The Torah records that among the compensatory damages which a person who has
inflicted bodily harm on another must pay, are the medical bills. The Talmud
derives from this verse that "nitna reshus larofeh lerapos" - "The Torah
grants permission to a doctor to heal." If Hashem has blessed a person
with the power to heal, why would a verse be required to permit him to
utilize this talent?
The Ibn Ezra's comments on this verse are perplexing. He notes that the
Torah juxtaposes the verse regarding a physician needing permission to heal
to the verses which discuss various types of external wounds inflicted upon
a person. Therefore, he deduces that a physician may only heal external
wounds; all internal maladies are in the hands of Hashem. The Mateh Moshe
finds the Ibn Ezra's comments unfathomable, citing numerous references in
the Talmud to medical procedures and medications which were given to treat
internal ailments. He therefore concludes that a physician is required to
treat internal ailments and if he refrains from doing so, causing the death
of his patient, he will be held responsible. How do we reconcile the
comments of the Ibn Ezra with the treatments mentioned in the Talmud?
To begin resolving the aforementioned difficulties, we must first reexamine
the statement "nitna reshus larofeh lerapos". The dictum is generally
understood to be granting permission to a physician to heal. However, an
alternative definition of the word "reshus" is "domain" or "realm". The
Talmud is stating that Hashem has placed the ability to heal entirely in the
realm of the doctor. He is completely equipped to deal with the malady in a
"derech hatevah" - natural manner; we do not view the malady or its cure as
a supernatural phenomenon which requires Hashem's intervention. To this, the
Ibn Ezra comments that only external ailments are completely within the
realm of medical procedures, while internal ailments are not subject to
clear cut medical diagnoses and cures. Although a physician must tend to
internal ailments as well, these maladies require Hashem's hand to insure
full recovery. Treatments offered by the Talmud for internal ailments are
not completely scientific in nature and are often accompanied by amulets,
incantations and the like, which supports the Ibn Ezra's assertion.
1. Bava Kama 85a
3. Refuos p. 358
Sorry Does Help
"an eye for an eye, a tooth for a tooth..." (21:24)
The Torah records that if two men come to blows and accidentally cause
bodily injury to a third individual, the assailant is held completely
responsible, "an eye for an eye, tooth for a tooth, hand for a hand, foot
for a foot". The Talmud states emphatically that the verse is not to be
taken literally. Rather, according to the Oral Tradition the responsible
party must pay the monetary value of the limb he destroyed in restitution
for his actions. The Talmud proves this assertion by stating that it would
be impossible to inflict an equitable injury upon the assailant, for no two
human beings are physically or emotionally alike. Why then does the Torah
couch the restitution in terms which, if taken literally, indicate that the
assailant is subject to physical injury?
In the Laws of Damages and Injuries, the Rambam records the various
compensatory requirements that must be made for injuring a human being.
Contrasting the restitution required for bodily injury to that of property
damages, the Rambam states that when a human being has been injured,
forgiveness is necessary for complete restitution. Why does the Rambam
deem it necessary to include the requirement to seek forgiveness in the laws
of financial compensation? Furthermore, the Rambam also includes this
requirement in the Laws of Repentance; he adds that even if a person has
made full financial restitution, he is not forgiven unless he appeases the
person he damaged. If the injured party has been compensated why is it
necessary to appease him? What is the Rambam's source for this ruling?
The Talmud teaches that although "nekama" - "revenge" is generally not an
acceptable form of behavior, it acknowledges that there are occasions when
"nekama" is permitted. The root of the word nekama is "kam" - "to
restore", for nekama restores the dignity and self-esteem of the slighted
party. The injury inflicted upon the victim is not solely of a financial
nature, but a blow to his self-esteem as well for the assailant has
exercised physical dominance over him. By recording the restitution in terms
indicating that the assailant is subject to physical injury, the Torah is
acknowledging that the only way to truly restore the victim's self-esteem
would be to inflict upon the perpetrator the same damage that he caused.
Through the Oral Tradition we understand that such restitution is not
possible and financial compensation is offered instead. However, money does
not restore a person's shattered self-esteem. Therefore, the assailant must
beg forgiveness from his victim. His seeking appeasement offers the injured
party some restoration of his damaged self-esteem.
It emerges that the appeasement is an integral component of the restitution
and therefore is recorded by the Rambam in the Laws of Damages and Injuries.
One cannot achieve atonement for taking something away from another unless
the stolen item is returned. Therefore, appeasement is a prerequisite for
receiving atonement since it helps restore that which was taken away.
Consequently, the Rambam records this ruling in the Laws of Atonement. He
derives his source for this law from the fact that the Torah acknowledges
that complete restitution cannot be attained through financial means alone.
1. Bava Kama 84a
2. Yad Hilchos Choveil Umazik 5:9
3. Yad Hilchos Teshuva 2:9
4. Berachos 33a