“On the Instruction of Experts” Some Halakhic Reflections on Science and the Pandemic
As our societies struggle to cope with the COVID-19 pandemic, we have encountered an underlying tension over the role of experts--of the scientific and medical community as a whole—in shaping our response to the disease. On the one hand, there is the widespread tendency, reflective of the trust that our culture has come to place in science and technology, to heed the advice of epidemiologists and public health specialists. On their counsel, governments have imposed a list of measures to halt or slow the spread of the coronavirus, measures that have exacted a significant price in the form of economic recession and social lockdown. Many of us have been willing to pay that price, to submit to the pain, precisely because we place our trust in the scientists and regard their advice as indispensable in this time of medical crisis. Many of us, that is, but not all of us, which brings us to the other side of that underlying tension, the (equally?) widespread tendency to reject the counsel of the scientists as alarmist, extremist, or overblown. This rejection is rooted in part in understandable economic and social factors. Many of us have calculated that the cost of the measures recommended by the epidemiologists, in terms of lost income and the freeze placed upon public cultural life, is simply too high; not a few political leaders have suggested that “the cure is worse than the disease.”[1] It also stems from a trend in our culture that runs counter to the “trust in the scientists” that I mentioned above. This trend, characterized by the title of a recent book as “the death of expertise,”[i] is anti-scientific at its core. To be more precise, its adherents take one side in the ongoing set of disputes commonly designated “the culture wars.” Under this rubric we find, alongside those who resist public health measures in the face of COVID-19, the opponents of vaccination, the deniers of climate science and others. These groups do not all uniformly reject “science” as such, but they deny that the recognized scientific community enjoys a monopoly over the determination of scientific fact. To put it another way, there are facts and there are “alternative” facts, and the anti-scientific segment of the population prefers the alternative. The counsel of experts, if by that we mean the consensus view of the medical establishment, counts for comparatively little in their eyes.
In this essay, I argue that Jewish tradition comes down decidedly on the side of science in this dispute. By “Jewish tradition” I mean the halakhic tradition, the historical text-based argument over the nature and details of Jewish religious practice that we refer to as halakhah or, imprecisely,[ii] Jewish law. When it comes to responding to the pandemic, halakhah advises us to heed or, in contemporary parlance, to privilege the counsel of medical science over the advice or wishes of politicians, economists, thought leaders or other sources of “expertise” within the society. It would also, however have us keep in mind the nature of science as an experimental or inductive – that is to say, imperfect – discipline and to adjust our expectations accordingly.
“From this mitzvah to save life, it follows that the practice of medicine (r’fu’ah), the activity by which we most commonly preserve life, is itself a mitzvah, even though the Torah contains no explicit commandment authorizing physicians to do their work.”
We begin with one of the primary values in Jewish legal thought: pikuach nefesh (פקוח נפש), the preservation of human life, which, as is well known, overrides almost every other religious duty (mitzvah).[iii] From this mitzvah to save life, it follows that the practice of medicine (r’fu’ah), the activity by which we most commonly preserve life, is itself a mitzvah, even though the Torah contains no explicit commandment authorizing physicians to do their work. On the contrary, any number of biblical and Talmudic texts speak disparagingly of physicians (hardly surprising given the esoteric nature of “healing” in ancient times) and advise us that the proper response to disease is prayer and repentance rather than resort to natural (i.e., “scientific”) medicine. The conviction that r’fu’ah is a mitzvah comes to counter those texts, to warn us against reading them as authoritative.[iv] In the face of disease, we are to avail ourselves of medical care, which entails that we heed the counsel of medical experts trained in the diagnosis, evaluation, and treatment of dangers to human health. Thus we read in the Mishnah (Yoma 8:5):
חולה מאכילין אותו על פי בקיאין
A person who is ill on Yom Kippur is fed according to the instruction of experts.
Similarly, the Shulchan Aruch, the preeminent code of Jewish law, declares (Orach Chayyim 328: 2):
מי שיש לו חולי של סכנה, מצוה לחלל עליו את השבת; והזריז, הרי זה משובח; והשואל, הרי זה שופך דמים
When a person is suffering from a serious illness, it is a mitzvah to violate the laws of Shabbat in order to treat them. One who does so promptly is worthy of praise; if one delays,[v] it is as though one has shed blood.
Consider the sweeping import of these rules. The mitzvot to fast on Yom Kippur and to abstain from activities defined as “work” on Shabbat are duties that the religious Jew takes with the utmost seriousness, yet they are suspended when the experts – that is, the מומחי הרופאים, “qualified physicians”[vi] - declare that the patient must eat or receive medical treatment to maintain his or her health. From this, we learn that to consult the physician on matters of disease is a religious duty rather than a merely permitted or optional course of action (r’shut).
This does not mean that we follow the advice of the physician in every case. The Talmud (B. Yoma 83a) offers this example:
חולה אומר צריך, ורופא אומר אינו צריך - שומעין לחולה
If the patient says (on Yom Kippur) ‘I need to eat’ and the physician says ‘he doesn’t need to eat,’ we follow the wishes of the patient.”
The reason that we ignore the physician’s opinion, says the Talmud, is based in the verse Proverbs 14:10, לֵ֗ב יוֹדֵעַ מָרַּת נַפְשׁוֹ, “the heart knows its own suffering”; that is, the individual is the best judge of his or her medical condition. But this reasoning is not applied in a consistent fashion. Let’s consider the opposite set of circumstances, when the physician prescribes food or other treatment on Yom Kippur and the patient says “I don’t need it.” There, the Talmud rules that שומעין לרופא, “we follow the physician’s advice.” But why? Does the heart not know its own suffering? Not in this case, says the Talmud, because the disease may have adversely affected the patient’s judgment. Of course, we do not use that reasoning in the first case, where the patient asks to be fed. The common denominator uniting both cases, obviously, is the mitzvah of pikuach nefesh, the basis of the duty to practice medicine. Whenever there is dispute over the seriousness of the disease, we err on the side of saving life. None of this lessens the halakhah’s high regard for the counsel of experts. Here is how Maimonides, the great halakhist, philosopher, and physician summarizes the rules pertaining to dispute over the proper course of treatment:
Whenever a patient says (on Yom Kippur) “I need to eat,” we feed them until they have had enough, even if all the physicians in the world declare that feeding is not necessary.
If a qualified physician instructs that the patient needs to eat but the patient says “I don’t need to eat at all,” we feed the patient and ignore their words.
When the physicians dispute the matter – some say the patient needs to eat while others disagree – we follow the counsel of those who are more expert on the subject or the counsel of the majority of the experts.
If the physicians are equally divided on the matter, both in their number [i.e., they split 50-50] and in their expertise [i.e., it is not clear that either side makes a more convincing medical case], we feed the patient on our own cognizance, because we follow the rule that “when there is doubt, we err on the side of leniency” [and therefore set aside the mitzvah to fast on Yom Kippur].
In brief: we heed the counsel of experts in virtually every case. We may ignore that advice only when we have good reason to believe that action must be taken to save life and health, even if the expert has not reached that conclusion. By contrast, we are never entitled to ignore the experts’ positive prescription for treatment.
How would those who are skeptical of the medical-scientific consensus answer this clear instruction to heed the counsel of experts? As we know, they tend to cite a host of evidence to support their position. They speak of mistakes[vii]that scientists have made and continue to make, of studies retracted[viii] and conclusions contested,[ix] and of the dismal record that specialists have amassed in predicting the future.[x] The skeptics have a point. Scientists are human beings, imperfect and prone to error, and even the most highly regarded scientific institutions are capable of mistakes, mismanagement, and negligence.[xi] More than that: even accurate scientific data do not automatically determine our responses to medical challenges. The risks associated with life during this pandemic are a case in point: just which risks to take and how to accommodate them are questions answerable not by data but by reasoned—though debatable—human judgment.[xii] Scientists are not umpires; they are not and cannot be the final arbiters of the decisions we must make as to how we conduct our lives during this time of coronavirus. As one observer, echoing Georges Clemenceau, aptly puts it, “Just as war is too important to be left to the generals, pandemics are too important to be left to the scientists.”[xiii]
“ The risks associated with life during this pandemic are a case in point: just which risks to take and how to accommodate them are questions answerable not by data but by reasoned—though debatable—human judgment. Scientists are not umpires; they are not and cannot be the final arbiters of the decisions we must make as to how we conduct our lives during this time of coronavirus.”
Yet with all that, it is the deniers—those who disparage the medical consensus surrounding COVID-19, those who refuse to wear masks in public places and who ignore the guidance on social distancing, along with the anti-vaxxers, those who reject climate change, and all the rest—who are wrong. They are wrong, not because the scientists are always right, but because “science” as we know it is founded upon a methodology of systematic, self-correcting observation and experimentation that continually tests its findings and ultimately produces answers in which we can have confidence. Two decades ago, a Reform responsum addressed the agitation against the use of vaccines with the following observation:
We rely upon “the overwhelming view” of scientists, not because scientists are immune to error, but because today’s science is a discipline defined by a rigorous methodology that leads to the recognition and correction of mistakes. The findings of any researcher are tested and retested carefully; they are subject to close scrutiny and peer review. Questions concerning the safety of any vaccine are vigorously examined by the medical community, and these examinations can and do lead to changes in the recommended schedules of vaccines. It is precisely because scientists acknowledge that they can be wrong and precisely because the medical community trains such a watchful eye upon the issue of vaccine safety that “the overwhelming viewpoint,” the consensus opinion among practitioners, is worthy of our confidence.[xiv]
Those words resonate today, perhaps with greater force and urgency, because among those who would have us doubt the counsel of experts, who tell us either to overlook the existence of COVID-19 or to ignore the consensus medical opinion in favor of quack and untested remedies, are holders of high political office. Were that responsum written today, therefore, it would likely tell us this: wear your mask in public; practice social distancing; wash your hands frequently; and above all, do not take medical advice from politicians! This does not mean that we idolize our epidemiologists (Judaism takes a dim view of idolatry at any rate) or that we believe that the scientists are always right. It means simply that science, as imperfect as its practitioners may be, is the way that we are meant to fulfill the mitzvah of pikuach nefesh.
Our tradition teaches us to heed the instruction of medical experts in the face of disease. That teaching is accepted not only by Reform Jews but by virtually all recognized Orthodox halakhic authorities.[xv] That teaching may sound obvious, but it is the object of no little controversy in today’s political debates. Our task, it would seem, is to remind ourselves and our fellow-citizens of the truth that lies at its core.
[1] This claim was made by Steve Hilton on Fox News, March 23, 2020.
[i] Tom Nichols, The Death of Expertise: The Campaign Against Established Knowledge and Why It Matters (Oxford and New York: Oxford University Press, 2017). For a deeper treatment of this theme see Susan Jacoby, The Age of American Unreason in a Culture of Lies (New York: Knopf Doubleday, 2018). The classic example of this genre remains Richard Hofstadter, Anti-Intellectualism in American Life (New York: Knopf Doubleday, 1966).
[ii] I say “imprecisely” because the identification of halakhah as “law” is contested by a number of scholars.
[iii] With the exception of idolatry, acts of incest or adulterous sex, and murder; B. Sanhedrin 74a.
[iv] This claim is made explicit by R. Moshe ben Nachman (Ramban; 13th-century Spain) in his Torat Ha`adam, sha`ar hasakanah. His words are incorporated in turn by the later authoritative codes (the Tur and the Shulchan Aruch, Yoreh De`ah 336). See also Maimonides (Rambam, 12th-century Egypt), Commentary to Mishnah P’sachim 4:10. For a summary treatment see W. Gunther Plaut and Mark Washofsky, eds., Teshuvot for the Nineties (New York: CCAR Press, 1997), no. 5754.18, pp. 373-380, https://www.ccarnet.org/ccar-responsa/tfn-no-5754-18-373-380 .
[v] That is, by seeking the opinion of a more eminent authority, medical or rabbinic, as to whether the treatment is really necessary. Doing so takes precious time and endangers the patient.
[vi] Maimonides (Rambam, 12th-century Egypt), Commentary to M. Yoma 8:5.
[vii] Roni Caryn Rabin, “The Pandemic Claims New Victims: Prestigious Medical Journals,” New York Times, June 14, 2020.
[viii] Apoorva Mandavilli, “Scientists Take Aim at Another Coronavirus Study in a Major Journal,” New York Times, June 18, 2020.
[ix] Sarah Kaplan and Joel Achenbach, “Researchers Hypothesize… but Other Experts Remain Skeptical,” Washington Post, May 6, 2020.
[x] See David Epstein, “The Peculiar Blindness of Experts,” The Atlantic, June, 2019,
[xi] Eric Lipton et al., “The C.D.C. Waited ‘Its Entire Existence for This Moment.’ What Went Wrong?” New York Times, June 3, 2020.
[xii] John I. Jenkins, “We’re Reopening Notre Dame. It’s Worth the Risk,” New York Times, May 26, 2020.
[xiii] Fareed Zakaria, “The Pandemic is Too Important to be Left to the Scientists,” Washington Post, April 30, 2020.
[xiv] CCAR Responsum no. 5759.10, “Compulsory Immunization,” https://www.ccarnet.org/ccar-responsa/rr21-no-5759-10.
[xv] R. Avraham Steinberg, The Coronavirus Pandemic 2019-2020: Historical, Medical, and Halakhic Perspectives, Second Edition, n.d., pp. 7-11.
