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Ethics 1: Getting Along with People

Ethics Series:
Illness & Healing

1. Orientation to Gemilut Chasadim (Selfless Kindness)

The world stands on three things: on Torah study, on serving [G-d], and on Gemilut Chasadim (selfless kindness).

(Ethics of the Fathers 1:2)

Rabbi Yonah (ibid. [1180-1263, Spain]) explains this uncommon phraseology:

In anticipation of mans future performance of three activities Torah study, serving G-d, and acts of selfless kindness G-d determined to create the universe.

Gemilut chasadim (selfless kindness) thus constitutes one of the three fields of human endeavor that support G-ds Creation. Why is gemilut chasadim such a prominent force in G-ds purpose for Creation? Classical sources discuss the benefits of gemilut chasadim on two levels social and spiritual. On the social level, gemilut chasadim is a vital component of any functioning society. On a spiritual level, gemilut chasadim is pivotal to ones developing and refining of the G-d-like nature that is the birthright of mankind. Let us explore these two levels more fully, noting how bikur cholim fits into the scheme of the mitzvah of gemilut chasadim on each level.

2. Social Level: The Mitzvah of Love your neighbor as [you love] yourself

In his codification of the general mitzvah, Love your neighbor as [you love] yourself, Maimonides (Laws of Mourning, 14:1-2 [1135-1204, Spain-Egypt]) discusses the sociological advantages of mutual concern among members of society:

The Torah mitzvah to Love your neighbor as [you love] yourself (Leviticus 19:18) teaches us to behave toward other people in the same manner in which we would like them to behave toward us. The Sages established certain acts of chesed (i.e., kindness) as standards of fulfilling this mitzvah. These acts are: visiting the sick, comforting mourners, burying the dead, and escorting guests.

Maimonides explains this mitzvah in terms of creating a bond of mutual assistance among people. The acts of kindness that Maimonides mentions encompass all members of society, who, at various times during the course of their lives, are in need of other peoples assistance.

Rabbi Yisrael Meir Kagan (Chofetz Chaim [1838-1933, Poland]) illustrates this ongoing need for performing acts of selfless kindness that affect everyday life.

Consider how completely the quality and basic functioning of a thriving society is dependent on its members regular performance of acts of charity and selfless kindness. At regular intervals throughout life, everyone needs outside assistance of one form or another. For example, even wealthy people may sometimes need to borrow money for personal needs or for business investments. People may find themselves in need of a job, or of customers to buy their merchandise or services; thus they would require that someone provide them with employment, or that someone recommend their business to potential customers or clients.

On joyous occasions, such as at a marriage, people need others to join in their celebration a celebration conducted in solitude is hardly joyous. Alternatively, when a person is depressed, or grieving over a loss, he greatly appreciates other peoples comforting words, which can effectively prevent him from lapsing into severe depression and illness.

When people travel, they need assistance from other people, including a host to provide them with lodging or meals. In times of illness, the sick person needs other people to visit him, to tend to his needs, and to take an interest in his wellbeing. In death the ultimate state of helplessness people need others to tend to their burial and to see that their final wishes are carried out.

These are but a few common examples that illustrate how mans world is built upon acts of kindness.

(Source: Ahavat Chesed/Love for Selfless Kindness, ch. 2)

3. Spiritual Level: Following in G-ds Ways

Independent of the social advantages of relating to others with acts of selfless kindness, mans spiritual essence is dependent on his performance of gemilut chasadim towards other people. Mans relationship to G-d, indeed mans very being, compels him to develop his character based on selfless kindness.

Before creating man, G-d defined the single, most essential element that would characterize man: with the words, Let us make man in Our image and in Our likeness (Genesis 1:26), G-d declared that man would be a G-dlike creation. Endowed with a G-d-given soul and empowered with the mission to dominate the earth through his free will, mans task is to represent G-ds Will on earth; in this way he becomes worthy of the title of man.

Prominent among mans G-dlike attributes is his ability to refine himself through the performance of gemilut chasadim. The Sefer HaChinuch (Book of Education, [14thcentury, Spain] Commandment #611) explains the Torahs system for developing this G-d-like attribute:

If only you will keep the commandments of G-d your L-rd and walk in His paths (Deuteronomy 28:9).

[How can a human being walk in G-ds paths?] We are commanded to follow conscientiously G-ds ways of truth and goodness, as they are described in the Torah, and to develop a balanced focus of kindness and compassion in our relationships with other people. This is G-ds Will relative to human behavior, and if we act in this way, we become worthy of receiving G-ds kindness.

A midrash enumerates G-ds standards for human behavior: Just as G-d is compassionate, so should you be compassionate; just as G-d bestows kindness on those who are not deserving, so should you perform acts of kindness to others even to those you feel may be undeserving; just as G-d is righteous, so should you be righteous (Midrash Sifri to Deuteronomy).

The Talmud (Tractate Sotah) cites specific examples, including Scriptural sources, for patterning human behavior after G-ds charitable ways:

Just as G-d clothed the naked, as the Torah writes: G-d made garments of leather for Adam and his wife, and He clothed them (Genesis 3:21) so should you cloth the naked.

Just as G-d visited the sick, as the Torah writes: G-d appeared to Abraham in the Plains of Mamre, while he was sitting at the entrance of his tent [recuperating from his recent circumcision]

Just as G-d buried the dead, as the Torah writes: [G-d] buried [Moses] in the vale in the land of Moab (Deuteronomy 34:6) so should you bury the dead.

Just as G-d comforted mourners, as the Torah writes: After Abraham died, G-d blessed Isaac, his son (Genesis 25:11) so should you comfort those who mourn.

Jewish law, as well as Talmudic and exegetical sources, establish gemilut chasadim the performance of acts of selfless kindness as a basis of all human life. Without it, societies cannot function properly, nor can man achieve his potential and his destiny as a G-dlike creation. In fact, mans spiritual essence depends on his performing acts of gemilut chasadim.

4. Defining Bikur Cholim

As we have pointed out, the general mitzvah of gemilut chasadim (selfless kindness) encompasses the mitzvah of bikur cholim. Nachmanides identifies three general objectives that visiting the sick should achieve:

  • Physical assistance: a visitor should try to help in attending to the sick persons physical needs
  • Spiritual assistance: a visitor should pray to G-d on behalf of the sick person
  • Emotional assistance: a visitor should be friendly to a sick person, providing him with a feeling of camaraderie

In addition to these positive objectives, Nachmanides identifies certain behaviors that a visitor should avoid, either because they cause pain, discomfort, or embarrassment to the sick person, or because they are burdensome to him in some other way. These behaviors will be discussed in upcoming lessons.

Rabbi Yitzchock Hutner (1904-1981, Europe-America-Israel) shows how our approach to helping the sick person is contained in the very words that identify the mitzvah, bikur cholim:

We must understand that the mitzvah of visiting the sick involves far more than a visit; a major purpose in performing this mitzvah is to inquire after the sick persons specific needs with the intention of offering assistance. This function of inquiring after the needs of the sick person derives from the word bikur, which can be translated as investigation. Thus, any assistance a person is able to provide for one who is sick is included in the mitzvah of bikur cholim. A person should use his own good judgment to decide whether a given action will actually prove helpful to the sick person.

(Collected Letters of Rabbi Hutner)

Bikur cholim is far more than a simple visit; it is an opportunity to participate actively in the healing process. Yet this crucial opportunity must be addressed with the utmost sensitivity to the one who is ill. In defining bikur cholim as an investigation, Rabbi Hutner was not implying that a visitor should interrogate the sick person, her family or her other caregivers. One can do a tremendous amount to help a sick person without knowing the details of the illness or the nature of the treatment being administered, and without offering unsolicited advice (in Lessons Two and Three, we will discuss the concept of privacy relative to illness).

A visitor should seek practical ways of helping the sick person, while remaining alert to the sick persons needs and sensitive to her feelings. Knowing what to say and what not to say to the sick person and to her family, praying on behalf of the sick person, timing ones visit, and offering the kinds of assistance that would truly be appreciated, are all part of conducting an investigation in fulfillment of the mitzvah of bikur cholim. In the upcoming lessons of this course, we will discuss practical ways of turning a visit into an investigation that will genuinely benefit the sick person.

5. The Challenges of the Mitzvah of Bikur Cholim

Why do people find it difficult to visit a sick person even, sometimes, to visit relatives or good friends?

People usually feel concerned about someone who is sick, yet, while many people take a strong interest in hearing news about the condition of the sick person and other details relating to the illness, these sincere sentiments do not always succeed in galvanizing them into action.

There are many reasons for the discomfort people experience over the thought of visiting someone who is seriously ill. Most people feel a general uneasiness about illness that sometimes manifests itself as fear, which results from identifying with someone elses suffering and uncertainty. People who do not fear the illness itself may fear the visit, feeling tongue-tied, since they are unsure about what to say and what not to say, fearing they might do more harm than good if they would say the wrong thing. Others may fear the prospect of having to come face-to face with the changed condition of a sick person. All these are common reasons people avoid performing the mitzvah of bikur cholim. Forgetfulness and procrastination are other common reasons.

All of these reasons for avoiding this mitzvah are understandable on some level, particularly in light of the fact that a sick person is almost always more sensitive than usual to anything that may be said or implied by well-meaning visitors. Moreover, any change in the sick persons physical appearance or emotional demeanor even if the visitor is prepared for it can be a most unsettling experience. Nevertheless, the magnitude of the kindness we perform in visiting one who is ill warrants our investing all our energies to overcome our hesitation.

Maimonides perspective on the mitzvah to Love your neighbor as [you love] yourself, and Sefer HaChinuchs perspective on the Torahs injunction to follow in G-ds ways, provide a powerful impetus to help us master our inhibitions regarding visiting a sick person.

On a social level, a persons attitude toward bikur cholim can change dramatically when he is personally affected by illness, whether his own illness or that of someone who is close to him. At such times, he can come to appreciate the value of the support of friends, relatives and members of his community. This awareness can be either a positive experience the reassuring feeling of a visitors concern for the sick person or a painful lesson, if others did not bother to visit, or if some lack of sensitivity rendered their visit unhelpful. The intense loneliness that accompanies illness, as well as the boredom and the burdens that become overwhelming when a sick person must carry on without sufficient help from others, can be bitter teachers, making one aware of how important it is to consider the needs of others who are ill.

On a spiritual level, the awareness that in fulfilling the mitzvah of bikur cholim we are in fact following in G-ds ways and refining our spiritual essence, effectively elevates a visit to a G-dly act.