Is there no alternative to kosher medicine?
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QUESTION: My son is a lifelong vegetarian but he has serious digestive problems and a doctor recommended medication which happens to contain a pork extract. My son objects to an animal product per se and he finds the idea of pork particularly repugnant, but there seems no alternative. What do we do?
Rabbi Naftali Brawer
Naftali Brawer is rabbi at Borehamwood and Elstree United Synagogue.
In the first instance, it would be helpful to establish whether your son’s condition is life-threatening. If it is determined by a doctor that this is indeed the case, then not only is your son permitted to take the medication but he would be obligated to do so. This is because Jewish law, with rare exception, puts the value of human life above other religious considerations.
The rare exceptions being murder, incest and idolatry— which a Jew must avoid even on pain of death. If your son’s condition is determined to be non-life threatening it would not be permissible for him to consume pork or any other non-kosher food item for the purpose of alleviating discomfort.
However, while non-kosher food itself is prohibited, there is a strong body of opinion that holds that food which is rendered inedible loses its non-kosher status. In your son’s case, the pork extract in the medicine is no longer recognisable as food. So long as it can be demonstrated that on its own it is truly inedible, it may be ingested as part of a medicine. Yet some authorities argue that if a person eats an otherwise inedible item, he thereby demonstrates that he regards it highly enough to eat. This then brings the item back full circle, conferring upon it the status of food.
However this argument does not apply to medicine for the following two reasons. Firstly, the logic that by eating something one confers upon it the status of food only applies if the inedible item is eaten alone. If it is mixed with edible stuff, the argument falls away. Secondly, the argument is inapplicable in relation to ingesting medicine as a cure since it is clearly not one’s intention to consume it as food.
In short, I would advise your son in the first instance to try to find an alternative medicine that contains only kosher ingredients. If this proves difficult, he may use the medicine with the pork extract if that is the only way to relieve his suffering.
Rabbi Jonathan Romain
Jonathan Romain is rabbi at Maidenhead (Reform) Synagogue.
The first step is to double-check whether there is no alternative. If indeed there is none, then the principle of pikuach nefesh/saving life takes precedence over the ban on pork.
Some might argue that a digestive problem is thoroughly unpleasant but not life-threatening, but I think it fair to extend the principle of pikuach nefesh to sparing suffering. There is no Jewish merit to being in pain when a means of avoiding it without harming anyone else is available. Another ruling is also relevant: if a non-kosher ingredient accidentally falls into a kosher product, then that product is still edible providing the treif element is less than one sixtieth of the overall volume. This raises the question of percentages. Although the pork extract in the medication is a deliberate addition, it is a minuscule element unrecognisable to the eye or the palate. It is still non-kosher, but it is far removed from being a public act of defiance or an attempt to cheat.
Technically, all non-kosher foods are as treif as each other, but pork does stand out in the popular mind as being much worse than anything else. This is partly because it is the most common non-kosher food in the high street (when did you last see bear or horse on sale?). It is also because persecutors have used it as a means of humiliation, trying to force Jews to eat pork, from the time of the Maccabees to the Nazi period. A Jew who voluntarily eats pork, without any coercion or medical need, is going far beyond breaking a mitzvah, but disregarding what has become a key aspect of Jewish identity fashioned by history.
As for vegetarianism, although not a Jewish obligation, it certainly has a respectable role in Jewish tradition: it is suggested that Adam and Eve were vegetarian in the Garden of Eden, and so will we be in the messianic era. Your son, therefore, is to be commended on his principles, but in this instance, it may be appropriate to make an exception without in the least negating the rules that he still applies to all foods.