NARR 239-241

CCAR RESPONSA

New American Reform Responsa

151. DRUGS TO RELIEVE PAIN

QUESTION: Does Jewish tradition set a limit to the use of drugs in order to alleviate pain? Frequently, physicians seem hesitant to prescribe drugs due to the fear of addiction or other reasons. What is our attitude toward pain and its alleviation? (Rena T. Hirsh, Santa Barbara CA).

ANSWER: Jewish tradition is not ascetic and does not endorse self affliction through pain. The only exception is Yom Kippur along with some of the lesser fast days. On that day we are commanded to “afflict our souls,” but that does not entail real suffering, only fasting and abstinence from sexual intercourse. Even fasting is not necessary for those who are physically impaired. We feel no necessity to renounce this world and its blessings and so need not afflict ourselves in order to attain salvation in the next world. This is in vivid contrast to some forms of Christianity.

It is true that rabbinic tradition has interpreted the suffering of the people of Israel and of individuals, as either Divine punishment or as a test (Job; B B 5a; Shab 55a, etc). However, in none of the sources and many others has anyone been asked to seek suffering, rather we try to avoid it. During illness we may use every medical means available to avoid pain (Shulhan Arukh Yoreh Deah 241.13 and commentaries).

There are enormous variations in the pain threshold of individuals. Many physicians refuse to consider this or do not appropriately deal with the entire issue of pain. Sometimes this is because specialists, who do not communicate with each other, are treating the patient; each is concerned with a specific organ or system and none is aware of the total effect on the patient. At other times, it is simply due to indifference and a lack of interest in the patient, possibly because the attending physician has never suffered any serious pain. There is certainly nothing within Jewish tradition which would restrain the treatment of pain. We would have a greater fear of continuous pain than addiction.

We must be equally concerned with pain of the terminally ill. There is a fine line of distinction between alleviating pain and prescribing a drug which may hasten death. When the pain is great the physician should alleviate the pain and not be overly concerned about the latter consequence, as death is certain in any case. (W. Jacob (ed) American Reform Response #79, etc).

There is nothing within Jewish tradition that would keep pain medication from being given when medically indicated. We would hope that the patient be made as comfortable as possible and that this will help recovery or make the last days of life easier.

August 1991

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