[Avodah] Fasting on Yom Kippur

[Daniel Israel]

On Thu, 03 Jan 2008 09:40:08 -0700 Meir Shinnar 
<chidekel at gmail.com> wrote:
>3) RDMI suggests that current medical practice, and especially
>obstetricians, are risk averse - and their level of risk assessment
>may not be halacha'.  As per my initial post, one of the halachic
>issues that needs to be determined is precise determination of what
>levels of risk are halachically acceptable.  However, being risk
>averse is one way of saying that one is machmir on pikuach nefesh,
>which has resonance in halachic terms.  Furthermore, to the extent
>that halacha, in the case of pregnancy, has agreed that physicians 
>may detemine whether a particular case is risky - means that being 
>machmir on fasting also  requires changing classical halachic 
norms - 
>as the norm of the average pregnant woman fasting and the norm of 
>listening to physicians about the risk are in conflict...(you 
can't go 
>back home again)  - and the question is which norm one is more 
willing 
>to change..

I don't agree that "risk averse" is the same thing as "machmir on 
pikuach nefesh," at least as I was using it.  I am suggesting that 
doctors are giving advice in part based on how much it opens them 
up for lawsuits, rather than on best medical judgement.  IOW, one 
important criteria for deciding how to respond to a question is a 
factor that has nothing to do with medicine.  Machmir on pikuach 
nefesh means that we are choshesh for less likely dangers, but the 
decision as to how dangerous a particular risk is still needs to be 
made on the basis of best available medical information.

As far as the question of changing halachic norms, I would assume 
(although I haven't looked in the sources, so I may be wrong) that 
the reason we follow that doctors advice is because the halacha 
assumes something about how doctors advise.  If my suggestion is 
correct, then what has changed is not the metzius of the risk, but 
the nature of doctors advice.  In this case, the halachic norm you 
are referring to is no longer applicable.

I would compare it to asking a non-Jewish expert about a ta'am in a 
mixture of kosher and non-kosher food: if for some reason we found 
out that today's non-Jews don't answer this type of question 
reliably, then we would presumably change our reliance on them.

--
Daniel M. Israel
dmi1 at cornell.edu