By Rabbi Zach Truboff
With the three day yom tov this week there have been a lot of conversations about what can or can’t be done for people who might experience distress over the holiday. Most of the discussion I have seen around the use of Zoom or calling people on Shabbat/Yom Tov focus only on the question of pikuach nefesh where there is a real chance someone’s life may be in danger. The problem, however, with focusing exclusively on sakanat nefashot is that can obscure the importance of alleviating suffering (something halakha takes very seriously) and instead fixates on question of suicidal ideation, something that very few of us are able to assess. This approach, however, seems incorrect to me or at least misleading and completely ignores the category of a choleh sh’ein bo sakanah. Here are the points that people should keep in mind that may offer a bit more depth to the halakhic conversation around these issues.
- The Shulchan Aruch (328:17) writes regarding a choleh sh’ein bo sakanah that if one is so sick that they must lie in bed, even if the condition is not life-threatening, one is permitted to do amira l’akum and even ask the non-Jew to perform a melacha deoraitta.
The Shulchan Aruch (328:17) brings multiple opinions about what can be done for a choleh sh’ein bo sakana however he seems to conclude that at the very least one would be able to a derbanan b’shinui. The Chochmat Adam (69:12) writes that while it should be done b’shinui if this is not possible, one can do an issur derabanan as normal. Rav Ovadiah (Chazon Ovadiah, Shabbat, pp. 257-259). explicitly permits one to turn off the light with a shinui for a choleh sh’ein bo sakanah if it is bothering them and they can’t sleep.
3. The Ramban and other rishonim are even more lenient. The Ramban writes in the Torat HaAdam that one can do an issur deoraitta b’shinui for a choleh sh’ein bo sakanah. While it is unclear whether the Shulchan Aruch poskins like the Ramban there are many achronim who permit one to do an issur deoraitta b’shinui for a choleh sh’ein bo sakana (See Iglei Tal Tochen 18 and Shulchan Aruch HaRav 328:19). The SSK (33:2:17*) writes in the name of Rav Shlomo Zalman that if one cannot do it through a non-Jew, one can rely on the authorities who permit the performance of an issur deoraitta b’shinui.
At the very least, a choleh sh’ein bo sakanah can do a derabanan b’shinui if it will alleviate their discomfort. That is the explicit pesak of Rav Ovadiah. This has nothing to do with sakanat nefashot. The sick person’s life is not put at risk in any way because they can’t sleep. Rather the pesak follows the sugya of “goneach yonek chalav b’shabbat” (Ketubot 60a) in which the mitigating factor is the tzaar of a choleh sh’ein bo sakana and not pikuach nefesh.
- If one assumes electricity is only an issur derabanan (and maybe at most undin d’chol according to R’ Shlomo Zalman) then a choleh shein bo sakanah should be allowed (ideally with a shinui) to call someone on shabbat or for another to answer their call if it will alleviate their suffering. The same should be true for Zoom. I have seen no one make a convincing argument that using a cellphone or Zoom is anything more than an issur derbaban. Even if one assumes that electricity is deoraitta, there would still potentially be room to be lenient for a choleh sh’ein bo sakanah according to the opinions listed above.
- It would seem reasonable to me to assume that anyone with a diagnosis of general anxiety disorder or depression or anyone who has exhibited self-harm in the past (cutting, vomiting etc) would fall into the category of a choleh sh’ein bo sakanah. Shemirat Shabbat Kehilchata (32:1) explicitly writes that one who is healthy at the moment but suffers from a chronic condition like athasma, diabetes, or arthritis and can become sick has the status of a choleh sh’ein bo sakanah. This applies even when the chronic conditions may not lead to life threatening illness. In Jason Weiner’s book “Guide to Traditional Jewish Observance in a Hospital” (p. 16) he explicitly cites the opinion that an individual with even mild clinical depression is to be considered a choleh sh’ein bo sakanah.
- We should keep in mind that it is estimated that 20-30% of the population actively suffers from anxiety or depression and that may be a low statistic. In our current moment, there are significant additional pressures that may trigger serious anxiety and depression for a much larger segment of the population. I highly recommend reading the attached article “The psychological impact of quarantine.” It highlights the fact that those in quarantine for more than 10 days have a significantly higher incidence of PTSD.
The harder case is someone who doesn’t have a diagnosis but may genuinely be in a bad situation because of isolation and come shabbat/yom tov. they start feeling really crappy. I would feel comfortable saying that even if one does not have a formal diagnosis, if they are exhibiting symptoms of depression or anxiety such as serious insomnia, extreme fatigue, or a the symptoms of a panic attack like rapid heartbeat, sweating, shaking, shortness of breath, chest tightness, nausea and fear of dying or losing control- it would be permitted for them to do an issur derabannan b’shinui if it will help them calm down. I found a similar teshuvah by Beit Hillel in their book Beit Hillel Omrim in which they make the same argument to permit an individual with an anxiety disorder to play music if they cannot sleep and it will allow them to calm down. (A copy is attached)
- A practical example of this approach: I have an immediate family member with a bi-polar diagnosis. Baruch Hashem, she does really well on medication and doesn’t suffer any major complications. However, she does still have some anxiety that has increased in the current situation. I told her that if she feels she needs to call me on shabbat or yom tov, I will pick up no matter what and that it does not need to be life threatening.
- One could even make an argument that tzaar alone would permit a derabanan on shabbat, even if a person does not have the status of a choleh shein bo sakana. The Shulchan Aruch (287:5) writes that one is permitted to ask a non-Jew to light a fire for young children if it is very cold however he disagrees with those that will do so even when it is only a little bit cold. The Magen Avraham (287:15) writes that perhaps some are lenient to rely on the Hagahot Maimoniyot who permits a shvut b’makom tzaar. He disagrees with this position and is only lenient in a case of shvut d’shvut b’makom tzaar. This would allow one to ask a non-Jew to perform an issur derbanan in a case of tzaar. Some poskim use this approach to permit one to ask a non-Jew to turn on air conditioning on a day when it is extremely hot. He argues that even according to the Chazon Ish, turning on the air conditioner would only be an issur derbanan. Rav Ovadiah cites rishonim who argue that in cases where it is permitted to do ask a non-jew to violate a derabanan for a Jew it is also permitted for a Jew to do the violation with a shinui.
While the risks are certainly greater over a three day yom tov, it is quite likely that people will not be able to be back in shul on Shabbat for many more weeks if not months. As social distancing continues, the stress that people are under will continue to be very serious. We as rabbis can play an extremely important role in addressing the psychological/emotional side of what many people are experiencing as genuinely traumatic. Most people I know who struggle with depression/anxiety find great relief in knowing that they can take steps to alleviate their pain/discomfort on Shabbat if they need to. Just knowing this is often enough to give them some relief and can help alleviate their anxiety even if they never need to do it in practice.