Jewish Halakhic Authorities' Attitudes Towards Treating Muslims in the 12Th
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The Review of Rabbinic Judaism 21 (2018) 108–133 brill.com/rrj “I bear the burden of treating the gentiles”: Jewish Halakhic Authorities’ Attitudes towards Treating Muslims in the 12th–18th Centuries Abraham Ofir Shemesh Ariel University, P.O.B. 3, Ariel, 40700, Israel [email protected] Abstract The paper focuses on the religious, social, and historical aspects of the ancient Jewish prohibition against treating non-Jews. It discusses the attitude of rabbinic authorities towards providing medical service to Muslims in medieval and pre-modern times. It points out that circumstances did not enable the public to fulfill these instructions to the letter, and therefore many halakhic authorities in the post-Talmudic period dispensed with the prohibition almost completely. The question of treating Muslims was discussed by halakhic authorities in both Christian and Muslim countries. Stricter views were voiced concerning the treatment of Christians, but the dispensation to treat Muslims and deliver their babies was more pronounced. Halakhic authorities claimed that the original prohibition regarded idolaters, while Muslims do not engage in idolatry. Another major claim supporting the concession was a concern for animos- ity and harassment within the non-Jewish environment. Keywords Maimonides – Baruch Harofe – Ḥekim Yakub – idolaters – halakhic authorities – Jews treating non-Jews The physician-patient relationship is the basis of all medical systems, and it is inherent in all enduring human societies. Such interpersonal relationships have social significance as well, as they create an essential point of conver- gence between people who belong to diverse faiths and cultures, which are © koninklijke brill nv, leiden, 2018 | doi 10.1163/15700704-12341339Downloaded from Brill.com09/26/2021 12:30:07PM via free access “I bear the burden of treating the gentiles” 109 sometimes rival and hostile. 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: “Whatsoever house I may enter, my visit shall be for the convenience and advantage of the patient; and I will willingly refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be my duty to cure, whether mistress or servant, bond or free.”1 The Hippocratic Oath does not deal explicitly with ethnic and racial differences between patients, but this issue has been incorporated in modern physicians’ oaths.2 Do the early Jewish halakhic sources agree with the ethical attitude of the Hippocratic Oath in its objection to distinguishing among patients? The Bible voices no injunction against medical relationships with non-Jews. The story of Elisha the Prophet who cured Na’aman, the Aramaic captain of the guard who suffered from leprosy, may indicate that no such restriction existed. The story was clearly intended to reinforce the status of the prophet as a miracle worker not only in the eyes of the Israelites but also as perceived by gentiles.3 Moreover, God is described in Scripture as one who “strikes and heals,” a prin- ciple applied to both Jews and gentiles. 1 For the English translation of the Hippocratic Oath, see James Copland, “The Hippocratic Oath,” in The London Medical Repository 23 [135] (1825), p. 258. For the Greek text, see W.H.S. Jones, ed., Hippocrates Collected Works (Cambridge: Harvard University Press, 1868), pp. 130–131. On the ethical principles of the oath, see Ludwig Edelstein, The Hippocratic Oath: Text, Translation and Interpretation (Baltimore: Johns Hopkins Press, 1943). 2 The modern version of the Hippocratic Oath is the Declaration of Geneva (Physician’s Oath) of the World Health Organization (WHO). The declaration is currently published by the World Medical Association (WMA). The revised version mentions the physician’s duty to cure all patients: “I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient.” See in the WMA website: http://www .wma.net/en/30publications/10policies/g1/ 3 2 Kings 5:1–14. On this trend in the Elisha stories, see Alexander Rofe, The Prophetical Stories: The Narratives about the Prophets in the Hebrew Bible, Their Literary Types and History (Jerusalem: Magnes, Hebrew University, 1982), pp. 42–64 [Hebrew]; Uriel Simon, Literary Reading of the Bible: Stories of the Prophets (Jerusalem and Ramat Gan: Biyalik Institute and Bar Ilan University Press, 1997), pp. 279–324 [Hebrew]. On the prophets as physicians see Ernst R. Wendland, “Elijah and Elisha: Sorcerers or Witch Doctors?,” in Bible Translator 43 (1992), pp. 213–223. The Review of Rabbinic Judaism 21 (2018) 108–133 Downloaded from Brill.com09/26/2021 12:30:07PM via free access 110 Shemesh The first signs of restrictions on Jewish-gentile medical relationships emerged and crystallized in the period of the sages (c. 300 BCE–500 CE). Medical prohibitions are one of many rabbinical restrictions on relationships between Jews and non-Jews, based on the concern that non-Jews would harm Jews, for example, when they received haircuts from non-Jewish barbers who used knife and scissors, or even just walked together, for fear of attack.4 The rabbis imposed a double restriction. First, they prohibited the provision of medical services to non-Jews—medical care, circumcisions, and delivering their babies5—based on the injunction against assisting and supporting pagan societies that contradict the foundations of monotheistic Jewish faith.6 We assume that these restrictions did not stem only from a conflict between monotheism and polytheism. The gentiles 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, second, receiving services from non-Jewish physicians and healers was limited for fear of harassment or murder disguised as a medi- cal failure.7 It was forbidden to receive medical treatment from non-Jews or to buy medicines that may be lethal if taken in inexact doses.8 Another con- cern 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.9 Still, with several restrictions, the sages allowed Jews to receive medi- cal treatment from non-Jews: If the patient is an important and prominent person, or if the physician is an expert with a well-known reputation, such 4 M. A.Z. 2:2; B. A.Z. 29a. On the ambivalent attitude of sages to gentiles in the period of the Mishna and Talmud, see Samuel Safrai, “The Relationships between Israel and the Nations after the Destruction of the Second Temple,” in Maḥanāyim 75 (1963), pp. 50–52; Gedalyahu Alon, The History of the Jews in Eretz Israel during the period of the Mishnah and Talmud (Tel Aviv: haKibbutz haMehuchad, 1975), pp. 342–352; Gary G. Porton, Goyim: Gentiles and Israelites in Mishnah-Tosefta (Atlanta: Scholars Press, 1988); Alan Brill, Judaism and Other Religions: Models of Understanding (New York: Palgrave-Mcmillan, 2010), pp. 31–62. 5 B. A.Z. 26b. On the injunction against assisting non-Jewish women in labor see M. A.Z. 2:1. 6 See M. A.Z. 1:1–2; 2:2; B. A.Z. 25b. 7 M. A.Z. 2:2; T. Hul. 2:21 (Zuckermandel ed., Jerusalem, 1975). 8 Such as opium and Theriac, See Y. A.Z. 2:2, 40d. 9 B. A.Z. 27b. The Review of RabbinicDownloaded Judaism from 21 Brill.com09/26/2021 (2018) 108–133 12:30:07PM via free access “I bear the burden of treating the gentiles” 111 that he would be prevented from any harmful intentions towards Jews,10 or if the patient is at death’s door, as in such case the treatment could only be beneficial.11 These restrictions and prohibitions reveal an atmosphere of distrust and social hostility between Jews and non-Jews. These religious restrictions might also have aggravated the friction between the faiths and created severe social conflicts, particularly in circumstances that entailed a mixed society utilizing joint systems (economy, trade). As a result, as early as the Talmudic age we see rabbinical reservations with regard to the all-inclusive prohibition against 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.12 Physician-Patient Relationships in Multicultural Societies: Historical Context and Theoretical Framework Beliefs and religious values are an inseparable part of human culture and have a major effect on the medical world. Researchers have indicated the impact of religion on medicine in several main areas: A. Rates of illness or health maintenance, for example traditional eating habits that contribute to main- taining health or creating health problems; B. Assigning causality to illness— associating illness with sin or with improper religious and moral behavior; C. Guidance in reaching medical decisions; D. Adherence or non-adherence to medical recommendations, with consequent impacts on treatment outcomes.13 In certain faiths, a person who contracts an illness is obligated to seek medical help in order to recover and return to a normative routine, and the physician is obligated to treat the patient.14Then again, some clerics instruct their followers to avoid conventional health care and recommend seeking the 10 Ibid., 28a. 11 Ibid., 27a. 12 Ibid., 26b. 13 On this factor, see Allen Harwood, ed., Ethnicity and Medical Care (Cambridge: Harvard University Press,1981), pp. 1–36; Aasim I.