I. Outdated Prohibition?
Medical technology has changed so dramatically over the past century that we can barely imagine the healing process of past years. Presumably, Jewish law should reflect that change, relating to current medicine rather than that of the past. In particular, the prohibition against taking medicine on Shabbos (absent pressing need) seems ripe for reevaluation. While halakhah is not changing, the appropriate rule for the different circumstances must be invoked.
We are forbidden to take medicine on Shabbos out of a concern that we might grind, which is biblically prohibited (Shulchan Arukh, Orach Chaim 328:1). However, medicine today is manufactured commercially and/or mixed at a pharmacy. We do not grind our own medicines but instead take the liquids and pills professionally prepared. If so, does this prohibition still stand?
To be clear, someone with a serious need for medication may certainly take it on Shabbos. There are numerous other exceptions (we’ll briefly mention some below) and you should discuss your personal situation with your rabbi. Good health is unquestionably a religious value. However, sometimes you just have a minor headache or need a little ointment or some other minor medical need that is not pressing. In ancient times, you might have ground yourself some herbs to relieve your pain. Must we retain this outdated concern?
I can imagine some people thinking that raising this question is bordering on heresy, revealing a lack of faith in the halakhic system. Quite the opposite! This is an excellent question that the greatest halakhic authorities of recent times have asked.
II. Permissible Today
R. Avraham Chaim Na’eh (Ketzos Ha-Shulchan 134 n. 7.2) considers the above logic to permit taking medicine in pill form on Shabbos. Since the rabbinic concern for grinding no longer exists, perhaps the prohibition no longer applies. He bases his argument on the Rema (Orach Chaim 339:3) who, quoting Tosafos (Beitzah 30a sv. tenan), permits clapping on Shabbos because we are no longer concerned that this might lead to fixing a musical instrument. Once the reason for the rabbinic decree ceases, the prohibition falls aside. However, because there are still some people somewhere in the world who grind herbal medicine (at the time of his writing and still today), R. Na’eh was not willing to rule leniently.
This general approach is very difficult because the view of the Rema and Tosafos seems to contradict explicit Talmudic passages. While resolutions have been proposed, none are particularly satisfying. As R. Joseph B. Soloveitchik is quoted as saying (Nefesh Ha-Rav, p. 173), we don’t understand the initial permission so how can we expand it to others cases? (See also Pischei Teshuvah, Even Ha-Ezer 13:4, 9; Iggeros Moshe, Orach Chaim 2:100.) For this reason, most later authorities reject R. Na’eh’s permissive theoretical view.
III. Two Approaches
R. Eliezer Waldenberg (Tzitz Eliezer vol. 8 15:15) takes a different path toward leniency. He argues that two general approaches exist to the prohibition against (non-essential) healing on Shabbos. Rashi (Shabbos 53b sv. gezeirah) believes that the Sages enacted a general (obviously rabbinic) prohibition against any type of healing on Shabbos. While the underlying concern was grinding on Shabbos, the prohibition itself is not directly related. We see this in a number of cases, such as the permission to place a plaster on your eyes on Shabbos, which would be forbidden because of healing except that it looks like cleaning your eyes (Rashi, Shabboss 108b sv. ve-nosein). And similarly, Rashi (Shabbos 111a sv. aval) explains that you may not anoint with rose oil because you are clearly doing it solely for medical purposes. None of these examples involve a concern for grinding medicine but are still forbidden because of the general prohibition.
On the other hand, Rambam (Mishneh Torah, Hilkhos Shabbos 21:31) permits certain acts of healing, implying that the prohibition was specifically against taking medicine to treat an illness that is generally healed with privately ground medicine. Even if you do not grind the medicine, taking it is forbidden because grinding is generally involved in treatment.
According to Rashi and those who agree with him, the change in medical technology does not undermine the general prohibition of the Sages. While they may not have enacted such a prohibition today, their ancient enactment remains in force. However, according to the Rambam, this enactment is specifically about grinding medicine on Shabbos that you normally grind during the week. Since we do not personally grind medicine anymore, the prohibition should no longer apply.
IV. Qualified Leniency
Significantly, the Shulchan Arukh (ibid.) adopts the Rambam’s approach. If we follow this view, then today when we do not normally grind medicine for any illness, we may presumably freely take medicine on Shabbos. However, R. Waldenberg is cautious because some people do grind homemade remedies and because there are other interpretations of the Rambam’s position. He therefore decides to be as lenient as possible without being entirely permissive.
He notes that some quote R. Shlomo Kluger as permitting continuing taking a medication on Shabbos that you have already started taking prior. While R. Waldenberg disagrees with R. Kluger, he permits continuing taking medicine if failing to do so will cause severe discomfort. He allows relying on R. Kluger’s view because of, additionally, the above argument to permit taking medicine in general.
Similarly, R. Ovadiah Yosef (Yalkut Yosef 328:52) finds R. Na’eh’s reasoning convincing but, without dismissing the prohibition, allows for great leniency. For example, he permits someone accustomed to swallowing pills to take medicine to relieve pain. R. Eliezer Melamed (Peninei Halakhah, Shabbos 28:5 and in harchavos) also allows taking medicine when suffering from pain that does not render you a choleh she-ein bo sakanah, because of the lenient views. See also She’arim Metzuyanim Ba-Halakhah (Beitzah 5a sv. kol).
V. Stricter Views
However, other authorities disputed R. Waldenberg’s conclusion, which is based on his original interpretation of the Rambam. As mentioned above, R. Joseph B. Soloveitchik opposed leniency on this subject. Similarly, R. Moshe Feinstein (Iggeros Moshe, Orach Chaim 3:53) forbids taking pills on Shabbos. R. Yehoshua Neuwirth (Shemiras Shabbos Ke-Hilkhasah 34:3), Dr. Avraham S. Avraham (Nishmas Avraham, Orach Chaim 328:5) also maintain the Talmudic prohibition against taking medicine.