of their sins. While lying in bed, one should do his best to pray. If it is difficult for him to read from the maĥzor, he should offer heartfelt personal prayers. But he must not eat or drink. If a mother is unable to both take care of the children and fast, because she is pregnant, nursing, or sick, her husband should stay home and take care of the children so that his wife can fulfill the Torah mitzva of fasting. Her fasting is more important than his praying in synagogue with a minyan.
Someone who is sick and suffering may take a medicinal pill, as long as it does not taste good. The pill should be dry-swallowed. Someone who cannot dry-swallow should either chew the pill or add a little soap to the water he swallows it with, thus ruining the taste.
Someone who is suffering due to the fast may also take a pill to alleviate pain. Therefore, someone who is suffering from caffeine-withdrawal headaches may take a caffeine pill or a painkiller. Similarly, a migraine sufferer may take a pill to prevent the onset of a migraine.
3. Someone Who Is Dangerously Ill
If a person’s fasting might kill him, it is a mitzva for him to eat and drink as needed, since danger to life takes precedence over fasting (just as it does over other mitzvot). Thus we read, "You shall keep My laws and My rules, by the pursuit of which man shall live; I am the Lord" (Vayikra 18:5). Our Sages extrapolate: "‘By which man shall live’ – and not die" (Yoma 85b). The mitzvot were given to promote life, not to cause death (Peninei Halakha: Shabbat 27:1 n. 1). Someone whose life may be in danger, but who decides to be "stringent" and not eat and drink, is actually committing a sin, as he is transgressing the Torah mitzva to take care of his health (Devarim 4:15). To such a person we apply the verse (Bereishit 9:5), "But for your own life-blood I will require a reckoning" (BK 91b).
The permission to eat is not limited to cases where the danger is overwhelming. Rather, in any case where it is possible that fasting will kill a person or weaken his ability to fight off a dangerous disease, it is a mitzva for him to eat and drink as needed. Similarly, if someone is deathly ill, and fasting will likely hasten his death, it is a mitzva for him to eat and drink as necessary. Eating and drinking on Yom Kippur is permitted even to extend life temporarily.
On the other hand, we should not take this too far and worry about very unlikely scenarios. For if we were to look at every standard illness as possibly life-threatening, we would render meaningless the rule that someone sick is obligated to fast on Yom Kippur. Furthermore, anyone with the flu would need to be hospitalized, or minimally have a doctor come by to check on him twice a day. Were we to really worry about minimal levels of risk, we would have to forbid people from traveling in cars or flying in planes. Certainly, we would have to prohibit driving in cars that did not pass inspection within the last month. We would also have to prohibit hiking and many other activities.
Rather, the underlying principle is that a danger which people normally take care of immediately – even if doing so involves a serious investment of time and energy such as rushing someone to the hospital in the middle of the working day – is considered life-threatening. To avoid reaching such a point, it is a mitzva to desecrate Shabbat, and to eat and drink on Yom Kippur. In contrast, a danger which people do not normally deal with immediately and in which they do not invest time and energy is not considered life-threatening.
4. Determining Danger
Determining the level of danger is generally the province of doctors, who use their medical expertise and experience to determine whether someone’s fasting would be life-threatening or not.
Unfortunately, many doctors tell anyone sick to eat and drink on Yom Kippur, either because they are overly cautious, or because they do not take the mitzva of fasting seriously enough. Some doctors mistakenly believe that if they tell a sick person to eat or drink only minimal quantities (le-shi’urim), there is no prohibition. In fact, even eating small quantities is forbidden by the Torah. Only a sick person who is considered dangerously ill is permitted to eat and drink. In such cases, it is preferable when possible that he eat minimally (as will be explained in the next section).
Therefore, questions about fasting must be posed to a God-fearing doctor. Wearing a head covering does not guarantee that someone is God-fearing. Rather, what is important is that the doctor is moral, has integrity, and will reach a decision responsibly, factoring in both the holiness of the fast and the holiness of human life. Patients must also approach the doctor with the proper attitude, informed by fear of heaven. For if they pressure the doctor to permit them to eat and drink, they are putting the doctor in a very difficult position. He already bears great responsibility, and they are now making it difficult for him to determine whether they are really at risk, or if they simply want to get out of fasting even though there is no risk to life at all. For a substantial amount of the doctor’s information comes from patient input. If patients press for a dispensation, the doctor may well conclude that they are in bad shape and permit them to eat and drink minimal amounts. If the patients report properly, however, it may well be clear that the situation is not life-threatening at all. In cases of misrepresentation, patients who receive an incorrect answer bear the primary responsibility for it.
If a God-fearing doctor is uncertain as to whether a person should fast, he should think about it this way: "What would I do on Yom Kippur were I to find out that this person was fasting? Would I be prepared to violate Yom Kippur by driving for ten minutes in order to instruct him to eat and drink, thus possibly saving his life?" If the answer is yes, this indicates that the doctor believes that there is a true danger to life. Accordingly, he should instruct the patient beforehand to eat and drink on Yom Kippur. If, however, despite the responsibility he feels for his patient’s wellbeing, he would not be prepared to drive on Yom Kippur for him, this indicates that the doctor believes that there is no true danger to life, and he should instruct the patient beforehand to fast. This suggestion is appropriate for the average doctor, who is not lazy, but also does not love to run around from patient to patient.
Let us say that someone sick made a mistake and consulted a doctor who is not God-fearing. This doctor instructed him to eat and drink. Before Yom Kippur, the patient must make every effort to re-ask his question to a God-fearing doctor. If the patient sinned by not doing so before Yom Kippur, he should eat and drink. Even though the doctor may not have answered correctly, it is possible that he did. The patient’s condition may truly be life-threatening. In cases of possible danger to life (safek piku’aĥ nefesh), we are stringent. Therefore, he must eat and drink.
As we said, these decisions are generally made by doctors. Nevertheless, if someone sick believes that he is in a life-threatening situation and that he must eat and drink, even if his doctor disagrees, he should eat and drink. This is because sometimes a person can sense a deterioration in his condition before the doctors can. Thus we read (Mishlei 14:10), "The heart alone knows its bitterness" (Yoma 83a; SA 618:1). However, if the sick person says he must eat, but the doctor feels that eating would endanger his life, we listen to the doctor (AHS 618:5-6; SSK 39:4).
5. Eating and Drinking Minimal Amounts
If someone is dangerously ill, but the doctor says it is not necessary for him to eat and drink large amounts, some prominent Rishonim write that it is preferable that he eat or drink small amounts to minimize the prohibition (as will be explained below). Even though eating or drinking even small amounts is prohibited on the Torah level, doing so does not subject one to the punishment of karet (for intentional transgression) or a sin offering (for unintentional transgression). Therefore, there is a certain advantage to eating or drinking in small quantities.
However, if there is any concern that eating and drinking this way may cause any deterioration in his condition, then the person must eat and drink normally. For example, if a woman who just gave birth is exhausted, it is better that she drink normally so that she will be able to sleep uninterruptedly, rather than drink small quantities over a long period of time, forcing her to stay awake.
Diabetics whose condition is not stable also need to be very careful. If there is a concern that eating and drinking minimally may lead to their not eating what they need, they should eat normally. It is also better that they pray in the synagogue with a minyan and eat substantial amounts every few hours, rather than eating minimal amounts over an extended period of time and thus be unable to come to synagogue.
Let us now explain the details of eating and drinking minimal quantities (le-shi’urim). For drinking, the quantity ingested must be less than a cheek full. This amount varies from person to person. Therefore, a sick person needs to check how much water his cheek holds. He should fill his cheek with water and spit it out into a cup. He should then mark the height the water reaches on the cup. Le-khatĥila, he should do this before the fast begins. Each time he needs to drink, he should drink less than this amount.
For eating, the quantity ingested must be less than the volume of a large date. Smaller than an egg but larger than an olive, it is approximately 30 cubic centimeters (SA 612:1-5, 9-10).
The minimum time between each round of eating or drinking must be that of "akhilat pras" (the time it takes to eat a half a loaf of bread). Some maintain that this is nine minutes, and le-khatĥila it is good to follow this opinion. Someone who needs to eat and drink more frequently may wait only seven minutes. If someone needs to drink even more frequently, it is enough to wait one minute, because some maintain that for drinking this pause is enough (SA 618:7-8). There is no halakhic difference if a sick person drinks water or other beverages; therefore, it is recommended that he drink calorie-dense drinks, which may make it unnecessary for him to eat.
6. The Psychological Aspect
Sometimes a person becomes so weak on Yom Kippur that he is afraid that he is going to pass out and die. This fear is usually overblown, as generally the fast and accompanying weakness are not dangerous. (There are some serious illnesses where fasting may even be helpful.) Nevertheless, it is possible that a person does have some issue which might make fasting dangerous. Therefore, if someone is so afraid he might die that he asks for food and drink despite the holiness of the day, we give it to him. However, since the need is sometimes simply psychological, we begin by giving him only a little bit to eat. Sometimes this is enough to reassure him and bring about a recovery. If this does not work, we continue giving him small quantities of food, spread out over time (as explained in the previous section). If this too does not work, he is allowed to eat and drink until he is reassured (SA 617:2-3).
Sometimes just knowing that it is permissible to eat and drink restores a person’s wellbeing. He calms down and feels able to continue fasting. There is a story in the Yerushalmi (y. Yoma 6:4) about R. Ĥaggai, who became very weak as a result of fasting. Once R. Mana told him to drink, he decided that he could manage, and he continued to fast. Many poskim find this story instructive (Kol Bo §69, cited by Beit Yosef 618:1).
On the other hand, we must be very careful not to take danger lightly. If the doctors have directed someone to eat and drink, he should do so joyfully, as he is fulfilling God’s commandment to take care of his health. Hopefully, a person will merit long life as a reward for observing this mitzva. Torah giants made it a practice to admonish the sick about this. If they knew that a particular sick person was likely to disregard medical advice and fast, thus endangering his life, they would visit on Yom Kippur to persuade him to eat and drink.
7. Those Eating on Yom Kippur
People who are allowed to eat on Yom Kippur (children and the dangerously ill) must recite berakhot before eating and drinking. If they eat or drink enough to require a berakha aĥarona, they recite that as well. Someone dangerously ill who is drinking only small quantities does not recite a berakha aĥarona, as he drinks less than a cheek full each time. (A berakha aĥarona is recited only after drinking a revi’it, which is 2.5 ounces or 75 milliliters; see Peninei Halakha: Berakhot 10:10.)
In terms of eating, even one who is eating small quantities may be obligated to recite a berakha aĥarona. This is because one who eats the volume of an olive is obligated to recite a berakha aĥarona, and someone eating le-shiurim on Yom Kippur is permitted to eat as much as a large date (ibid. 10:5).
As we said above (section 5 and n. 6), it is preferable when possible for the dangerously ill to eat and drink minimally, but when that is difficult, they should eat and drink normally. For example, a woman who just gave birth and needs to sleep can eat and drink regularly to help her recovery. Diabetics who are praying with the community should eat and drink normally, so that they can attend synagogue without endangering themselves. Children who eat and drink on Yom Kippur should also do so normally.
People who are eating bread must first do netilat yadayim (ritual hand-washing). However, rather than washing to the wrists, they should wash only to the knuckles. They should wash each hand twice (Peninei Halakha: Berakhot 2:3, 2:11). Someone who intends to eat less than the volume of an egg does not recite "al netilat yadayim." If he intends to eat more than that, he recites the blessing (Peninei Halakha: Berakhot 2:6).
Someone who always washes mayim aĥaronim before reciting Birkat Ha-mazon may do so on Yom Kippur as well. If someone does not normally do so, he should not do so on Yom Kippur either (9:5 below).
Someone who eats bread that is at least the volume of an olive must recite Ya’aleh Ve-yavo during Birkat Ha-mazon and mention Yom Kippur. If he forgot to do so, he does not repeat the prayer. If Yom Kippur is on Shabbat, he should also recite Retzei, but if he forgot, he does not repeat Birkat Ha-mazon.
Someone who is reciting Al Ha-miĥya should mention Yom Kippur. It goes without saying that if he forgot to do so, he does not repeat it, since even on a normal Shabbat someone who forgot to mention Shabbat during Al Ha-miĥya does not repeat it.
Some say that a dangerously ill person who is eating on Yom Kippur must make "ha-motzi" over two loaves of bread (leĥem mishneh). Additionally, if it is Shabbat, he must make Kiddush before eating. However, according to most poskim, one does not need to make Kiddush or use leĥem mishneh on Yom Kippur, and the halakha follows them.
8. Pregnant Women
Pregnant and nursing women are obligated to fast on Yom Kippur (Pesaĥim 54b; SA 617:1). They are even obligated to fast on Tisha Be-Av, which is a rabbinic requirement, so certainly they are obligated to fast on Yom Kippur, which is a Torah requirement.
In recent times, some rabbis have been allowing pregnant women to drink minimal amounts on Yom Kippur, because they believe that pregnant women are weak and may miscarry if they fast. However, research done both in Israel and abroad shows that fasting does not increase the risk of miscarriage. In rare cases, fasting during the ninth month may bring on labor, but this is not life-threatening. There is also no basis for the claim that people today are weaker than they used to be. On the contrary, people are healthier than they have ever been, whether due to the abundance and variety of available food or due to advances in medicine. Life expectancy has gone up by decades. Therefore, there is no reason to be more lenient today than in the past, and the law still applies – pregnant and nursing women are required to fast (Tzitz Eliezer 17:20:4; Nishmat Avraham 617:1).
This means that even pregnant women who throw up, have slightly elevated blood pressure, low hemoglobin, or other normal discomforts associated with pregnancy are obligated to fast on Yom Kippur, and are not permitted to drink even minimally. Consulting a God-fearing doctor is only necessary if a woman is in the first few weeks of pregnancy following IVF or going through an especially difficult or high-risk pregnancy. If the doctor says that there is possible danger to the life of the mother or the fetus, then she may drink, preferably le-shi’urim. In contrast, a woman experiencing a normal pregnancy with normal symptoms (even if this includes throwing up) must fast. There is no reason to even ask a rabbi about it. Nevertheless, if a pregnant woman who is fasting feels that her situation has become dangerous, she should eat and drink as needed.
9. During Labor and After Birth
From the moment labor begins, or from the moment a woman is hospitalized pre-birth, she is considered to be dangerously ill, and she must eat and drink as needed. This is her status for the first three days following birth as well, defined as 72 hours from the moment of birth. If these 72 hours end during Yom Kippur, she can eat and drink as needed until that point. As we have seen, it is preferable for anyone dangerously ill to eat and drink minimally, if this will not be harmful. If a woman who gave birth wants to sleep, and eating and drinking minimally will make it hard for her to get the rest she needs, then she should eat and drink normally.
Cases where a woman is between three days and a week after birth need to be evaluated individually. If it is clear to her and her doctor that she is in no danger, then she should fast. If they are uncertain, she should not fast (SA 617:4).
10. Nursing Women
As we have stated, pregnant and nursing women are obligated to fast on Yom Kippur (Pesaĥim 54b; SA 617:1). True, there are poskim today who believe that nursing women may drink le-shi’urim, to ensure that the fast will not cause their milk to dry up. Nevertheless, according to most poskim, nursing mothers must fast on Yom Kippur and even Tisha Be-Av. Even though nursing makes the fast more difficult because of the additional loss of fluids, this is not life-threatening. It does not endanger the baby either, because even if the mother’s milk decreases or dries up, milk substitutes are available. In fact, women who fast are generally able to continue nursing.
Good advice for nursing mothers is to skip every other feeding. This will help them make it through the fast relatively easily. In other words, a woman who normally nurses every three hours should nurse at 10 AM. At 1 PM she should use formula or another substitute, and then nurse again at 4 PM. At 7 PM she should once again use a substitute. This way, she will not suffer too much during the fast, and she will not produce less milk. Some babies will not accept a substitute from their mother, in which case someone else needs to feed them formula or sugar water.
The following case is an exception. Let us say that the baby is so small, weak, and sickly that the doctor believes that he must have mother’s milk. But if the mother fasts, there is a concern that her milk will dry up or be considerably depleted. In such a case, she may drink le-shi’urim if a God-fearing doctor instructs her to do so (BHL 717:1). However, this is rare; if a nursing mother drinks a lot the day before the fast, it is almost certain that her milk will not be depleted as a result of fasting. It is even better if, starting three days before the fast, she drinks and sleeps extra. This will increase her milk supply. Additionally, she can pump in the days before the fast. This way the baby will have plenty of milk during the fast, and there is no concern that the mother’s milk will be depleted.

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