By Rabbi Moshe Rotberg
- Taking Tzom Kal and Other Supplements Prior to Yom Kippur
It has become increasingly popular for people to take a variety of different pills and supplements prior to Yom Kippur to help make the fast easier. At times these are Tylenol or caffeine pills which are slowly released throughout the fast. The S’dai Chemed (Maereches Yom Kippur end 1) brings that this is prohibited since in fact this would be a violation of the requirement for one to be pained of hunger on Yom Kippur.
Most Achronim disagree with his premise. They explain that the prohibition of v’ineesem es nafshosaichem is simply not to eat on Yom Kippur, if one eats prior to Yom Kippur as is required by halacha he is not prohibited in doing so just because he may not be as hungry during the fast (See Tzitz Eliezer Vol. 7; 32).
Therefore, according to most Achronim taking pills or supplements prior to the fast would be halachically acceptable.
- Taking Medications or Suppositories on Yom Kippur when the individual is not a choleh sheyesh bo sakana
Today there are certain supplements which do not have to be taken orally. Some of these items may be medications or caffeine.
There is much talk in the Achronim whether or not someone who keeps drinking less than the shiur to the point where he is no longer thirsty is chayav kores, since ultimately he did not fulfill the requirement of v’ineesem. While suppositories (and IV fluids, however see what was written further in regard to that) would not be in the same category, most Achronim nonetheless rule that it is prohibited to do so.
The only allowance given is for someone who is sick that is classified as a choleh sheain bo sakana (meaning they are in a lot of pain or they are so weak that they are bedridden). In that case there are those who then allow for suppositories.
As such, there are some Achronim (See Rav Shlomo Zalman Auerbach zt”l, Halichis Shlomo Hilchos Yom Kippurim) who write that a choleh sheain bo sakana can also take a pill so long as it tastes bitter. If it does not taste bitter, he advises to wrap the pill in a piece of paper so that it is not k’derech achila.
Each year Hatzolah members and doctors are approached in Shul or called with regards to individuals who are ill from fasting. While no one will ever tell a person not to call or consult a medical professional it is important to still know some basic guidelines.
A choleh who a doctor (or even anyone with knowledge of what is needed) instructed to eat on Yom Kippur must do so. Even if the doctor maintains that the person will not necessarily die but the illness will intensify, that person still must eat. The reason is that Chaza”l feared that the person will die as a result [of the illness intensifying] (Mishnah Berurah 618; 2). When it comes to the risk of life we give the medical professionals the benefit of the doubt, which means that even if the patient or another doctor disagree with regards to the need to eat we listen to the doctor who mandates that there is a need to eat. Conversely, if the doctor states that a person does not need to eat and the patient disagrees, we listen to the patient.
All cholim r”l should consult a doctor and Rov prior to Yom Kippur to see if they are allowed to fast. In addition, they should try to ask the doctor whether drinking and not eating would suffice to make sure that there is no risk. One should try to verify whether eating and drinking pachus m’kshiur would suffice.
- Pregnant and Nursing Women
Pregnant and nursing women are required to fast as per the ruling of the Shulchan Aruch. Dayan Fisher zt”l as well some other Poskim maintain that since there is a risk of miscarriages and pre-term labor, pregnant women should be allowed to eat. However this has not been accepted by most of thePoskim (See Tzitz Eliezer Vol. 17; 20 T’shuvos V’hanhagos Vol. 2; 292 and others). Therefore, pregnant women in general are required to fast. Obviously a woman with a difficult pregnancy; or a woman who has compounded risk factors needs to consult with a doctor (and a Rov) prior to fasting.Rov). As such, anytime someone is really not feeling well they need to consult a medical professional even on Yom Kippur .
In general, nursing women do not have an added allowance to eat. (In a rare case where the baby is ill and can only nurse from the mother without any other substitute there may be room for lenieincy. See Chazon Ish (O.C. 59; 3-4) with regards to Shabbos , however today this issue does not seem all that prevalent.)
- Post-Partum Women
A woman who is within three days of giving birth should not fast on Yom Kippur. There is some debate as to how we calculate these three days. TheMishnah Berurah (Ibid 13) writes that this means 72 hours from the delivery. From the third to the seventh day if the woman states that she feels she needs to eat she may.
A woman in labor (consult a Rov to ascertain the correct time) is considered a yoledes and may eat (if her doctor allows her to). A woman who miscarries may also be considered a yoledes. (When the miscarriage is prior to 40 days of gestation a Rov must be consulted regarding how to classify this- See Biur Halacha s.v. Yoledes and the Sdai Chemed Mareches Yom Kippurim 3; 1 which he refers to .)
- I.V. Fluids on and Prior to Yom Kippur
At times people will call Hatzolah to ask for a paramedic to administer an I.V. line on Yom Kippur. Most times this should not be done as we will explain.
A choleh who needs to eat on Yom Kippur should not ask to have an I.V. line inserted prior to Yom Kippur to enable fasting. Rav Moshe Feinstein zt”l(O.C. 3; 90 O.C. ; 101) maintains that one is prohibited from doing so. His reasoning is that one who is allowed to eat according to halacha has no right to inflict a wound on himself (via I.V. administration) to alleviate a symptom in order to fast. He also maintains that there are always some risk factors with any procedure, and, albeit a small one, it is still not required to take this risk when halacha clearly states that he does not need to fast. He also maintains that it is not likely that IV fluids totally satisfies the body as eating would. Rav Shlomo Zalman zt”l (Halichos Shlomo, Refuah) has a similar position.
On Yom Kippur one should certainly not ask for someone to do a melacha (of inserting the I.V. line) in order to enable them to fast when they can simply eat permissibly.
- Husband’s Staying Home from Shul
Rav Moshe zt’l (Ibid) Rav Shlomo Zalman zt”l (Ibid) and Rav Shternbuch ybl”c (Ibid ) write that if a woman will not be able to fast because she is weak from taking care of the children and household and there is no other help, the husband must stay home to help her so that she will be able to fast. In addition, if one will go to Shul, and by doing so risk getting weak and need to eat, it is better that they should stay home and not daven with a minyan, so they can fast.
- Can a Choleh who is Eating on Yom Kippur Get an Aliya?
Rav Akiva Eiger zt”l (Vol. 1; 24) writes that someone who is not fasting on Yom Kippur since he is sick can still get an aliya. He explains that the reason for this is since in essence this person is not doing an avaira, he is not an avaryon. However, he debates whether the same holds true with getting analiya by Mincha . There are those who say that when the person is eating less than the shiur then he can , as well as when Yom Kippur falls out on Shabbos.
BAIS HAVAAD HALACHA CENTER