Chapter 16 | Praying for a Terminally Ill Patient

Rabbi Yuval Cherlow, Rabbi Uriel Ganzel, Rabbi Shaul Baruchi

Chapter 16 from the booklet The Halakhot of Treating a Terminally Ill Patient and a Patient Suffering From Dementia

1. It is a great mitzva to pray for a sick person that he should be healed and live, particularly when he is in a life-threatening condition1.

2. If there is no chance of recovery, it is appropriate to pray to God to spare him from suffering, treat him with compassion and do that which is good in His eyes. It is preferable, from both a halakhic and psychological perspective, not to pray directly for his death (although one who does so has upon whom to rely)2.

הערת שוליים

  1. Shulḥan Arukh, Yoreh De’a 335:4–6.
  2. The Gemara (Ketubot 104a) recounts the prayer of Rabbi Yehuda HaNassi’s maidservant that led to his death: “May it be His will that the upper worlds should impose their will upon the lower worlds.” Although this is not a clear halakhic statement that permits one to pray for a person’s death, it does appear that the Gemara views the maidservant’s prayer positively, as it does not criticize her. In addition, there are other sources where the Gemara mentions prayers for a person’s life to end. The poskim cited below bring proofs from passages in Bava Metzia 84a; Ta’anit 23a; Rosh HaShana 17a; and the Jerusalem Talmud, Shabbat 19:2. It should be noted that Rabbi Eliezer Waldenberg (Tzitz Eliezer, V, Ramat Rachel, 5; ibid. VII:49, Kuntres Even Yaakov, 13:1; ibid. IX:47; ibid. XVIII:48, 5; ibid. XIX:10, 1), in keeping with his general approach, rejects all of these proofs.

    The main source for the halakhic ruling on this matter is the Ran (in his commentary to Nedarim, 40a). The Ran infers from a discussion in Nedarim that “sometimes one should pray that a sick person should die, such as when the patient is suffering greatly from his sickness and cannot survive.” The Ran notes that two conditions must be met for this prayer to be appropriate – the patient is suffering, and there is no hope for his recovery. We do not find any reference to this halakha in the Rambam and the Shulḥan Arukh, but many later poskim rule in accordance with the Ran. See Arukh HaShulḥan, Yoreh De’a 335:3; Iggerot Moshe, Ḥoshen Mishpat, II:73, 1; ibid. 74, 1 and 4; Minḥat Shlomo, I:91, 24. Similarly it is stated in the name of Rabbi S. Z. Auerbach that despite the maxim, “even if a sharp sword is resting upon a person’s neck, he should not prevent himself from praying for mercy” (Berakhot 10a), if the sword is not “resting” but is actually “cutting” the neck, one should stop praying (see Naḥum Stepansky (ed.), VeAleyhu Lo Yebol: The Customs and Teachings of Rabbi Shlomo Zalman Auerbach vol. 2 (Jerusalem: 2001), p. 132. See also Encyclopedia of Medicine and Halakha, vol. 5, “A Terminally Ill Patient (a),” pp. 162–66; Nishmat Avraham, Yoreh De’a 335:16). By contrast, Rabbi Eliezer Waldenberg, in his responsum listed above, maintains that one should not pray for a sick person to die. He contends that the Ran’s is a lone opinion that is not cited as halakha by the Shulḥan Arukh or the other poskim, and was thus rejected as halakha. Apart from his reasons for rejecting the proof for the opinion of the Ran, Rabbi Waldenberg adds that even a patient who is in a state of agony and wants to die might in fact still recover, and therefore it cannot be decided in practice that the time has come to pray for his death.

    The poskim who rule leniently add several qualifications: (a) The prayer is permitted only if it is motivated by compassion for the patient, not for the sake of the one praying, e.g., because it is difficult for him to care for the patient or to see his suffering. Therefore, only someone who is not related to the patient may pray for his death (Ḥikekei Lev, I, Yoreh De’a 50; Aseh Lekha Rav, V:112; see also ibid. IX:22). (b) The prayer is permitted only when the patient is greatly suffering and there is no hope of his recovery (Teshuvot VeHanhagot, II:82; Shevet HaLevi, X:26; the other lenient poskim also imply that their ruling applies only in a case of a grave illness and when there is much suffering). Consequently, it is very difficult to determine when such a prayer is permitted, and such a decision may not be made by every person. (c) This does not apply to a patient who is defined as being in a “vegetative state,” since he is not suffering (Shevet HaLevi, X:26).

    Some maintain that only especially righteous individuals may recite such a prayer. See Iggerot Moshe, Ḥoshen Mishpat, II:74, 1. In his opinion, it is doubtful that there is anyone in our generation who may pray in this manner. See also Shevet HaLevi, ibid.

    Notwithstanding all of the above reservations, when there is no chance of the patient’s recovery, it is better not to pray fervently for him to be healed, as we pray only for natural outcomes, not for miracles. This opinion is attributed to Rabbi S. Z. Auerbach in Nishmat Avraham, Yoreh De’a, 335:12, and in Halikhot Shlomo (edited by Rabbi Yitzḥak Treger and Rabbi Aharon Auerbach) I, Tel Aviv, 2000, chapter VIII, footnote 56. See also Rabbi Re’em HaCohen, “Praying for a Brain Dead Patient,” Sefer Assia 16 (2019), pp. 249–50. He maintains that it is prohibited to pray for the recovery of a brain dead person, as this is a prayer issued in vain. See the response of Rabbi Mordekhai Peterfreund, who disagreed with him (ibid., pp. 251–55) and the subsequent rejoinder of Rabbi Re’em HaCohen (ibid., p. 256). Accordingly, it seems that the best approach is to pray to God that He alleviate the patient’s suffering, or that He have mercy upon the patient and treat him with compassion, without mentioning death. Such a prayer encompasses any outcome in which the suffering is alleviated, including both recovery and death. It also stands to reason that a prayer of this kind is easier for the one praying to cope with, as he places his trust in God, who knows what is good and best for the patient, rather than submitting a direct prayer for his death. For more, see the position paper, “Praying for the Death of a Patient who is Suffering and for whom there is no Hope of Recovery” (

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