YEHUDA TURETSKY

Prayer and the

Terminally Ill Patient
Introduction
Advances in modern medicine have led to better health
care and quality of life than were ever possible in previous gen-
erations; they have increased life expectancy rates throughout
much of the world and contributed greatly to physician and
patient understanding of many illnesses. These improvements
have also led to situations that rarely existed in previous eras,
as patients are informed that they suffer from a terminal illness
and are left to cope with the information.
Several studies have assessed the role of prayer in such
circumstances from a medical perspective.1 The purpose of this
article is to address a variety of issues that arise regarding prayer
and the terminally ill patient from a Torah based outlook,
hopefully lending insight into the role and function of prayer
in such contexts. While this is not a comprehensive analysis of
all the relevant issues, this article has numerous implications
for the ideal form and type of prayer to be offered and can serve
as a springboard to assess different questions relating to one’s
orientation during prayer in these unfortunate circumstances.

Prayer in Times of Crisis

There are several indications that prayer has a unique

1 See, for example, E.J. Taylor and F.H. Outlaw, “Use of Prayer Among
Persons with Cancer,” Holistic Nursing Practice (2002): 16(3), 46-60, and
L.B. Bearon and H.G. Koenig, “Religious Cognitions and Use of Prayer in
Health and Illness,” The Gerontologist (1990): 30(2), 249-253.

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status and function in times of crisis, which clearly has specific

relevance for terminally ill patients and those impacted by their
illness. It is important to clarify if there is an obligation to pray
in such situations, as well as to relate to the precise relationship
between prayer and crisis.

Is there an obligation to pray?

The Rishonim debate whether one is biblically obligated
to pray each day. Rambam maintains that such a requirement
exists,2 while Ramban disputes Rambam’s position and argues
against a biblical obligation to pray daily.3 However, Ramban,
at least as understood by later authorities, equivocates whether
there is nevertheless a biblical obligation to pray in trouble-
some or crisis situations (what he calls an “eit tzarah”). Magen
Avraham4 notes that Semak also maintains that one is biblically
required to pray in crisis situations.5 According to both Ram-
ban and Semak, however, it is not entirely clear what qualifies
as a troublesome situation and if it is limited to severe or com-
munal calamities. 6
There is an oral tradition that R. Yitzchak Zev Soloveit-
chik would often offer short prayers, even in the middle of
2 Hilkhot Tefilah 1:1; Sefer Ha-Mitzvot, positive commandment 5. See also
Ta’anit 2b; Sefer Ha-Hinukh, mitzvah 433; and Smag, positive mitzvah 19.
3 Ramban, glosses to Sefer Ha-Mitzvot, positive commandment 5. Sup-
port for his approach can be found in Berakhot 21a and Sukkah 38a. Many
Rishonim accept Ramban’s view; see, for example, Rashi, Berakhot 20b. For
a possible limitation of Ramban’s view, see Hiddushei Ha-Grah Ha-Levi on
Rambam, Hilkhot Tefilah 4:1.
4 Magen Avraham, Orah Hayim 106:2.
5 Semak, mitzvah 11.
6 See Sefer Ha-Hinukh, mitzvah 433, in the name of Ramban and the dis-
cussion in Ishei Yisrael 7:1:11, p. 61, regarding whether Ramban’s position
is limited to communal tragedies or extends to individual crises.
According to R. Soloveitchik, Worship of the Heart (Hoboken, NJ: Ktav
Publishing, 2003), 30-33, and Reflections of the Rav (Hoboken, NJ: Ktav
Publishing, 1993), 80-81, the entire debate between Rambam and Ramban
regarding whether there is a biblical obligation to pray daily is based on mu-
tual agreement that one is obligated to pray in crisis situations. They differ
specifically in regard to the type of crisis that necessitates prayer.

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conversation with another person. Some view this as a possible

reflection of a more ambitious understanding of Ramban that
necessities prayer at even minimal amounts of crisis and trou-
ble.7 If one accepts such a position, a terminally ill individual
would undoubtedly be required to pray for his illness to go
away, and the same might also be true for other people directly
impacted by the illness.
Another possible source for prayer in such situations
emerges from Rambam’s rulings in Hilkhot Ta’aniyot. Rambam
maintains that an obligation to pray exists whenever a calamity
befalls an entire community.8 He later adds that just as a com-
munity fasts for their calamities, an individual should fast and
pray for mercy if such a misfortune occurs.9 As such, individu-
als suffering from terminal illnesses should pray in fulfillment
of this halakhah.10
Aside from the ill individual’s own prayer, it is possible
that others are obligated to pray on his behalf.11 Sefer Hassidim
maintains that because all of the Jewish People are responsible
for each other, all are obligated to pray when someone is ill.12
Similarly, R. Alexander Ziskand appears to argue that praying
for an ill individual is a fulfillment of the commandment to
7 See She’arim Be-Tefillah, 31.
8 Hilkhot Ta’aniyot 1:1.
9 Ibid. 1:9. Rambam assumes the prayer would be part of the formal fast
day service. See also Tur, Orah Hayim 569; Shulhan Arukh 569:1.
10 While these authorities mention the need to fast in the face of personal
crisis, many ill patients would be prohibited from fasting because of the
potential health risk involved. Similarly, while not referring to this par-
ticular context, many authorities caution against fasting nowadays unless
it is mandated by Halakhah, as fasting often impinges on one’s ability to
effectively pray, study Torah, and perform mitzvot. They therefore maintain
that it is better to pray and learn more than engage in fasts. For a discussion
of the appropriateness of fasting nowadays for one who would otherwise
be engaging more substantively in prayer and Torah study, see R. Moshe
Tzuriel, Otzrot Ha-Mussar, vol. 1, 115-16.
11 For a discussion of sources that maintain that others are obligated to
pray, see Bi-Torato Yehegeh, vol. 2, 105-6.
12 Sefer Hassidim, no. 753. He is referring to the halakhic category of arvut;
see Shevuot 39a.

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love one’s fellow Jew.13 R. Moshe Feinstein also significantly

expands the number of people obligated to pray, maintaining
that one is obligated to pray whenever one is aware that an
individual is ill, and all the more so when asked to pray on
behalf of a sick person.14 R. Feinstein powerfully proves that
the prayer of any individual may be accepted, regardless of per-
sonal piety or observance, so long as they believe in God.15
That such an obligation exists reflects a powerful per-
spective on prayer’s relationship to crisis. It highlights one’s de-
pendence on Hashem and the need to turn towards God when
presented with terrible news. According to R. Feinstein, such
an obligation may exist for even those individuals who are not
directly impacted by the illness. While not all people are medi-
cal professionals or in positions to provide direct care to the
patient, all have the power and obligation to pray.16

Prayer and Crisis: What Causes What?

The above mentioned sources clearly highlight the

13 Yesod Ve-Shoresh Ha-Avodah, sha’ar 1, chapters 7-8. The requirement of

“ve-ahavta le-rei’akha kamokha” (Vayikra 19:18) is attributed significant sta-
tus in rabbinic literature; see Rashi ad loc. and Shabbat 31a. R. Ziskand’s
approach is based on a fairly ambitious understanding of this command-
ment. For a discussion of the opinions of various Rishonim, see Minhat
Asher on Vayikra, 276.
14 Iggerot Moshe, vol 8, Yoreh De’ah 4:51. He proves this from the laws of
visiting the sick, in which the primary mitzvah is to pray on behalf of the
sick individual. In this regard, see Nedarim 40a; Shabbat 12a-b; Rema, Yoreh
De’ah 335:4; Shulhan Arukh, Yoreh De’ah 335:5; and Iggerot Moshe, Yoreh
De’ah 1:223.
15 R. Feinstein notes that the prayer of scholars is particularly potent. The
Talmud (Bava Batra 116a) instructs someone with a sick person in his
house to ask a scholar to pray on behalf of the ill individual. Since the likeli-
hood that the prayer will be accepted is greater, R. Feinstein cautions such
scholars to pray for people when requested to do so, as they have a special
obligation to pray because of the efficacy of their prayers. Regarding who
qualifies as a scholar, and in particular the inspiring words of R. Feinstein
about his own status, see the end of the aforementioned teshuvah.
16 For further discussion of the connection between prayer and crisis, see
Shearim Be-Tefillah, 26.

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unique status of prayer as a response to crisis. Indeed, the Jew-

ish people prayed as a result of their misfortunes while sub-
jected to servitude in Egypt,17 and many biblical figures prayed
because of their infertility.18 The connection between crisis and
prayer is clear. As R. Soloveitchik observed:

Only distress warrants prayer. If the mind is

not haunted by anxiety, not plagued by tzarah,
narrowness and constriction, if neither fear nor
forlornness assault of the mind, then prayer is a
futile gesture.19

According to R. Soloveitchik, it is calamity and anxiety

that allows for and generates authentic prayer. The troublesome
situation, which for Ramban and Semak may lead to a biblical
obligation to pray, not only changes the status of the prayer; it
also allows for a more intense and powerful prayer.
Others have offered a related but fundamentally differ-
ent approach to that of R. Soloveitchik.20 They, too, point to
a link between troublesome experiences and prayer, but they
emphasize that the reason for the crisis itself is to inspire prayer
and increase closeness to God. Because of the crisis, a person
becomes closer to Hashem through prayer, and that is the ulti-
mate reason why the crisis came about in the first place.
Irrespective of these different perspectives, the termi-
nally ill individual and those aware of and impacted by the ill-
ness are in a unique position to pray. The rest of the article will
relate to one’s orientation during prayer, the content of prayer,
and whether it is ever appropriate to stop praying.

17 Shemot 2:23. See the comments of Or Ha-Hayim ad loc.

18 See, for example, Bereishit 25:21.
19 Worship of the Heart, 29.
20 Siftei Rennanot, 83-85, cites formulations of this perspective from R.
Yechezkel Levenstein (Tefillat Hannah, 27) and R. Chaim Friedlander (Siftei
Hayim, Mo’adim, vol. 2, 181) and brings support from Hazal for such an
approach.

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Belief in the Acceptance of Prayer

Those who are terminally ill or have terminally ill fam-
ily members are often faced with a tension regarding the ideal
orientation to have during prayer. On the one hand, it is the
belief in the efficacy of prayer that generates the desire to pray;
such a powerful conviction offers encouragement and hope,
and at times even confidence in the future. However, many
are cautious to place too much hope in their prayers being ac-
cepted, in case, God forbid, the patient does not experience a
complete recovery. This tension emerges clearly in certain state-
ments of Hazal.
Hazal state in numerous contexts that there are ways to
ensure that one’s prayers will be answered. The Talmud states
that anyone who lengthens his prayer will not have his request
returned empty handed,21 and the Talmud Yerushalmi reaches
a similar conclusion.22 The Talmud also states that while the
gates of heaven may be closed, the gates of tears are always
open,23 and that one should go to a Torah scholar if someone
is sick at home, as the scholar’s prayers will undoubtedly be
answered.24 Indeed, halakhic authorities have even questioned
whether one may violate the Shabbat to ensure that a scholar
will pray on a sick person’s behalf, a possible indication of the
confidence in the efficacy of that prayer.25
21 Berakhot 32b.
22 Yerushalmi Berakhot 4:1. It is not entirely clear what the Talmud means
when it refers to lengthening prayer. R. Yaakov Chaim Sofer, “Be-Inyan
ha-Marbeh bi-Tefillah,” Yeshurun 3 (1997): 395-96, maintains that it does
not refer to spending a long time on individual words and praying with
increased intensity. Instead, it refers to multiple prayers and continuing to
beseech the Almighty that one’s prayers be answered. He finds precedents
for his understanding in the Talmud itself (Berakhot 55b) and the writings
of Netziv (Ha’amek Davar, Devarim 9:19), R. Y.Y. Kanievsky (Hayei Olam
2:2842), and others. R. Sofer also relates to the apparent tension in Hazal
between praise of lengthening prayer and the Yerushalmi’s criticism of ex-
cessively long prayers (Yerushalmi Bikkurim 2:1).
23 Berakhot 32b.
24 Bava Batra 116a.
25 See, for example, R. Yehuda Shaviv’s discussion in Assia, available at

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While these and other sources offer much encourage-

ment, they also raise a fundamental question for those whose
prayers are not answered. If, for example, the gates of tears are
never closed, how is one to understand prayer that is offered
while crying but apparently not accepted? Three perspectives to
this question will be outlined below, shedding light on various
possible orientations towards prayer in such circumstances.26
One approach is that Hazal should not be understood
literally. They did not intend to convey that one will surely
be answered, but instead that following certain guidelines will
increase the likelihood that the desired result will be achieved.
This general perspective is offered by R. Moshe Feinstein in
relating to the implication of the Talmud’s statement (as un-
derstood by Rashbam) that promises that a prayer recited by a
Torah scholar on behalf of a sick individual will be answered.
R. Feinstein notes that the prayers of various Tannaitic figures
were not answered, leading him to suggest that the Talmud
means simply that it is more likely that a Torah scholar’s prayer
will be answered, not that success is guaranteed.27 According
to this approach, one’s orientation should be hopeful that the
prayer will be answered if one follows Hazal’s suggestions for
effective prayer, but realistic about the fact that the prayer may
not be answered as desired.
Another perspective is that God does not answer prayers
in the affirmative if it is not in the best interest of the suppli-

http://www.daat.ac.il/daat/kitveyet/assia/refua-2.htm. Alternatively, this al-

lowance may reflect the extent to which one must go to find a cure, even
if it involves transgression of a prohibition. When exactly one is allowed to
violate the Shabbat on behalf of an ill individual is beyond the scope of this
article.
26 While other possible perspectives exist, these appear to be three primary
approaches towards this issue.
27 Iggerot Moshe, supra n.14. This may reflect a general perspective, accord-
ing to which certain statements of Hazal are not meant to be taken literally.
For more on this, see, for example, Taz, Yoreh De’ah 242:1; R. Tzvi Hirsch
Chajes, Mavo Ha-Talmud, chapter 19; and R. Ovadiah Yosef, Me’or Yisrael,
Shabbat 12b.

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cant.28 In other words, God always responds to the prayer, but

sometimes He answers in the negative. One prays based on
one’s perspective, but God responds based on a broader vision.
As the Talmud observes, “all that God does is for the best,”29
and that may entail the rejection of certain prayers. As such, the
supplicant’s orientation is one of fervent desire for the prayer
to be accepted, with the recognition that God is in control and
may, in fact, respond in the negative.
According to this view, it would seem that even appar-
ently negative events should be viewed positively, as they are
clearly part of God’s plan no matter how distressing or unwant-
ed. However, such an approach may be somewhat difficult to
understand, as Halakhah demands that one respond to certain
events as negative, not as positive events not properly under-
stood. The Talmud’s statement that “one must bless God for
the bad just as he blesses Him for the good”30 strongly implies
that certain events are in fact negative. Similarly, the notion
of punishment for sins indicates that not every decree from
heaven is positive, nor should it be accepted as such.31 Thus,
it would seem that prayer may be rejected even if this is detri-
mental to the supplicant.
A third perspective argues that all prayers are answered,
but not always for what the person requests. Sefer Hassidim
quotes an opinion that even if one’s prayers do not appear to be
answered, the prayers will in fact have an effect for the suppli-
cant and his descendents in the future.32 Thus, as the Talmud
28 See Midrash Tanhuma, Terumah 9.
29 Berakhot 60b.
30 Ibid. 54a. See below, n.42, for Dr. Moshe Halbertal’s explanation of the
prohibition to pray for miracles, which relates to this Talmudic statement.
31 A more thorough discussion on this topic is beyond the scope of this
article.
32 Sefer Hassidim, no. 387, cited in Siftei Renanot, 80. Mabit, Beit Elokim,
chap. 15, maintains a similar view, and this appears to have been the view of
the Hazon Ish according to certain oral traditions; see Tuvkha Yabi’u, vol. 2,
286. R. Reuven Margoliot, Mekor Hessed (Commentary to Sefer Hassidim,
ad loc.), notes a possible source for this view in the Yerushalmi (Berakhot
4:3).

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states, appropriately recited prayers are indeed answered – just

not always for the person for whom the prayers were made. Ac-
cording to this approach, one’s orientation when praying for a
terminally ill individual involves an awareness of the potential
impact of the prayer and the possibility of the ill individual be-
ing cured, with the understanding that the prayers are never in
vain, as they will stand for the supplicant and his descendents
in the future.
All of these perspectives relate to a fundamental ques-
tion about bitahon (trust in God), regarding which a major
debate persists regarding what one must believe while under-
going difficult circumstances. Hazon Ish famously maintained
that trust in God does not require one to believe that every-
thing will turn out for the best or that a cure will come, but
rather that God is always in control, no matter what happens.33
Others, however, reject his view.34 For them, trust in God does
in fact demand the belief that everything will work out and all
will be healed. These are two very divergent views with implica-
tions for one’s orientation during prayer.

Praying for a Miracle and Giving up Hope

In particularly unfortunate situations, terminally ill pa-
tients or their family members may be informed that from a
medical perspective, there is nothing more that can be done
for the patient. In such circumstances, there is little room for
hope barring a miracle, and an important question that then

33 Emunah U-Bitahon, ch. 2. For a discussion of Hazon Ish’s view, in par-

ticular the possibility of alternate readings of his approach, see R. Daniel
Stein, “The Limits of Religious Optimism: The Hazon Ish and the Alter
of Novardok on Bittahon,” Tradition 42:1 (Summer 2010): 31-48, and
the response to his article by R. Gidon Rothstein on the RCA’s blog Text
and Tradition, available at http://text.rcarabbis.org/what-makes-a-belief-
%E2%80%98traditional%E2%80%99-the-case-of-bittahon-by-gidon-
rothstein/.
34 For sources in the Rishonim that appear to reject Hazon Ish’s view and a
lengthy discussion of his opinion, see R. Moshe Tzuriel, Otzrot Ha-Mussar,
vol. 1, 325-32.

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emerges relates to the status of praying for a miracle from a

halakhic perspective.
The mishnah states that praying for an event that has
already occurred is a prayer in vain. Thus, for example, one
who prays that his pregnant wife will give birth to a boy of-
fers a worthless prayer, since the baby’s gender is already de-
termined.35 The gemara questions the mishnah’s critique of
praying for a fetus’ gender to switch based on a tradition that
Leah prayed for her baby to become female and was answered
affirmatively by God. The gemara responds that one should not
bring a proof from a miracle.36 The clear implication is that
while miracles are possible, one should not pray for one to oc-
cur, and Leah’s actions should not be used to support an oppos-
ing view.37 The Talmud Yerushalmi explicitly cautions against
praying for miracles as well.38
The practical implications of this position are signifi-
cant. It would seem that one who has essentially lost hope from
a medical perspective would not be allowed to pray to be cured
through a miracle, despite that being the only real chance at
survival. There do, however, seem to be certain exceptions to
this rule. Rema endorses the recitation of a text that explicitly
asks God for miracles to be performed in our time just as they
were performed during the time of Chanukah. While its reci-
tation is limited to one who forgot to recite the prayer of Al
Ha-Nissim, this prayer’s very existence appears to reflect a per-
missive approach to praying for miracles.39 Furthermore, there
is no explicit ruling in Shulhan Arukh that prohibits one from

35 Berakhot 54a.
36 Ibid. 60a. The gemara offers an additional answer that Leah may have
prayed for the gender switch within the first forty days of being pregnant,
before the child’s gender has been determined.
37 It is not entirely clear from the Talmud whether there is a prohibition to
pray for a miracle, or simply that praying for a miracle will not be effective.
See Birkat Avraham, Berakhot 54a.
38 Yerushalmi Ta’anit 3:2; see also Sefer Hassidim no. 794.
39 Rema, Orah Hayim 187:4 and 682:1.

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praying for miracles.40 As such, some ambiguity exists regard-

ing the precise scope of the Talmud’s ruling.41
Numerous possible exceptions to the Talmud’s rule are
suggested, but there appear to be three general approaches tak-
en with regard to terminally ill patients.
One school of thought accepts the Talmud’s prohibi-
tion to pray for miracles, with the implication that praying for
recovery would not be appropriate.42 The Rema’s ruling justify-
ing such a prayer is either rejected, as was done by Maharam
Mi-Rutenberg,43 or is limited to circumstances irrelevant to the
terminally ill patient. For example, Bekhor Shor suggests that
Rema’s ruling is limited to miracles affecting a community;
one is prohibited, however, to pray for a miracle to occur to
a specific individual – including one who is terminally ill.44 In

40 This is noted by Bekhor Shor (Shabbat 21b). However, this claim does
not appear to be entirely accurate. Shulhan Arukh, Orah Hayim 230:1, cites
the Talmud’s statement in Berakhot that one should not pray for events that
have already occurred or been determined, such as not praying that one’s
pregnant wife give birth to a child of a specific gender.
41 Some assume that the Talmud’s rule does not apply to exceptionally pi-
ous people; see Bekhor Shor, ibid., and Gevurat Ari, Ta’anit 19a. Shome’ah
Tefillah, vol 2, 291, notes that this is also the position of Or Ha-Hayim in
Hafetz Hashem, Berakhot 60a and that Hatam Sofer, Ketuvot 106a, argues.
Einayim Le-Mishpat, Berakhot 60a, mentions several different explanations
for Rema’s ruling, many of which are mentioned below. One omitted from
the body of the article distinguishes between Israel and outside Israel; one
can only pray for miracles in Israel, since it always functions above the realm
of nature. See Shome’ah Tefillah, ibid., for additional discussions.
42 Some suggestions regarding the underlying logic for this approach will
be noted below. For an additional perspective, see Dr. Moshe Halbertal,
“The Limits of Prayer,” Jewish Review of Books, available online at http://
www.jewishreviewofbooks.com/publications/detail/the-limits-of-prayer,
and the discussion in Shome’ah Tefillah, vol. 2, ch. 35.
43 Cited in Avudraham, Chanukah. Avudraham notes others who reject
Maharam’s view.
44 Bekhor Shor, Shabbat 21b, cited in Sha’arei Teshuvah 187:3. Einayim
Le-Mishpat, Berakhot 60a, explains that the text of Rema’s prayer refers to
miracles that will occur in the future that the Jewish People are assured will
come to fruition. An individual, however – including a terminally ill patient
– should not pray for a miracle. As noted above (n.37), praying for a miracle

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slightly different ways, this view has been attributed to Minhat

Hinukh,45 as well as more contemporary authorities R. Yosef
Shalom Elyashiv46 and R. Yechezkel Levenstein.47
A second, more nuanced approach accepts the Tal-
mud’s position against praying for miracles, but limits its scope
in a way that may allow certain types of prayers. Yeshuot Yaakov
explains that the Talmud cautions against praying for a miracle
because the acceptance of such a prayer would come at the ex-
pense of the supplicant’s own merits. However, he permits one
to pray for a public miracle that will sanctify God’s name, as the
reward for the sanctification of God’s name will compensate for
the merits lost through the performance of the miracle.48 Ac-
cording to this approach, one would be allowed to pray for a
terminally ill patient to be cured only if the cure would create
a sanctification of God’s name, thereby justifying the usage of
the supplicant’s merits.
The opposite approach is suggested by Bekhor Shor. In a
different attempt to explain Rema’s ruling, he distinguishes be-
tween miracles that work through nature, which can be prayed
for, and miracles that transcend nature, for which one should
not pray.49 If so, a terminally ill patient is allowed to pray for a
may not be a prohibited, but simply ineffective.
45 Oral tradition cited in R. Ben Zion Rabinowicz, (translated by Daniel
Worenklein and Reuven Mathieson), Mevaser Tov, Techias Ha-Meisim, 5.
46 An oral report is quoted in the article by Dr. Moshe Halbertal, supra
n.42.
47 Cited by R. Herschel Schachter, available at http://www.torahweb.org/
torah/1999/parsha/rsch_korach.html.
48 Yeshuot Yaakov, Orah Hayim 682. A similar approach is suggested by
Einayim Le-Mishpat, Berakhot 60a, as one of his explanations of Rema’s
ruling.
49 Bekhor Shor, Shabbat 21b. Interestingly, Bekhor Shor justifies Rema’s
prayer for a miracle similar to the Chanukah miracle by viewing it as a
miracle within nature, whereas Yeshuot Yaakov views it as a public miracle
that transcends nature. It is possible to argue that each of the Chanukah
miracles – the military victory and the oil lasting for eight days – represents
a different type of miracle.
Bekhor Shor’s position relates to a larger discussion about the relationship
between revealed and hidden miracles. See, for example, David Berger,

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miracle that can be justified as having occurred through nature.

For example, he might pray that a cure be discovered for his ill-
ness. Although such a discovery might constitute a miracle, it
would seemingly be viewed as having occurred within nature.
The third approach is much more permissive and es-
sentially rejects any practical relevance of the Talmud’s position
against praying for miracles for a terminally ill individual. Ein-
ayim Le-Mishpat cites the Talmud’s statement that one should
pray for mercy even if a sharp knife rests on his neck,50 as well
as a number of other Talmudic sources, as indicating that one
may pray for a miracle in a life threatening situation.51 Accord-
ing to this perspective, one may pray for a terminally ill patient
without any limitations, as the Talmud’s rule does not apply to
such individuals. Others permit one to pray in times of crisis,
although only under certain guidelines.52
Additional support for a perspective that limits the im-
pact of the Talmud’s statement can be gleaned from the Midrash
Tanhuma, which appears to argue with the Talmud and allow
prayer for a miracle,53 and Rabbeinu Bechaye, who writes that
prayer has the ability to change nature.54 A particularly strong
argument in favor of this approach is made by R. Ben Zion
Rabinowicz of Biala (author of Mevaser Tov), who published an
entire book dedicated to proving that one should never give up
hope in cases of sick and terminally ill patients. He writes: “Just
“Miracles and the Natural Order in Nahmanides,” in Isadore Twersky (ed.),
Rabbi Moses Nahmanides (Ramban): Explorations in His Religious and Liter-
ary Virtuosity (Cambridge, MA, 1983), 107-28.
50 Berakhot 10a.
51 Einayim Le-Mishpat, Berakhot 10a, 60a.
52 Shome’ah Tefillah, vol. 2, 307, notes Darkhei Hayim Ve-Shalom’s citation
of the Sanzer Rebbe that a terminally ill patient should pray only in thought
and not out loud. See there for additional sources.
53 Midrash Tanhuma, Vayetzei 8. Some attempt to reconcile the midrash
with the Talmud; see Melekhet Shlomo, Berakhot 9:3, and Birkat Avraham
(ibid).
54 Kad Ha-Kemah on tefillah and commentary to Devarim, 11:13. Birkat
Avraham (ibid.) cites this comment and discusses its relationship with the
Talmud’s statement.

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as it is certain that the dead will be revived, it is equally certain

that the sick can be healed. We must not despair; there is every
reason to pray and hope for their recovery.”55

Praying for Someone to Pass Away56

In certain circumstances, an illness can be extraordi-
nary painful for the sick individual. In extreme cases, when
the patient experiences the pain as unbearable, Ran allows one
to pray for such a person to pass away.57 However, the Poskim
debate whether Ran’s opinion is normative. While many au-
thorities accept Ran’s opinion, including Arukh Ha-Shulhan,58
Tiferet Yisrael,59 and a host of more contemporary authorities,60

55 Mevaser Tov, Techias HaMeisim, 22. This discourse was originally pub-
lished in Hebrew, but has been translated into English by Daniel Woren-
klein and Reuven Mathieson as “Mevaser Tov, Techias HaMeisim.” Cita-
tions to the work in this article are from the English translation.
56 This author benefited from the extensive discussion in Shome’ah Tefillah,
vol. 2, 244-7, where the author cites an impressive collection of Aharonim
who discuss Ran’s position and other relevant sources, as well an online
post by R. Ezra Schwartz and the ensuing discussion between R. Schwartz
and Prof. Lawrence Kaplan. See http://text.rcarabbis.org/praying-for-one-
to-die-philosophical-considerations/.
57 Ran, Nedarim 40a. His opinion is based on Ketuvot 104a. For a discus-
sion of the implications of the Talmud’s statement there, see the discussion
in Tzitz Eliezer vol. 5, Ramat Rahel 5; and Shome’ah Tefilla, vol. 2, 246.
58 Arukh Ha-Shulhan, Yoreh De’ah 335:3
59 Tiferet Yisrael, Yoma 8:7.
60 R. Yitzchak Yosef, Yalkut Yosef, Yoreh De’ah 335 (in the most recent edi-
tion of Yalkut Yosef on Hilkhot Bikur Holim and Aveilut, 63-66), writes that
his father, R. Ovadiah Yosef, accepts Ran’s position and has implemented
it in actual situations, though he cautions against doing so without con-
sultation with a Hakham. R. Shlomo Zalman Auerbach, Minhat Shlomo
1:91:24, also accepts this view. R. Ezra Schwartz has noted that this is also
the opinion of R. Chaim Kanievsky, as cited in Siah Tefilla, 719. Other
Poskim also accept Ran’s view, at least in modified versions. See the views
of R. Nahman of Breslov, cited in Sefer Ha-Middot, Tzadik, no. 116; and
R. Sholom Messas, Teshuvot Shemesh U-Magen, vol. 3 (brought to my at-
tention by R. Dr. David Shabtai); See Shome’ah Tefillah vol. 2, 246, for
additional sources.
For a discussion of the position of Hikikei Lev vol. 1, Yoreh De’ah 6, see

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others do not accept Ran’s ruling. R. Eliezer Waldenberg notes

that Ran’s position is not cited in the Tur, Shulhan Arukh, or
any of their commentaries, clearly implying that it is not ac-
cepted as normative. Additionally, other Rishonim do not in-
terpret the Talmud in Nedarim upon which Ran comments in
the same manner that he does, with Maharsha even question-
ing Ran explicitly.61 As such, R. Waldenberg maintains that
one is not permitted to rely on Ran and pray for a sick per-
son to pass away, even if the patient is experiencing signifi-
cant pain.62 Other Poskim, such as R. Moshe Feinstein63 and
R. Shmuel Wosner,64 fundamentally accept Ran’s position, but
argue against practically relying upon it nowadays for various
reasons. According to several Poskim, most prominently R.
Moshe Sternbuch, the question of whether one should endorse
Ran’s position is esentially a question about the value of life, in
particular with regard to seriously ill patients. R. Sternbuch is
uncomfortable supporting Ran’s position in instances when the
patient is capable of clear thought and performance of mitzvot.
65

The precise rationale behind Ran’s position, as well

as that of his detractors, is not entirely clear and has evoked
some debate.66 Part of the rationale for these views may relate

Tzitz Eliezer vol. 5, Ramat Rahel 5. There is also debate regarding whether
the She’iltot, no. 93, accepts Ran’s position; see She’eilat Shalom and Ha’amek
She’eilah ad loc., as well as Tzitz Eliezer, ibid., and Havatzelet Ha-Sharon,
Bereishit, 190.
It is important to note that even amongst those who accept Ran’s view, there
is some disagreement regarding the text of such prayer and the extent to
which one is supposed to directly pray for the patient to die.
61 Maharsha, Nedarim 40a.
62 Tzitz Eliezer vol. 5, Ramat Rahel 5. See Shome’ah Tefillah, ibid., who cites
other Poskim who concur with this view.
63 Iggerot Moshe, Hoshen Mishpat 2:74:1.
64 Siah Halakhah, 772.
65 Teshuvot Ve-Hanhagot 2:82. His position is reflected in statements of
Hazal that emphasize the value of living for even a brief period of time.
66 See the aforementioned post by R. Ezra Schwartz with Prof. Kaplan’s
comments, supra n. 56, as well as Havatzelet Ha-Sharon, Bereishit, 190.

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to end-of-life care in general and what is considered inappro-

priate hastening of death, as opposed to passive attempts at
ensuring comfort. It also may relate to the above mentioned
debate about bitahon and the appropriateness of giving up
hope in dire circumstances. To the extent that one believes
that all things will turn out for the best, rejecting Ran’s posi-
tion becomes all the more likely. This issue also touches upon a
philosophical question about the purpose of yissurin and how
to relate to hardships that impinge on one’s ability to fulfill the
Torah’s commandments.

Conclusion
The purpose of this article was to highlight a variety of
issues relating to prayer and the terminally ill, including the
possible obligation to pray for such individuals and the proper
orientation during prayer for terminally ill patients. The article
also addressed the permissibility of asking for miracles and of
praying for the passing of individuals in certain dire and ex-
treme circumstances.
Terminally ill patients and their families undoubtedly
experience exceptionally challenging times. It is often the be-
lief in the efficacy of prayer and the community’s support that
offer encouragement to the patient and his or her family. May
those who are ill gain strength and support from the prayers
and kind gestures of those around them, and may God, the
ultimate healer of the sick, bestow His kindness upon all those
suffering and bless them with a full and complete recovery.

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