Academic journal article Journal for the Study of Religions and Ideologies

The Physician vs. the Halakhic Man: Theory and Practice in Maimonides's Attitude towards Treating Gentiles

Academic journal article Journal for the Study of Religions and Ideologies

The Physician vs. the Halakhic Man: Theory and Practice in Maimonides's Attitude towards Treating Gentiles

Article excerpt

1.Introduction

The relationship between the doctor and his patients is the basis of all medical systems and it is inherent in all enduring human societies, from ancient times to the modern era. Such interpersonal interactions have social significance as well, as they create an essential point of contact between people who belong to diverse faiths and cultures that are sometimes rival and hostile. The current paper focuses on the rigid halakhic attitude of Maimonides (12th century), a medieval Rabbi and physician, towards providing medical services to gentiles. The issue of treating people from a different ethnic or racial background is also relevant for modern contemporary society, which is varied and multicultural.

The physician's ethical duty to provide medical treatment to patients from all backgrounds and social classes is one of the principles of the Hippocratic Oath (Copland, 1825, 258; Edelstein, 1943). In fact, the Hippocratic Oath does not deal explicitly with ethnic and racial differences between patients and this issue has been incorporated in modern physicians' oaths (WHO, 2006). The question is, do the Jewish halakhic sources agree with the ethical attitude of the Hippocratic Oath and its objection to distinguishing between patients?

1. The attitude of Classical Rabbinic Literature to medical relationships of Jews and non-Jews

The bible voices no injunction against medical relationships with nonJews. However, the halakhic attitude of the sages is different. The first signs of medical restrictions of Jewish-gentile relationships emerged and crystallized in the Mishnah and Talmud periods (c. 3th century BCE-5th century CE). The classical rabbis imposed a double restriction. First of all, they prohibited the provision of medical services to non-Jews - medical care, circumcisions, and delivering their babies (Mishna, Avoda Zara, 2:1; Babylonian Talmud, ibid., 26b). The prohibition is based on the injunction against assisting and supporting pagan societies that contradict the foundations of monotheistic Jewish faith (Mishna, Avoda Zara, 1:1-2; 2:2; Babylonian Talmud, ibid., 25b). We assume that these restrictions did not stem only from a conflict between monotheism and polytheism. The gentiles that are presumed in Sages texts were not only the advocates of an objectionable theology, but the rapacious Roman occupying power with whom the Jews were also in a protracted struggle for political independence.

At the same time, receiving services from non-Jewish physicians and healers was limited as well for fear of harassment or murder disguised as a medical failure (Mishna, Avoda Zara, 2:2; Tosefta, Hulin, 2:21, Zuckermandel edition, 503). It was forbidden to receive medical treatment from non-Jews or to buy medicines that may be lethal if taken in inexact doses, Such as opium and Theriac (Jerusalem Talmud, Avoda Zara, 2:2, 40d). Another concern was the use of idolatrous elements contradicting the patient's Jewish faith as part of the medical treatment, or the negative religious influence of non-Jewish physicians on Jewish patients (Babylonian Talmud, Avoda Zara, 27b).

These religious restrictions might have aggravated the friction between the faiths and created severe social conflicts, particularly in circumstances that entailed a mixed society utilizing joint systems. As a result, as early as the Talmudic age we see rabbinical reservations with regard to the all-inclusive prohibition of medical relationships. Accordingly, the risk of interfaith tension served as grounds for permitting medical treatment of non-Jews and assisting in the labor of non-Jewish women, for a fee (Babylonian Talmud, Avoda Zara, 26b).

2.The physician-patient relationship in multicultural societies: Past and present

Intercultural differences between practitioners and patients are inevitable in socially diverse societies. Medical conflicts emerge in multicultural environments when an ethnic minority resides within the geographical boundaries of another group or in countries where the population is comprised of many nationalities with different cultural identities, usually an outcome of migration and demographic transitions (Ayonrinde 2003, 233-248). …

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