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Volume 17 : Number 054

Monday, May 29 2006

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Subjects Discussed In This Issue:
Date: Sun, 28 May 2006 20:00:36 -0400
From: "Zvi Lampel" <hlampel@thejnet.com>
Subject:
Doctor's fees


R. Eli Turkel:
> R. Zilberstein, one of the world's experts on the area, has said
> that the doctors fees are legitimate since you need their prescriptions
> and for that they need state/country permission which requires all the
> training. ....

I don't understand how this changes things from yesteryear, when
/something/ a doctor would otherwise charge for would be gratis because
of the prohibition. The need for presecriptions and the requirement for
official permission based upon expertise is already stated in the halacha
in Shulchan Aruch under discussion, and yet the Shulchan Aruch prohibits
"sechar ha-chochma v'ha-limud," (which is defined by the commentators
as a fee for medical advice).

also
:> I received the following answer from R. Neustadt after he discussed
:> doctor's fees on shabbat in his halacha page
> It's not an issue, see Aruch hashulchan 3,

> BTW what is the reason that he cannot charge for his expenses in
> medical school?

Perhaps you can supply a link to Rav Neustadt's halacha page. I don't
follow the synopsis supplied:

Aruch HaShulchan 336:3 simply quotes the Tur's quote of Ramban's Toras
HaAdam, and adds that "sechar ha-chochma v'ha-limud" (for which it is
prohibited to accept payment) refers to payment for his knowledgable
advice, and "sechar ha-torei'ach" refers to payment for the physician to
travel to the patient and to payment for writing out the prescription. (He
does not define here "sechar batala.")

To clarify:
Sechar ha-chochma v'halimud--fee for medical advice--prohibited.
Sechar ha-torei'ach--fee for travel and writing prescription--permitted
Sechar batala--fee for taking off from other activities--permitted.

So I don't see how this indicates there is no issue. On the contrary, it
seems to me that the Aruch HaShulchan's (and all the other commentators')
definition of the prohibited "sechar ha-chochma v'ha-limud" as payment
for the physician's knowledgable advice refers precisely to payment for
the time, money and effort that went into gaining that knowledge.(Just
as a Shabbos baal korei's pay is not for his leining per se, but his
mastering of it during the week.) I say that because if payment for
the past schooling expenses are a separate, permitted matter, I would
expect the permissibility (or impermissibilty) to accept payment for
them to be clearly noted. (It is clearly not "sechar batala," and surely
it took time, effort and money [although probably less, less and less]
for the physicians of earlier times, too, to learn medicine.) Once the
halacha introduces a prohibition against charging for "sechar ha-chochma
v'halimud"--the medical advice" and presumably the time, money and effort
that went into acquiring and mastering--how does the "sechar batala" turn
around and figure in the fee charged by others of the same or related
professions, which is based on the time, money and effort they invested?

Or does this halacha mean that a physician is permitted to demand
payment to cover the expenses of his education, and is only prohibited
from charging an additional fee for dispensing that knowledge? It sure
doesn't seem to be the gist of the words.

> also we will not have medical care unless they get paid, and paid well. 

This explains why the patient is forced to pay the bill, but not why
a physician who is a yarei shomayim and who should refuse payment for
fulfilling a mitzvah should send the bill.

> It is all considered sechar batalah, since they can get a similar job
> treating non-Jews and get paid for it.

Several posters have written along these lines. Well and good. But
wasn't it always the case that a Jewish doctor could get a similar job
treating non-Jews and get paid for it? What new situation emerged today,
that did not exist at the Tur's time, that permits shomrei-Torah doctors
to charge as much as all others? I'm not denying the physicians their
right to charge as they do; I'm just trying to identify the halachic
grounds that produced a difference between now and the Tur's times,
when /something/ was prohibited. More on this following:

R. Meir Shinnar:
> ...I would point out that, as I suspect the poster intended, there
> are similarities to the pay for rabbanim.

The doctor is right on the money <g>!

> However, there are also differences.
> a) The issue of social necessity - the requirement for doctors -
> applies just as much ... However, there is no issue for doctors of being
> mechallel hashem, mevaze hatora, umechabe or hadat -as there is for any
> paid rabbanut.

Agreed, the Rambam (for whom these are issues regarding public support of
rabbanim and students) may not have foreseen the circumstances spurring
medical professionals to commit the ethical lapses widespread among them
today (Medicaid fraud, etc). He did not envision government programs
that would support medical services to those who cannot afford them,
by taxing its citizens, and then forcing health professionals to rely
on inefficient and paltry government distribution of those taxes to
defray the costs. Indeed, the Rambam does not even mention any limit in
a doctor's fee.

But the Tur we are discussing does not follow the Rambam's absolutist
shitta prohibiting public financial support of rabbanim and students. (It
is first introduced into the Shulchan Aruch by the Remah, and only
to go on to re-cast it as a chassidus.) The Tur is instead quoting
the shittas HaRamban (from Toras HaAdam), which does not entertain the
Rambam's shitta and most likely holds--as did the Rambam's predecessors,
contemporaries and successors--that the only issue is the more general
one of accepting payment for performing any mitzvah. So whether regarding
rabbanus or medicine, the issue in the Tur/Shulchan Aruch is the same.

> b) Rabbanim don't have a general marketplace to compare their
> services. Doctors do .... - so the marketplace determines them.

Which makes the high doctor fees even more problematic if, as so many
posters have suggested, the hetter is "sechar batala." All explanations
of "sechar batala" I've seen depict it as an ad-hoc fee less than, not
equal to, the fee a dedicated professional would charge. Whereas there
may not be any gauge regarding the market value of the work of rabbanim
and students, there is one for doctors, as RMS is pointing out.

In any event, even if one would posit that there are non-Torah-learning
counterparts (clergy? academia? researchists? think-tank members?) by
which to gauge the value of rabbanus and Torah-study, I have the strong
impression that rabbanim, and certainly kollel yungerleit, are paid
less than those. But is there any difference between the fee charged by
shomrei-halacha doctors and that of others (who also have the necessary
intelligence for higher-paying jobs, but choose the one they're doing)?

Incidentally, note that what underlies this entire rationale is the
value and necessity the public perceives in the one service as opposed
to the other. And this illustrates my oft-repeated point that, contrary
to how the Rambam perceived it (and in line with the rationale expressed
by some of his opponents on this issue), non-payment to lomdei Torah
reinforces the idea among the masses that Torah-learning is less valued
than paid-for occupations, not more.

> I don't know of sources that require a religious doctor to charge
> substantially less than the marketplace fees ...

Neither do I -- besides the halacha in Shulchan Aruch we are
discusiing. Which is my problem: "How this squares with today's doctor's
fees."

Perhaps all doctors are really earning the bare minimum necessary to
survive, once one deducts their overhead and expenses and can't afford
to charge any less. But their lifestyles do not seem to support this idea.

> c) There has been a drop in the quality of applicants to medical
> school, because the purely economic case for being a doctor has become
> far less attractive in comparison with other options available to the
> top potential candidates. The social necessity issue is a real one -
> even if we don't like it.

I don't understand how point (c) illustrates a difference between rabbanus
and medicine. Seems to be another similarity.

> d) The notion that there is a general issur on taking fees for
> performing mitzvot is problematic - after all, even the rambam allows
> paying (and accepting) for teaching torah shebikhtav (eg, a melamed) -
> where that is the norm. This is clearly qualified by normal practice,
> social needs, etc.

Indeed. The same can be said for rabbanus -- and for Kollel. But somehow
one does not sense the righteous indignation against new ways Torah study
is financed today, because of socio-economic changes, that one senses
about the b'dieved practice, brought about by soci-economic changes,
that condones paying physicians.

Zvi Lampel

P.S. I must emphasize again that I am not chv"s begrudging anyone's
parnasa, or claiming that any doctor should not charge the fees he
does. I'm just trying to discuss how this works halachically.


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Date: Sun, 28 May 2006 17:48:50 -0400
From: "Zvi Lampel" <hlampel@thejnet.com>
Subject:
Re: Malachim


Thu, 25 May 2006 from: "Lisa Liel" <lisa@starways.net> wrote:

On Sun, 21 May 2006 18:06:10 -0400, "Zvi Lampel" <hlampel@thejnet.com> wrote: 
>> RYGB once suggested that leshitas haOS, they lack bechirah 
>> because in Shamayim, good vs evil is obvious, not a choice. Which 
>> would mean that when sent down here, where tov is occluded, 
>> perhaps they do. This would answer the timing of mal'achim when 
>> down on earth, eg saying shirah at qeri'as Yam Suf. Since they 
>> obtain bechirah, time follows suit. 

> Question: Is it established that they were down on earth?...

RLL:
> With respect, it's not even established that the melachim mentioned in 
> the Torah were melachim in the Kabbalist/angelology sense.
> A malach is essentially an extension of Hashem's will. Technically,
> everything in creation that lacks free will is a malach in a certain
> sense. That would include people, if Hashem overrode their bechira to
> cause them to bring a message.

The melachim under discussion were those who attempted to say "shira"
at krias yam suf, and these are not melachim mentioned in the Torah,
but in the MIdrash. I think you are referring to the Rambam in MOreh
Nevuchim (II:6) where he states that the forces of nature and creatures
that perform Hashem's will are referred to as "melachim." But there he
also defines "real" angels spoken of in the Torah in what I think you
mean by the "angelology sense:

"As for the existence of angels, there is no necessity to cite any
proof from Scripture, where the fact is frequently mentioned. ...
We have already stated above that the angels are incorporeal. This
agrees with the opinion of Aristotle: there is only this difference
in the names employed -- he uses the term "Intelligences," and we say
instead "angels." His theory is that the Intelligences are intermediate
beings between the Prime Cause and existing things, and that they effect
the motion of the spheres, on which motion the existence of all things
depends. This is also the view we meet with in all parts of Scripture:
every act of God is described as being performed by angels.

But "angel" means "messenger." Hence every one that is intrusted with
a certain mission is an angel. Even the movements of the brute creation
are sometimes due to the action of an angel, when such movements serve
the purpose of the Creator, who endowed it with the power of performing
that movement; e.g.," God hath sent His angel, and hath shut the lions'
mouths that they have not hurt me" (Dan. vi. 22)....How could the
Creator be assisted by those whom He created! They only show that all
parts of the Universe, even the limbs of animals in their actual form,
are produced through angels: for natural forces and angels are identical."

RLL:
> Or maybe not. But in any case, the ambiguity throughout the Torah in
> which we see men acting as malachim can be reconciled in this way.

Sometimes men are called melachim. But sometimes melachim are called
men. In the case of the three "men"-who-were-melachim who visited Avraham
Avinu, the Rambam (ibid.) understands it as a vision:

"We have already stated that the forms in which angels appear form part
of the prophetic vision. Some prophets see angels in the form of man,
e.g.," And behold three men stood by him" (Gen. 18:2)."

Some time ago there was much discussion on Avodah as to how/if this
works out in the pesukim.

Zvi Lampel


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Date: Sun, 28 May 2006 16:22:19 -0400
From: "Zvi Lampel" <hlampel@thejnet.com>
Subject:
Call me Pinhead


Thu, 25 May 2006, I wrote, [Re: Malachim (was Spilling drops of wine at
the Seder)]:
> ...Actually, I'm somewhat uncomfortable, and feel like I'm getting way 
> over my head, talking about the nature of mal'achim (haven't decided yet 
> about the numbers of them possible on pins of needles...)

Make that "on heads of pins."

Zvi Lampel 


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Date: Sun, 28 May 2006 20:23:19 -0400
From: Micha Berger <micha@aishdas.org>
Subject:
Re: Call me Pinhead


On Sun, May 28, 2006 at 04:22:19PM -0400, Zvi Lampel wrote:
:> ...Actually, I'm somewhat uncomfortable, and feel like I'm getting way 
:> over my head, talking about the nature of mal'achim (haven't decided yet 
:> about the numbers of them possible on pins of needles...)

: Make that "on heads of pins."

Just FYI, the question was not whether the number was 613 or 603,550.
Rather, whether or not the number was finite.

The debate was about whether infintesimals exist, phrased as whether
an angel can get infintesimally small -- and therefore if an infinite
number of angels can fit on the head of a pin.

-mi

-- 
Micha Berger             Today is the 45th day, which is
micha@aishdas.org        6 weeks and 3 days in/toward the omer.
http://www.aishdas.org   Tifferes sheb'Malchus: What is the beauty of
Fax: (270) 514-1507               unity (on all levels of relationship)?


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Date: Sun, 28 May 2006 21:12:39 EDT
From: T613K@aol.com
Subject:
Re: Nasi


RMB:
> Hillel's matrilineal connection to beis david was therefore a point
> in his favor

Matrilineal? Did you mean patrilineal? (I thought Hillel was a
descendant of Dovid Hamelech?) Or did you really mean matrilineal,
and if so, why would that matter?

 -Toby  Katz
=============


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Date: Sun, 28 May 2006 21:18:29 -0400
From: "S & R Coffer" <rivkyc@sympatico.ca>
Subject:
RE: Avot and Mitzvot


On May 28, 2006, Zvi Lampel wrote:
> On the other hand, the Rambam in his Hakdama L'Payrush HaMIshnayos
> ("Hakdama L'Seder Zeraim") in his long piece about the Aggada "Ain
> L'Hakadosh Baruch Hu B'Olomo Ella Dalet Amos shel Halacha" (he doesn't
> have the girsa, "since the Destruction of the Bes HaMIkdash") asks
> rhetorically: "And in the time of Shem and Eiver [who were in the time
> of Avraham] and afterwards, when there was no halacha, would we be able
> to say that HKBH had no part in this world at all?!"

I don't see the problem. The ma'amar Chazal states that the Avos were
mikayem the Torah *before* it was given which means that technically
there were no halachos in the conventional way they are normally
understood. Thus the Rambam still has his kasha although he may very well
take the ma'amar Chazal re the Avos literally. Ultimately he modifies the
meaning of 'halachos' in his answer to include the activity of righteous
people in general and this would definitely include the activities of
the Avos.

Simcha Coffer 


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Date: Sun, 28 May 2006 18:32:14 -0700 (PDT)
From: Mark Levin <mlevinmd@verizon.net>
Subject:
R Itche der masmid


>> I would like to append a story to this email. R' Aryeh Carmel relates that
>> R' Itchele (Yitzchok) Masmid

> Slight mishearing there - he was known as "Itche der masmid". His real
> name was R Yitzchok (Halevi) Gurevitch.

>>                 ... He once had occasion to visit London and stayed
>> by Rav Dessler for several weeks. During that time, these two gedolim
>> traversed the pathways of pinimius haTorah such that Rav Dessler reported
>> that these several weeks were the most enriched of his life. But here's
>> the kicker. R' Itchele was so enamoured with Rav Dessler's tefisa in
>> penimius haTorah that his (Rav Dessler's) Rebbetzin reported that for
>> the entire time that R' Itchele stayed with them, she didn't have to make
>> his bed. He simply didn't sleep due to his excitement over Rav Dessler.

This is recorded in the ArtScroll biography of R. Dessler, p.129 where
it says that R. Itchele often did not sleep in a bed from Shabbos to
Shabbos. It says there that they discussed specifically R. Dessler's
view of tsimtsum - that there was no disagreement between Baal Hatanya
and the Vilna Gaon on this topic, see Michtav M'Eliahu 5, 324. One can
speculate that R. Dessler had influence in this regard - see a letter
from the Lubavitcher Rebbe contesting this postion to R. Yerachmiel
Benjaminson of London (who I gather was a Lubavitcher), 19 Shevat, 5999,
translated in "I will write it in their hearts", by R. Elaihu Touger. For
a response vis Kodshei Yehoshua, V:421-423, pp.711-736. See Marbitse
Torah U'Mussar III, p. 66

  M. Levin


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Date: Mon, 29 May 2006 16:18:01 +0200
From: saul mashbaum <smash52@netvision.net.il>
Subject:
Re: chag habikkurim


RETurkel asks:
> Why is Shevuot designated as chag Habikkurim when the Omer is brought
> earlier and the first fruits are brought beginning the next day and only
> the shtei halechem occurs on shvuot itself.

Apparently, shtei halechem alone is enough to give Shavuot the name
"chag habikurrim".

In this context it is relevant to point out that RYBS has been quoted
as saying that Rav Chaim related to Shavuot as chag shtei halechem,
not chag mattan Torah (I think is saw this in "Moadei Harav", edited bt
Shlomo Pick). It is clear that in the terms of the text of the Torah,
this is correct, although it flies in the face of universal practice
and tradition.

Saul Mashbaum


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Date: Sun, 28 May 2006 18:54:08 -0700 (PDT)
From: Mark Levin <mlevinmd@verizon.net>
Subject:
tsimtsum kipshuto


[RYGB:]
> I do believe tzimtzum k'peshuto is heretical (or, at least, close to
> it). I do not think anyone really holds of tzimtzum k'peshuto. . I
> continue to maintain (along with Rav Dessler) that there is no such
> opinion.

The actual words of the Ari in the beginning of Otsros Chaim sound very
much like that. Also, those who hold tsimtsum kipshuto are cited in Shem
Mishimon on Eitz Chaim 1:2, R. Emanuel Ricci in Yosher Levav. Lubavitch
sources claim that this is the view of the Gro, f.e. this claim appears
in "The Great Maggid". The truth is that both views appear in the name of
the Gro, one in his pirush on Sefra D'Tsniusa and the other in the klalim,
see Mordechai Pechter, Kabbalas Hagro in Hagro Ubeis Midrasho, Bar Ilan U.

  M. Levin


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Date: Sun, 28 May 2006 22:59:25 -0400 (EDT)
From: "Jonathan Baker" <jjbaker@panix.com>
Subject:
Tzimtzum K'Peshuto


From: YGB <rygb@aishdas.org>
> I do believe tzimtzum k'peshuto is heretical (or, at least, close to
> it). I do not think anyone really holds of tzimtzum k'peshuto. To which
> my correspondent just responded:
> but see:
> <http://www.afn.org/~afn19926/dvar.htm>
> It is indeed worth looking there - note that the assertion that Misnagdim
> held of tzitmtzum k'peshuto is not sourced. I continue to maintain
> (along with Rav Dessler) that there is no such opinion.

On the other hand, see <http://www.safed-kabbalah.com/Arizal/Teachings.1.htm>
where R' Moshe Miller explains the Arizal as holding of tzimtzum kipeshuto
(it's hard to find anyone on the Web explaining such things who isn't
a Lubavitcher, with their biases), and in so doing explicitly rejecting
the earlier ideas of concealment and limitation of the Or. That earlier
idea seems close to the "tzimtzum not kipeshuto" espoused by Chabad.

Looking in the Etz Chayim myself (shaar 1 anaf 2) it does look rather
like tzimtzum kipeshuto - tzimtzem es atzmo Ein Sof. It looks like
there were two phases, 1) removal of atzmo ES, and 2) removal of or ES,
so that the vacuole is empty, hollow air. In that vacuole He created
the universe. Although there is enough ambiguity to support those who
read it eino kipshuto.

As for the Gra, Allan Nadler in "The Faith of the Mithnagdim" maintains
that the Gra held of allegorical tzimtzum, but thought it was sort of
"halacha v'ein morin kein" because of the danger of the uneducated
coming to "worship the twigs and stones" (according to a famous letter).
The piece brought from the Nefesh haChaim also shows R' Chaim Volozhin
holding of allegorical tzimtzum. The Gra's letter of 11 Tishrei 5557
seems to be one of the keys, and it is understood differently by different
writers. Not that it makes very clear what the doctrinal differences are:

"The generation how their poor have been raised up, and repeat words
towards the Cause,: "These are your gods, Israel, every tree and stone"
(Wilensky relates this to Tzavaas HaRivash, 'there is no place in the
world empty of holy sparks, even trees and stones...' Wilensky believes
the Gra had access to preprints of the Tanya, and relates this to the
first chapter of the second part of Tanya) and reveal faces in the Torah
against Halacha in the verse: "Blessed is the glory of Hashem from His
place", (Wilensky relates this to Tanya I:42, how one should meditate
for an hour every day on how Hashem fills every place in the world) and
the verse "You sustain everything." (Wilensky: referring to Tanya II:2,
"read 'give existence to' rather than 'sustain'). Woe to the evil ones
who see this who have looked into their hearts and put in a new law and
a new Torah...

So it seems to me, from superficial review, that the late Rebbe may have
been mistaken in his assertion that the Misnagdim of the Alter Rebbe's
time held of tzimtzum kipeshuto. One hears two such assertions made
by Chasidim, particularly Chabad Chasidim (e.g. the posters here, and
R' Nissan Mindel in his biography of the Alter Rebbe), that a) the Gra
believed in tzimtzum kipeshuto (note the recent comments that the passages
in the Safra D'Tzniusa indicating the Gra held of tzimtzum kipeshuto
may not actually be his), and b) the Gra was misinformed by maskilim
about the activities of the chasidim. Neither seem to be entirely borne
out by reliable second witnesses. However, it seems entirely likely
(other writers have said the same) that the Arizal did hold of tzimtzum
kipeshuto, so to say that "there is no such opinion" may be overreaching.

   - jon baker    jjbaker@panix.com     <http://www.panix.com/~jjbaker> -


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Date: Mon, 29 May 2006 16:38:25 +0200
From: Daniel Eidensohn <yadmoshe@012.net.il>
Subject:
Tzimtzum KePeshuto


[RYGB:]
> I do believe tzimtzum k'peshuto is heretical (or, at least, close to
> it). I do not think anyone really holds of tzimtzum k'peshuto.

The attached is part of an article published in "Heichal HaBesht" [1:1]
- a Chabad magazine published in Monsey.. It also addresses the defense
of Rav Dessler's position by his son in law.

[See <http://www.aishdas.org/avodah/faxes/tzimtzumKePeshutoHaBesht.pdf>
-mi]

Regarding the Gra - there is fact a dispute what he actually held and
whether the writings ascribed to him are forgeries.

However as the above article points out it is problematic to label a
position held by gedolim as heresy - unless you are yourself a gadol or
are quoting one..

This issue is also discussed in an article by Prof Tamar Ross "Two 
Explanations of Tzimtzum : R' Chaim Voloshner & R Shneur Zalman" 
Jerusalem Studies (#2 1982 pp 153-169). I have it in pdf but it is a 
blemished copy]

Daniel Eidensohn


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