Question: Is there a mitzvah to perform bikur cholim on a patient stricken with coronavirus?
Short Answer: According to the simple understanding of a t’shuvah by the Rama, one fulfills the mitzvah of bikur cholim when visiting a patient stricken with a contagious disease. However, many poskim disagree with the Rama, and other poskim rule that even the Rama agrees that one must not endanger himself in order to perform this mitzvah.
I. Infectious Disease in the Gemara
The Gemara (K’subos 77b) relates that one should be careful of flies from “baalei raasan,” which transmit this infectious disease (“raasan”). The Gemara cites numerous Amora’im who were careful not to sit in an area where the wind of the baalei raasan could infect them. Other Amora’im would not enter a house where baalei raasan lived, and would not eat from food that originated from that area.
The Gemara subsequently notes that, despite the opinions of the previous Amora’im, Rabbi Yehoshua ben Levi would learn Torah and sit right next to the baalei raasan, as the Torah protected him.
Nevertheless, the implication of the Gemara is that, unless one is on the level of Rabbi Yehoshua ben Levi, one should be careful not to contract a dangerous infectious disease.
II. Being Careful
Indeed, the halachah is clear that one must avoid dangerous situations. The Rama (Yoreh Dei’ah, 116:5) rules that one should avoid danger, even when the danger is only a “safeik.” Therefore, one should leave a city that is inflicted with a plague.
The sefer Mitzvas Bikur Cholim (Rav Yaakov Farbstein, siman 10) points out that the Mishnah B’rurah (Orach Chayim 576:14) likewise emphasizes the need to stay away from individuals with an infectious disease. The Mishnah B’rurah writes that one should take his children and leave a city where the inhabitants have a deadly rash.
Similarly, the Ateres Paz (Yoreh Dei’ah 3:7) cites numerous sources that it is forbidden for a person to enter into even a “safeik sakanah,” a situation where there is even a chance for danger. He cites the Sefer Chasidim (633) who writes that a contagious person (“mukas sh’chin”) may not bathe together with a healthy individual unless he warns him. If he does so, he violates the prohibition of “Lifnei iver lo sitein michshol” – Do not place a stumbling block in front of a “blind” man. Further, he cites a midrash that explains that people were not allowed to come into close contact with a m’tzora because he was contagious.
The Tiferes Yisrael (K’subos 7:10) likewise learns that it is forbidden to cause danger to oneself from a mishnah in K’subos. The mishnah states that a woman may not demand a divorce from a man who has numerous ailments. The only exception is a man with a certain contagious rash (“mukas sh’chin”). A woman married to such a man may demand a divorce (and her k’subah). The Tiferes Yisrael elaborates that a person afflicted with an infectious disease may not hire any worker to care for him, nor a person to bury him if necessary, Rachamana litzlan.
Based on these sources, it appears clear that there is no mitzvah to perform bikur cholim on an individual stricken with a contagious disease.
III. The Famous T’shuvas HaRama
There is, however, a famous and hard-to-understand t’shuvah by the Rama that appears to contradict the above sources, including his own ruling on the Shulchan Aruch.
The Rama (20) is discussing an owner of a house who agreed to rent his house to a certain person. The owner is now trying to renege on the rental agreement based on the fact that the tenant’s wife has a “contagious disease” that the owner does not want “on the walls of his house.” The Rama rules that the owner cannot renege on the rental, as the fact that the tenant’s wife is “contagious” is “kulo hevel” – complete nonsense – and it is merely the “personal anxiety” of the owner that is causing him to renege on the rental. Indeed, writes the Rama, if we allow him to renege and take actions based on the contagiousness of a disease, the entire concept of bikur cholim will be obliterated, as we never find in halachah any difference between bikur cholim to a non-contagious sick person and bikur cholim to a contagious sick person – you are obligated to perform the mitzvah on both, and there is no allowance to ignore the mitzvah because of contagiousness. The Rama concludes that unless the wife is a “baalas raasan” (this highly contagious disease), we do not factor in her contagiousness into bikur cholim or to arguments concerning rental agreements.
Clearly, this Rama holds that bikur cholim applies to individuals with infectious diseases.
The Shiurei K’neses HaG’dolah (Yoreh Dei’ah 335) cites this Rama as the practical halachah. Moreover, the sefer Leket MeiHegyonei HaTorah (K’subos, p. 777) notes that the Ya’avetz agrees with this ruling, as well, as he has a special prayer in his siddur for a visitor to recite when visiting a contagious person to prevent the visitor from being harmed.
Likewise, Rav Chaim Palacci in Nishmas Kol Chai (49) notes that there are many who visit contagious people and are not harmed, as the mitzvah protects the visitor from being harmed. See also Pis’chei T’shuvah (1:175).
IV. Disagreeing with the Rama
Many Acharonim disagree with this Rama and rule that it is forbidden to perform bikur cholim (at least in person) with an individual stricken with a contagious disease.
The Sheivet HaLevi (8:251:5) challenges the Rama. Who cares if we ignore bikur cholim? We are talking about life-threatening diseases, and perhaps there is no mitzvah in such a situation, especially where contagious diseases are only a small percentage of illness. Moreover, one can still fulfill the mitzvah by staying far away, such as in an outer room, and offer to take care of the sick person’s needs. There is thus no heter to enter into the room and endanger yourself, contrary to the ruling of the Rama.
The V’Darashta V’Chakarta (4:50) cites the Shulchan Gavo’ah, who disagrees with the Rama, as it is forbidden to enter into a situation of safeik sakanah. He notes that the S’dei Chemed cites both opinions and does not come to a practical resolution. The V’Darashta V’Chakarta concludes that the best idea is to follow the Sheivet HaLevi, and simply stand far away when performing the mitzvah of bikur cholim on a contagious sick person.
Similarly, the Chemdas Tzvi (3:43) rules that one may not perform bikur cholim on a contagious sick person. Since the primary reason that a m’tzora announces “tamei tamei” is so that others know to stay away from him, we see that one must take great precaution to avoid getting too close to someone with a contagious disease. See also the Divrei Y’tziv (Choshen Mishpat 79:11).
Notably, Rav Tzvi Spitz, in his sefer Mishp’tei HaTorah (1:88) writes that one should call a contagious sick person on the telephone, and thereby rely on the lenient opinions, such as that of Rav Moshe Feinstein zt”l (Igros Moshe Yoreh Dei’ah 1:223), who rule that one may fulfill the mitzvah over a telephone if he cannot visit in person. [For a greater discussion on fulfilling bikur cholim over the phone, see Visiting the Sick, by my father, Rabbi Dr. Aaron Glatt, pgs. 67 and 73].
V. Even the Rama Agrees
Some Acharonim go even further and suggest that even the Rama himself did not rule that one fulfills the mitzvah of bikur cholim by performing it in a dangerous way. The sefer Mitzvas Bikur Cholim (Rabbi Avraham Zev Rosner, p. 80) cites the Maharsham (Yoreh Dei’ah 8) who suggests that the Rama merely meant that one should fulfill bikur cholim on a contagious individual by standing outside his room and in a safe manner.
The Ateres Paz (ibid) notes that the Rama simply felt that the Gemara (K’subos, mentioned earlier) is telling us that no disease other than that of baalei raasan was contagious. Even if doctors think that other diseases are contagious, medical opinions are constantly changing, and thus the Rama means that we must always perform bikur cholim in the safest way, based on our current medical knowledge. Only bikur cholim to baalei raasan can never be done properly. This is very similar to the Tzitz Eliezer’s explanation. See Tzitz Eliezer (9:17).
Indeed, the Ateres Paz concludes that since, according to many poskim, bikur cholim is only Rabbinic, we can be lenient when in doubt, and thus one should not perform bikur cholim (if it can’t be done safely) on an individual with a contagious illness.
However, the sefer Mitzvas Bikur Cholim (Rav Yaakov Farbstein, ibid) suggests a few additional answers for the Rama. First, perhaps the Rama only ruled that there is a mitzvah to perform bikur cholim on a contagious individual in cases where there was no large outbreak. In a “mageifah” (outbreak), then of course one must not increase the spread by visiting the sick. Second, perhaps the Rama holds that one may put himself into safeik sakanah in order to definitely help someone else, although the Rishonim dispute this issue. Since bikur cholim benefits the sick person, the Rama rules that one may risk endangering himself to visit. Third, perhaps the Rama never ruled that there is a mitzvah to visit a contagious person. Rather, the Rama just felt that the tenant’s wife was NOT contagious, as the Rama himself acknowledges that it was the anxiety of the owner that was causing him to renege on his rental agreement.
VI. Taking Away His Sickness
The Maadanei Asher (Parshas VaYeira, 5768) notes that the Gemara in N’darim (39b) says that visiting a sick person transfers 1/60 of the sick person’s illness onto the visitor. If so, surely there is a mitzvah to visit a contagious person, as ALL sicknesses are contagious to the visitor. He subsequently rejects this proof, as (i) either 1/60 is not enough to truly endanger the visitor, or (ii) based on the Maharal who says that the sickness is not transferred to the visitor but merely dissipates based on the psychological benefit of having visitors.
Next Week’s Topic: How should a bris milah with social distancing be performed in a COVID-19 world?