Community Magazine April 2014

78 COMMUNITY MAGAZINE Rav Moshe Feinstein similarly ruled that even non-seriously ill patients may swallow hametz -containing non-chewable pills on Passover, for two reasons. First, any hametz in the pill was nullified before Passover, as it constitutes a small percentage of the mixture. 2 Secondly, Rav Feinstein ruled that ahsheveh does not apply to medication, since a person would eat virtually anything, food or non-food, if he thought it would make him feel better or cure him. By swallowing a pill, a person is not implying that he considers the pill to be a food; he merely utilizes it for its curative properties. While other major poskim (rabbinical authorities) agree, Hacham Ovadia Yosef and Rav Shlomo Zalman Aurbach add the caveat that this applies only to somebody who is sick. Aperson who is generally healthy but is dealing with a minor ailment or mild discomfort may not take pills that likely contain hametz . Finally, it is important to remember that most pills that contain problematic substances, likely contain cornstarch, which falls under the category of “ kitniyot ,” foods which Ashkenazic Jews avoid on Passover but are permissible for Sepharadim. And even regarding pills that do contain wheat starch, the hametz is almost certainly rendered inedible before Passover. For these reasons, an ill person is certainly permitted to take any type of non-chewable pill on Passover (unless there is a readily available substitute that has no hametz concerns) and has no excuse to discontinue his medications without the assent of his physician. Due to concerns that patients will improperly stop their medications on Passover if they are not confirmed kosher for Passover, at least one rabbinic body was reported to have stopped publishing lists of kosher for Passover medications. Conclusion The above discussion dealt almost exclusively with bitter liquids or tasteless, non-chewable pills. Flavored liquids or chewable pills with a taste are much more problematic and may present a particular problem for pediatric medications which are usually one of these two types. Several rabbinic organizations have published practical guidelines to help navigate the complex variety of medicine types. One simple formulation, which is an excellent starting point for evaluating medications, is the Chicago Rabbinical Council’s statement regarding the use of medicines on Passover, which divides medicines into three basic categories as shown in the sidebar on the right. It becomes apparent that kosher for Passover lists are most useful for flavored liquid and chewable medicines, and non- essential medications, such as over-the-counter medications, vitamin supplements, and food supplements. It is still necessary to consult a competent halachic authority if you have any questions regarding into what category a given non-essential medication falls. For instance, while there is general consensus that vitamin supplements are considered food and require reliable Passover kosher supervision, there is a consensus that prenatal vitamins that are prescribed by a physician may be taken without any hesitation. Additionally, there are unique issues related to children’s medications and many types of non-conventional treatments, such as homeopathic remedies, that may require special consideration. Dr. Daniel Eisenberg is a practicing radiologist in the Department of Radiology at the Albert Einstein Medical Center in Philadelphia. Dr. Eisenberg is a noted lecturer in the area of Jewish medical ethics, lecturing around the world, including serving as the medical ethics scholar-in- residence for the New England Institute for Jewish Studies in Jerusalem and for the Schlesinger Institute for Medical-Halachic Research. Dr. Eisenberg also publishes extensively on topics of Jewish medical ethics and is available for lectures and speaking engagements to professional and community groups. Many of Dr. Eisenberg’s articles can be viewed at his website, www.jewishmedicalethics.com. All pill medication (with or without hametz ) that one swallows is permitted. Vitamins and food supplements do not necessarily fall into this category (even when they are in pill form), and each person should consult with their Rabbi. Liquid and chewable medications (or pills coated with a flavored coating) that may contain hametz should only be used under the direction of a Doctor and Rabbi, who will judge the severity of the illness, the likelihood that the medicine contains hametz , and the possibility of substituting a swallowable pill. Important: Do not discontinue use of liquid, chewable or any other medicine without consulting with your Doctor and Rabbi. Liquid and chewable medications that are hametz -free but contain kitniyot , may be consumed by someone who is ill. A healthy person, who would like to consume this type of medicine to merely relieve a minor discomfort, should only do so if the product is known to be free of both hametz and kitniyot (this applies only to Ashkenazim, who avoid kitniyot on Pesach). THE 3 BASIC CATEGORIES OF MEDICATIONS 2 If even a slight amount of hametz is mixed with other food on Passover, the mixture is forbidden, but if the foods were mixed before Passover, and the hametz comprises a very small percentage of the mixture, it may be eaten on Passover.