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Question: I was recently told by my physician that I shouldn’t fast on Tisha B’Av or Yom Kippur for health reasons. However, I feel very uncomfortable following this directive as I have never eaten on these two fast days in my life. What should I do?

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Answer: I am asked this question in some form or another quite frequently. First, it’s important to differentiate between Tisha B’Av and Yom Kippur, the former being a fast that’s only based on the word of the prophets.

Zechariah 8:19 states: “Koh amar Hashem Tzvakot tzom harevi’i tzom hachamishi v’tzom hashevi’i v’tzom ha’asiri yihyeh l’Beit Yehudah l’sasson u’l’simcha u’l’moadim tovim v’haemet v’ha’sholom ehavu – Thus says the Eternal L-rd of Hosts: The fourth fast [17th of Tammuz], the fifth fast [9th of Av], the seventh fast [Yom Kippur], and the tenth fast [10th of Tevet] shall be for the House of Judah joyous and happy [days if] you love truth and peace.”

The prophet Zechariah is telling us that if we serve Hashem with love, truth, and peace, Hashem will abolish these fast days and make them festivals. Of these four fasts, though, only Yom Kippur appears in Chumash. We read in Leviticus (23:27): “Ach be’asor la’chodesh ha’shevi’i ha’zeh Yom HaKippurim hu mikra kodesh yih’yeh lachem v’initem et nafshoteichem v’hikravtem isheh la’Shem – However on the tenth day of the seventh month is the Day of Atonement; there shall be a holy convocation unto you, and you shall afflict your souls; and you shall bring a sacrifice by fire to Hashem, the Eternal L-rd.”

The Torah (Leviticus 23:29) records a harsh punishment for those who don’t fast on Yom Kippur: “Ki chol ha’nefesh asher lo te’uneh b’etzem hayom hazeh v’nichreta me’ameha – For all souls who shall not afflict himself on that very day shall be cut off from his people.” In other words, he gets karet.

Although Tisha B’Av, like Yom Kippur, is a 25-hour fast on which even wearing leather is forbidden (on all other fast days, only eating and drinking are prohibited), the command to fast on that day does not appear in the Torah, and if a person eats on the fast, he does not get karet. Thus, there is more room to be lenient on Tisha B’Av than on Yom Kippur.

The Gaon Rabbi Ovadia Yosef, zt”l, discusses your general question in his responsa (Yechaveh Da’at vol. 1:61). He notes that Tractate Yoma (85b) teaches us that nearly every mitzvah is set aside in the face of danger to life (pikuach nefesh) based on Leviticus 18:5, which reads “U’shmartem et chukotai v’et mitzvotai asher ya’aseh otam ha’adam v’chai bahem ani Hashem – You shall keep My statutes and My ordinances, which if a man does, that he shall live by them, I am the Eternal L-rd.” The Talmud expounds: “‘That he live by them’ – and not die by them.”

The Rambam (Hilchot Shabbos 2:3) cites this Gemara and concludes: “We see from here that the judgments of the Torah are not meant as a source of vindictiveness in this world but rather to spread compassion, kindness, and peace in the world, as it states (Proverbs 3:17): ‘Dracheha darkei noam v’chol netivoteha Shalom – Its paths are the paths of pleasantness and all its ways are peaceful.’”

The Rambam continues with very harsh words: “And those apikorsim who say it’s prohibited to transgress the Sabbath or Yom Kippur even to save a life – about them Scripture (Ezekiel 20:25) states: ‘V’gam ani natati lahem chukim lo tovim u’mishpatim lo yichyu bahem – And I will also give them statutes that are not good and judgments with which they will not live.’”

Rabbi Yosef also quotes the Ramban (Milchemet, to Sanhedrin 74b) who writes, “There is no measure of piety for a choleh she’yesh bo sakana – a dangerously-ill patient – to be strict to decline someone transgressing the Sabbath or Yom Kippur [on his behalf]. On the contrary, a person who withholds himself from any cure in the face of danger to himself is guilty of endangering his own life, as the Torah in Parshat Noach (Genesis 9:5) states: ‘V’ach et dimchem l’nafshoteichem edrosh – And surely the blood of your lives will I demand an accounting.’”

The Ramban also cites the Jerusalem Talmud (Yoma 8:5): “One who questions a sage whether it’s permitted to transgress the Sabbath or Yom Kippur in the face of pikuach nefesh is guilty of spilling blood [because every second counts]. Therefore, one who is quick to assist even if it means transgressing Sabbath or Yom Kippur restrictions – may he be praised.”

It seems quite clear, then, that Rabbi Yosef’s view is very straightforward: A dangerously ill patient must not fast on Yom Kippur if his doctor tells him not to. To be a “hero” and fast is to act contrary to halacha.

Rabbi Yosef cites other views, though. For example, Rabbi Avraham Ibn Ezra in his commentary to Parshat Mishpatim expresses the view that Heaven only grants physicians the right to heal external and superficial wounds. In making his point, he cites the Ramban (in his commentary to Parashat Bechukotai) who writes (citing Proverbs 16:7) that a person should not involve himself with physicians. The Ramban writes that righteous men in the age of prophecy visited, not doctors, but prophets when they were ill. Indeed, Asa sinned by seeking out physicians when he was ill rather than G-d.

Based on the above, Rabbi Avraham Bernstein (Responsa Avnei Nezer, Choshen Mishpat 193) concludes that an individual who is instructed by a physician to eat a certain non-kosher food as a medicine is allowed not to follow his advice.

He also cites Rabbi Shlomo Kluger (Responsa Ha’elef Lecha Shlomo) who writes that if there’s a dispute about the nature of a person’s illness, he may be stringent and fast on Yom Kippur.

Rabbi Yosef seems to take issue with anyone who opts for any kind of stringency in reference to seriously-ill patients. In his view, even where there’s a doubt about the seriousness of a person’s condition, he should never disregard medical advice.

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Rabbi Yaakov Klass is chairman of the Presidium of the Rabbinical Alliance of America; rav of Congregation K’hal Bnei Matisyahu in Flatbush, Brooklyn; and Torah Editor of The Jewish Press. He can be contacted at yklass@jewishpress.com and Rabbi@igud.us.