Biblical Ethics on Withholding Medical Intervention
Biblical ethics on withholding medical intervention are complex, with various traditions offering distinct perspectives rooted in their interpretations of scripture and tradition. Generally, the question involves balancing the preservation of life with other ethical considerations, such as the source of treatment or the patient's condition.
In Jewish rabbinic tradition, there is a strong emphasis on the preservation of life, which often mandates seeking medical treatment. Maimonides, in the Mishneh Torah, discusses various aspects of medical intervention. For instance, he notes that if a condition for marriage is based on the absence of blemishes, and a physician can heal those blemishes, the condition can be met, implying the legitimacy and efficacy of medical treatment [1]. The Mishneh Torah also addresses specific medical practices, such as inducing vomiting, distinguishing between methods that might lead to forbidden labor (like crushing herbs) and those that are permissible (like placing a hand down one's throat) [2]. This suggests a nuanced approach to medical actions, where the method and its potential implications for other religious laws are considered.
However, the Jewish tradition also introduces qualifications regarding the source of medical care. The Babylonian Talmud, in Avodah Zarah, permits receiving medical attention from a gentile if one's life is in danger and no other treatment is available [3, 5]. This permission is contrasted with treatment from a "heretic," which is generally prohibited due to the concern that one might be drawn to their heresy [3, 5]. This highlights a tension between the imperative to save a life and the concern for spiritual integrity. Maimonides further elaborates on this, stating that it is forbidden to offer medical treatment to an idolater, even for a wage, unless there is fear of negative consequences or ill feeling. However, a ger toshav (resident alien) may be treated without cost, as their well-being is commanded [8].
The severity of an illness also plays a role in Jewish ethical considerations. Maimonides distinguishes between dangerously ill individuals and those who are not. For a dangerously ill person, actions that might otherwise be forbidden on the Sabbath are permitted to save a life [6]. For those not dangerously ill, taking medication might be rabbinically prohibited if it involves forbidden labors, or even if it's a minor ailment [6]. This indicates that the urgency and life-threatening nature of the condition are crucial factors in determining the permissibility of medical interventions.
Patristic thought, as seen in the writings of early Christian fathers, also touches upon the role of medicine, sometimes with a degree of skepticism regarding its ultimate efficacy compared to divine power. Clement of Alexandria, for example, suggests that while some may be healed by material medicine, "much more will he be healed by having recourse to the power of God" [7]. This does not necessarily prohibit medical intervention but places it within a broader theological framework where divine healing is paramount. Origen, in a similar vein, discusses how teachers of Christianity might be accused of preventing people from consulting "skilled physicians" (referring to philosophers), but he clarifies that the Gospel is not meant to turn people away from beneficial knowledge but to offer a different kind of healing [9]. Augustine, in his homilies, uses the analogy of a skilled physician who is an enemy of a sick man's powerful friends, implying that one should not reject necessary help due to external animosities, especially when eternal salvation is at stake [4]. This suggests a pragmatic view where effective treatment, regardless of its source, should not be arbitrarily rejected.
In Reformed theology, as articulated by Charles Hodge, divine intervention in healing is acknowledged, often through "special interventions of God" that produce effects "without any intervention of second causes" [10]. This perspective emphasizes God's ultimate sovereignty over health and healing, whether through miraculous means or through the ordinary course of nature and human agency, including medicine. While not directly addressing the withholding of medical intervention, this theological framework implies that all healing ultimately derives from God, whether directly or through the means He provides.
Sources
- Mishneh Torah (Maimonides) (Jewish (Rabbinic)) “Mishneh Torah (Maimonides), Mishneh Torah%2C Marriage 7:9: If [a man] consecrates [a woman] on condition that she does not have physical blemishes, and she does have blemishes, she is not consecrated, even if [afterwards,] she goes to a physician who heals these blemishes. 14 The wording used by the man is significant. If he states: "Behold, you are consecrated on condition that you will not have blemishes," the kiddushin are binding if a physician is able to heal her ( Shulchan Aruch, Even HaEzer 39:7). When, by contrast, a man enters into a marriage contract on condition that he is not bound”
- Mishneh Torah (Maimonides) (Jewish (Rabbinic)) “Mishneh Torah (Maimonides), Mishneh Torah%2C Sabbath 21:31: A person may not cause himself to vomit food on the Sabbath. When does this apply? When he uses a drug, 143 Note the Shulchan Aruch ( Orach Chayim 328:39), which states that because this is a wasteful activity, it is forbidden during the week as well, unless one is suffering discomfort. for he may come to crush herbs. It is, however, permitted to place one's hand down one's throat so that one will vomit. It is forbidden to press the stomach of an infant so that he will defecate, 144 This is one of the instances where the commentaries ”
- Babylonian Talmud (Jewish (Rabbinic)) “Babylonian Talmud, Avodah Zarah 153b.54:8: The Gemara explains: Heresy is different, as it is enticing. In other words, it is prohibited to accept medical treatment from a heretic, as one might come to be drawn after his heresy. By contrast, receiving medical attention from a gentile is permitted if it is certain that one will die if he is not treated.”
- Schaff ANF/NPNF (Patristic) “NPNF1 Vol 6: Augustine — Homilies on the Gospels — SERMON XXXVII. (part 12): the smoke be taken away which vanishes as it mounts; let them be utterly despised when the question is of this salvation. 13. If any one in a city had some bodily sickness, and there was in that place some very skilful physician who was an enemy to the sick man's powerful friends; if any one, I say, in a city were labouring under some dangerous bodily sickness; and there was in the same city a very skilful physician, an enemy as I said, of the sick man's powerful friends, and they were to say to their friend, "Do not ”
- Babylonian Talmud (Jewish (Rabbinic)) “Babylonian Talmud, Avodah Zarah 27b.8: The Gemara explains: Heresy is different, as it is enticing. In other words, it is prohibited to accept medical treatment from a heretic, as one might come to be drawn after his heresy. By contrast, receiving medical attention from a gentile is permitted if it is certain that one will die if he is not treated.”
- Mishneh Torah (Maimonides) (Jewish (Rabbinic)) “Mishneh Torah (Maimonides), Mishneh Torah%2C Sabbath 2:10: When a sick person is not dangerously ill, 35 This refers to ailments which, although not threatening to a person's life, are after all serious, and cause him to be confined to bed ( Shulchan Aruch, Orach Chayim 328:17) or which cause him to feel weakness throughout his entire body (Ramah, loc. cit. ). In contrast, if the person merely feels ill or has a minor ailment in a particular limb, there is a Rabbinic prohibition against taking medication even when the performance of forbidden labors is not involved. (See Chapter 21, Halachah 3”
- Schaff ANF/NPNF (Patristic) “ANF Vol 2: Hermas, Tatian, Theophilus, Athenagoras, Clement of Alexandria — CHAP. XVIII.--THEY DECEIVE, INSTEAD OF HEALING.: But medicine and everything included in it is an invention of the same kind. If any one is healed by matter, through trusting to it, much more will he be healed by having recourse to the power of God. As noxious preparations arc material compounds, so are curatives of the same nature. If, however, we reject the baser matter, some persons often endeavour to heal by a union of one of these bad things with some other, and will make use of the bad to attain the good. But, ju”
- Mishneh Torah (Maimonides) (Jewish (Rabbinic)) “Mishneh Torah (Maimonides), Mishneh Torah%2C Foreign Worship and Customs of the Nations 10:2: From the above, we can infer that it is forbidden to offer medical treatment to an idolater even when offered a wage. If, however, one is afraid of the consequences or fears that ill feeling will be aroused, one may treat them for a wage, but to treat them free is forbidden. [With regard to] a ger toshav , since we are commanded to secure his well-being, he may be given medical treatment at no cost.”
- Schaff ANF/NPNF (Patristic) “ANF Vol 4: Tertullian IV, Minucius Felix, Commodian, Origen — CHAP. LXXV. (part 1): But as he afterwards says that "the teacher of Christianity acts like a person who promises to restore patients to bodily health, but who prevents them from consulting skilled physicians, by whom his ignorance would be exposed," we shall inquire in reply, "What are the physicians to whom you refer, from whom we turn away ignorant individuals.? For you do not suppose that we exhort those to embrace the Gospel who are devoted to philosophy, so that you would regard the latter as the physicians from whom we keep a”
- CCEL (Reformed (Old Princeton)) “Charles Hodge, Systematic Theology, Vol. 2, section 140: means; that He intervenes by his immediate efficiency producing effects by his simple volition without any intervention of second causes. In such cases the effect is to be referred exclusively to his almighty power. There special interventions of God, for what we know, may be, and probably are, innumerable. However this may be, it is certain that the Bible is full of recorded cases of this kind. All his supernatural revelations, all inspiration and prophecy, all supernatural gifts, and all miracles, whether in the Old Testament or in the”