Shabbat Parashat Vayigash | 5764
From the works of Hagaon Harav Shaul Yisraeli zt”l - Doctors’ Wages - From Chavot Binyamin, siman 110
Although classically, it is forbidden for people to take money in order to heal others (Shulchan Aruch, Yoreh Deah 336:2), there is room to say that these days the situation is somewhat different, as we will explain.
The gemara (Kiddushin 58b) says that although one may not take money to sprinkle or sanctify the special water of the para aduma, as one may not demand money to perform mitzvot, he may take money to “bring and fill the water.” The Machane Ephrayim (Sechirut 17) explains that the sanctifying and sprinkling is a mitzva, while the bringing and filling is not. This distinction can explain the Ramban’s statement (in Torat Ha’adam, Inyan Hasakana) regarding the wages of a doctor. He rules that a doctor may not take money for the wisdom and learning required to heal, but he can take money for the toil, because it is analogous to the fees for “bringing and filling.” This is because of the difficulty and expense of going through the training to become a doctor, which is not an obligatory mitzva on any given person, as no one is specifically obligated to choose the field of medicine as his profession.
The aforementioned can also explain the distinction between money taken by a doctor and that demanded by a ferry operator who charged an exaggerated fee from one who was fleeing from prison (see Bava Kama 116a). In the latter case, the fugitive is not required to pay the price he promised. The Ramban says that the doctor is different, because the obligation is not upon him specifically, as opposed to the ferry operator. It is not clear what case the Ramban is referring to. After all, if a doctor is specifically approached, and especially in a case where he is the only one in the vicinity who is capable of offering the necessary help, why shouldn’t he too be required to save the life for free? Rather, the Ramban means that the obligation was not specifically on him to study how to heal others, and he may take money from the beneficiaries of his expertise for making the effort to receive training. Since it is difficult to estimate how much that price should be, any price that the sick person agrees to is binding.
In the case of the ferry operator, as well, if there were other available ferries, and the fugitive promised one operator a high price, he has to pay, because he was not forced to use this ferry operator. However, if all the ferries charged an unreasonable price, then he would be exempt from paying the high price. Similarly, if all of the doctors were to charge an unreasonable price, one would be exempt from paying it. However, since the Ramban says, “there is no price for his wisdom,” one cannot refuse to pay after previously agreeing. Let it be clear, though, that if the doctor charges more than he deserves [for the toil, expense, and lost opportunity of another profession] he transgresses his obligation to provide the service for free. Likewise, when he charges a price, he chooses to forgo the opportunity to do the mitzva of saving someone for its own sake into a business opportunity to compensate for the toil of his training. [Ed. note- Rav Yisraeli probably meant that there is an element of the mitzva that is lost, but the positive nature of the occupation still exists.] However, he is permitted to take money because of the training.
The aforementioned approach seems to be nearly explicit in the Taz (YD 336:3). The Taz also combines the factor that originally the doctor was not responsible to learn medicine with the fact that he made a condition that he would take money. If he is taking money for his work in the present, what difference does it make that, some time in the past, he was exempt from studying medicine? It must be, then, that the money that he takes is for those preparations. [Ed. note- the simple language of the Taz sounds like there is a prohibition to demand the money, but that the person who promised it is required to pay, from his perspective.]
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