The Visitor’s Halachic Guide to Hospitals

Published Spring 2009

A person visiting a hospital patient is performing the great  mitzvah  of  bikur cholim .  It is one of the  mitzvos  for which a person reaps benefits in this world, while the principal reward is saved for the next world.  While visiting the sick, some  halachic  issues may arise.  This article addresses these issues from the visitor’s point of view.  Questions affecting the patient (such as adjusting the bed, using the call button, and asking the staff to perform tasks on  Shabbos ) are important issues that should be posed to one’s rabbi.

Although visiting a patient in the hospital on  Shabbos  may present a number of challenges, this does not mean one should necessarily refrain from visiting the sick.  To the contrary, the patient may benefit greatly from a  Shabbos  visit since fewer people tend to stop by on this day and he may welcome the company or need an advocate.2 One who has the opportunity to look around the hospital before  Shabbos  should do so, in order to identify any potential  Shabbos concerns.  (Unless otherwise noted, all references in this article to  Shabbos  include  Yom Tov, as well.)
Doors  – Hospitals generally have one of three types of entrance doors:  manual, electric eye, or revolving.
Ideally, one should use a manual door when entering or leaving a hospital on  Shabbos .  If there are none available, he should wait until a non-Jew triggers the electric-eye door with his movement, and then immediately walk through the doorway.3 He should not linger near the door.

A manually operated revolving door does not present difficulty on  Shabbos , nor does an electrically powered door that revolves continuously, since walking through such a door does not affect its operation.  However, an electric eye which continuously checks for the presence of people is a problem on  Shabbos .  When someone approaches this kind of door, he may cause it to activate.4 Therefore, one should wait until a non-Jew activates the door and then immediately walk through the doorway.

Interior doors may also be motorized.  They are activated by pressing a button on the wall, or by pulling slightly on the door; they may also be controlled by an electric eye.  One hospital door that was evaluated was triggered by a person standing as far as 15 feet from the door.  One should be on the alert for these types of doors and walk through them only when they are already opened, as stated above.

Robots – Hospital robots (which may look like mechanized carts) may be used to deliver medicine and supplies throughout the building.5  They navigate to their destination and can activate doors and elevators, using sensors to avoid a collision.  One should avoid walking near the robots, since this will cause them to change direction, stop, or ask that one move to a different area.

Elevators – Hospitals often have many floors.  Is it permissible to use an elevator on  Shabbos ?
Use of an elevator involves a number of issues, including:6

  1. Elevator doors are equipped with a mechanism which prevents them from closing when people are in the elevator entranceway.  One who triggers this mechanism is transgressing a  Shabbos  prohibition.
  2. To reach a specific floor, one generally presses a button which starts the elevator and may cause the button to illuminate.

Therefore, if at all possible one should avoid using an elevator on  Shabbos .  If it is very difficult for a visitor to use the stairs, he should enter the elevator immediately after a non-Jew to avoid activating the door through the electric eye.  (This is not easily accomplished; due to limited space, the electric eye may unfortunately be triggered.)  He should not ask anyone to press a button for him, rather he should exit on the nearest level and walk to the desired floor.
In case of need, one may use a “ Shabbos  elevator” which stops on each floor and remains open for a short while.  One should enter or exit the elevator as soon as the door opens.  He should not block the elevator doorway as this will activate the electric eye.

Stairwell – The door to the stairwell may be hooked up to either an alarm or electromagnetic lock mechanism.  Some hospitals and nursing homes prefer locks that incorporate electronics which alert the security personnel so they can determine whether or not to let a person leave a particular ward or floor.  Pressing the bar or turning the handle on this kind of door may activate a mechanism which will sound an alarm or use electricity to unlock the door.  If one needs to use such a door on  Shabbos , he is permitted to ask non-Jewish personnel to open the door for him.

There may also be a security camera in the stairwell.  It is best to avoid being videoed by such cameras on  Shabbos , since the image is projected onto a screen.  In a hospital, however, it is difficult to avoid this and one is permitted to walk past the cameras.7

Beds – Some hospital beds, particularly in the intensive care unit, are responsive to movement and adjust automatically.  A visitor should be aware that sitting down or resting his hand on this type of bed will cause it to move.

Washrooms – Hospitals may be equipped with toilets that are controlled by an electric eye. In a situation where there is no alternative, one may use the toilet on  Shabbos  due to the   kavod habrios  (human dignity) involved.8  However, one may not use the sink if it is similarly controlled.9

Food On  Shabbos  – It is permitted to have non-Jews heat up food on  Shabbos  for patients who are ill,10  however, this leniency does not apply to visitors.  If a hot meal is brought for a visitor, he may not eat it until the food has cooled down to room temperature.11  Even if a hot meal was brought for the patient, a visitor may not partake of it until it cools down.12

If a  kiddush  cup is unavailable, any cup is acceptable for  kiddush ,13 however, a non-disposable cup is preferred.  If there is no wine or grape juice available for Friday night, one may wash and then recite  Kiddush  over  challah  (or even a slice of bread), substituting the  brocha  of  Hamotzie for  Boreh Pri Hagafen .  If bread is unavailable and the visitor cannot wait to eat upon returning home at a late hour, he may  daven  and eat without making  Kiddush .14
There is a  mitzvah  to use two whole  challahs  for  lechem mishneh .  Bagels or buns may be used instead of  challahs.   If they are sliced, they are acceptable with the following conditions:  1. The two halves are still attached, even if only slightly; and 2. When picking up the smaller piece, the larger piece remains attached and does not break off.

Shabbos  Candles –  Hadlakas Neiros Shabbos  is an obligation that applies even to someone who is hospital bound.  A patient whose spouse is lighting candles at home should nonetheless light with a  brocho  in the hospital room.15  A rabbi should be consulted regarding the  halacha  as to whether or not both the patient and an overnight visitor are obligated to light Shabbos  candles.  Since hospital regulations forbid the actual lighting of candles in the room, one should light an electric incandescent lamp or flashlight in the hospital room and recite a brocho .16

Eruv Chatzeiros  – An  eruv chatzeiros 17 is not needed in order to carry within a hospital.

Security – In some hospitals, especially in the emergency room, visitors may be asked to pass through a metal detector upon entering the facility.  One may do so only upon removing all metal items so as not to set off the detector.


Meals  – A hospital may serve meals which are pre-packaged, similar to airline meals.  If the meal is served in two segments, a hot and a cold portion, always check that the hot and cold portions come sealed and labeled.  Furthermore, one should make sure that the portions correspond with each other; both parts should be labeled “Meat” or “Dairy.”  It is possible that the components could be mixed, or that a non-kosher cold portion could be mixed with the kosher hot portion.  This is especially true regarding bread, beverages and dessert which may have inadvertently originated from the non-kosher kitchen.18

Davening  – Many hospitals have an on-site non-denominational chapel.  Although it is preferable to find another area in which to  daven , one is permitted to  daven  in such a place in the absence of religious symbols or other worshippers.

In a hospital with a religious affiliation, there may be religious symbols hanging in the patient rooms.  If there is no other alternative, one may  daven  in the room and face away from the symbol, even if it requires facing a direction other than east.19

One may not  daven  in the presence of human waste.  If he is far enough away where no odor can be detected, and the waste is covered (even in a transparent receptacle), he may  daven  in the room.20  The bed is not considered a covering for a pan which is placed beneath it.21  A visitor may  daven  in the presence of a catheter.22

Kohen  – kohen  who visits a hospitalized patient may unknowingly be in the presence of a deceased patient.23  This is based on the fact that  tumah  travels through doorways throughout the hospital and can travel from one room to the next, even between floors.24  It is important to ascertain whether a majority of patients in the hospital are Jewish, as this would present a halachic  concern.  The  kohen  should also try to determine the presence of any deceased patients in the hospital rooms.

kohen  should visit a hospital patient only if the majority of patients are not Jewish and there is a great need to do so, e.g. when a relative is ill and family relationships must be considered25 or the patient is seriously ill and requires specific assistance from a  kohen .  If possible, the  kohen  should close the door to any room he enters. It is advisable for a  kohen  to discuss with a  rav  any potential hospital visits prior to his actual visit to the hospital.26

Bikur Cholim  Pointers

Although ‘ bikur ’ is commonly translated as ‘visiting’, the  Sefer Maavar Yavok  writes that it is derived from the word ‘ bikoret ’– to research or investigate.27  A visitor should try to determine if there are any patient needs to which he can attend such as arranging for proper nutrition, comfort and cleanliness or even family needs including child care or coordinating meals. Even with all the care available nowadays, there are often things that the patient is still missing. Advice concerning the patient’s medical care should be offered only when appropriate, as very often it is not fitting to advise a patient in this regard.28

Before entering the hospital room, one should knock lightly at the entrance to ensure that the patient is ready to receive visitors.  One should carefully consider if it is appropriate for a man to visit a woman or vice versa, as it is difficult to make a general statement.There are tznius and other considerations that will play a role in the decision. Praying for the patient’s welfare is a very important part of  bikur cholim .  Someone who visits and does not pray has not fulfilled the  mitzvah .29  This may consist of a simple  brocho  for a  refuah shelaima 30 or a lengthy recital of  tehillim , when appropriate.31  When  davening  for the patient while in his or her presence, one does not need to mention the patient’s name.32

An important goal of visiting the sick is to bring pleasure and joy to the patient.33  Therefore, a visitor’s demeanor should not reflect signs of sadness.34  One should be a good listener if the patient wants to talk about his illness, but ought not to pry into the details of the illness.  The visit should not be lengthy, unless one is specifically requested to stay.  A long visit is likely to be a burden to the patient.35  In some cases, any visit may be a burden and one should first consult with family members concerning the patient’s wishes.36 One may also consult with the family to ask if there is any gift that might raise the patient’s spirits.

The patient need not arise when a visitor enters his room, even to honor a  talmid chochom .37 There is a dispute among authorities as to whether the patient may do so if he wishes, but he is certainly permitted to show honor by raising himself slightly.38

Although it is preferable to visit someone in person, if one is unable to do so or if the patient prefers, one may fulfill the  mitzvah  of  bikur cholim  by telephoning (or emailing) the patient.39One should also visit a non-Jewish person who is ill (e.g. a neighbor or co-worker) in the interest of  darchei shalom .40  Since there is often more than one patient assigned to a room, a visitor should also acknowledge the patient’s roommate.

Rav Moshe Feinstein,  zt”l , penned a response dealing with people who are deaf.  He concludes, “I close with a blessing that all this should not be needed, G-d forbid, that there should be no deaf among  klal Yisroel , and that all the deaf people should be completely healed upon the speedy arrival of  Moshiach , whom we long for every day, and then this response will remain solely for the sake of the study of  Torah .”41  We, too, pray that this article will not be needed.  We eagerly anticipate the days of  Moshiach  when hospitals and this article will no longer be needed.


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1. This article was written  l’iluy nishmas  the author’s father, Asher ben Zvi  A”H .  The idea for this article was formulated while the author visited his father in the hospital.


2.  Mishna Berura  287:1 (see  B.H. ) discusses when  Shabbos  visits are appropriate.  See also Responsa  Tzitz Eliezer  13:36.

3. If one is uncertain if the person opening the door is Jewish, we follow the majority. Therefore, in the U.S. we may assume he is not Jewish. See also  Toras Hayoledes  24:note 2.

4. This kind of door is not immediately obvious, but with some attention it can be seen that the revolving door stops after a while when no one walks through.

5. There are currently 1,000 in use in the U.S, and that number is expected to grow rapidly. March 15, 2012.

6.  Shemiras Shabbos Kehilchasa  ( S.S.K. ) (23:49) writes that going down in an elevator is more problematic than going up.  However, there are various types of elevators, in addition to changing technology, and this point is not applicable everywhere.  See also  Shevet Halevi  6:39.

7. When he has no interest in being seen by the cameras.   Rav  Yosef Shalom Elyashiv, in a personal conversation with  Rav  Moshe Heinemann (also cited in  Orchos Shabbos  15, note 55); Rav  Shmuel Vozner (Responsa quoted in  Orchos   Shabbos  pg. 513).  See  Shulchan Shlomo siman  340, note 12b citing  Rav  Shlomo Zalman Auerbach.

8. Before he rises, he should cover the electric eye so that the mechanism will not be activated.  It can be covered with a piece of paper, even though the paper may fall off at a later time. (See also Nishmas Shabbos 6:74(2nd)).

9. There are alternatives available to using the sink, for example using water from a pitcher or a conventional sink. It is important to avoid spreading germs in the hospital.

10.  Shulchan Aruch   O.C.  328:17 and  M.B.  47. On  Yom Tov , food may be heated even for a visitor.

11. This assumes the meal was only heated, but not actually cooked on  Shabbos .

12.  Shulchan Aruch  318:2.

13.  S.S.K.  57:11. See  Igros Moshe  3:39.

14.  M.B.  289:10. If he returns home that night, he should recite the  kiddush  he missed and eat bread.  Of course, one should plan ahead and arrange for wine and  challah  at the hospital, if possible.

15.  Mishna Berura  263:28 and  Biur Halacha  ( Bochurim ),  Toras Hayoledes  38:2.

16.  Toras Hayoledes  38:5. See  S.S.K.  43:4, note 22, Responsa  Tzitz Eliezer  1:20:11, and Responsa  Yabia Omer  O.C. 2:17.

17. An “ eruv chatzeiros ” refers to  matzoh  or bread that has been set aside to allow for carrying between different areas inside a building.  This is distinct from what is commonly called an  “ eruv ”, which is constructed from poles and wire and permits carrying outside a building.  In a hospital, the rooms are not considered different areas since all of the rooms are owned by the hospital and the patients are moved at the hospital’s discretion.  See  Beiur Halacha  370:3 ( aiynom ).

18. Tap water in New York City hospitals may contain water insects called copepods.  For a discussion of these insects, see here.

19.  M.B.  94:30.

20.  O.C.  87:3, 76:1. See  M.B.  76: 3 and B.H.  Siman  79 who cites a dispute if a distance of 4 amos  is required, as well. In the case of a hospital room, it would seem that one may certainly be lenient.

21.  M.B.  87:9.

22.  Igros Moshe   O.C.  1:27.  He writes that it is preferable to cover it.   Nishmas Avrohom  ( O.C. 76:9) cites a ruling from  Rav  Shlomo Zalman Auerbach, that it is unnecessary to cover it.

23. Limbs, fetuses, and a  goses  (someone in the throes of death) are also sources of  tumah  for a  kohen .

24. In U.S. hospitals,  tumah  is often contained to one floor since the law requires that fire doors and stairwell doors be closed at all times.  For this reason, the morgue is not usually a concern for someone visiting a patient, since it is on a different floor.

25.  Igros Moshe Y.D . 2:166, see also  Y.D . 1:248.   Tzitz Eliezer  16:33 takes a somewhat more lenient approach.  Also, see  Sefer Taharas Hacohanim  pp 11, 52.

26. The  rav  may inquire as to the layout of the hospital. The concern is intensified when visiting an intensive care unit, and extra care should be taken before entering this unit.

27. Cited in  Gesher Hachaim  pg 27.

28.  Gesher Hachaim  pg 28.

29.  Ramo Y.D . 335:4.

30.  Shulchan Aruch  335:6 states that one should  daven  that the person be healed, “ בתוך שאר חולי ישראל  ” — among other ill Jews.  Some authorities are mystified as to why many omit this final phrase both in  davening  and every day speech.  We suggest the following explanation. Because it is a straightforward phrase, oftentimes one wishes a  refuah shelaima  to people who are not really “ cholim ” in the true sense of the word, e.g. someone who has a cold.  At the same time, one would not want to ascribe the term “ choli ” to those individuals (See  Nedarim 40a and  Taz Y.D.  335:1), as that would imply a more serious condition.  Therefore, we simply wish them a “ refuah shelaima ” and omit “ בתוך שאר חולי ישראל  ”.  After all, even people who are not “ cholim ” need “ refuah ” in the sense that it means a setting right or fixing – see  Shulchan Aruch  6:1, regarding  Asher Yatzar .  However, due to force of habit, people incorrectly continue this practice even when addressing actual “ cholim ”, and leave off the proper “… בתוך  ”.

31. On  Shabbos , the correct  brocho  is “ שבת היא מלזעוק ורפואה קרובה לבוא  .”  Shulchan Aruch, Ramo O.C.  287.

32.  Brochos  34a,  Mogen Avrohom O.C.  119 :1.  The  tefillah  is more effective when the name is not recited ( Sefer Zichron Meir  pg. 87, quoting the  Chasam Sofer ).

33.  Sefer Zichron Meir  pg 80.

34.  Gesher Hachaim  pg 28.

35. See  Gesher Hachaim  pg 27,  Sefer Zichron Meir  pp. 77 and 83.  The  Rambam  ( Aveilus 14:6) details the laws of  bikur cholim,  and writes that one should  daven  for the  choleh v’yotzeh ”  – and then leave.   Rav  Moshe Heinemann commented that since obviously one leaves after the visit, this seemingly extra word in the  Rambam  is meant to indicate that he should not linger more than necessary.

36. See  Shulchan Aruch Y.D.  335:8.  Also see  Kovetz Igros Chazon Ish  1:114, in a letter assumed to be written to  Rav  Issur Zalman Meltzer – “I would have liked to visit…but I have heard the doctors have found that nothing is better than peace and quiet…”

37. If the patient does get up, the visitor should not tell him “ shev ”, sit down, because this also connotes  “stay in your illness.” ( Ramo  Y.D. 376:1)  However,  Rav  Moshe Heinemann distinguishes between the Hebrew word “ shev ” which one should not use, and the English word “sit” which is permitted, since in English it does not have the same connotation.

38.  Gesher Hachaim  pg 212.

39.  Igros Moshe Y.D.  1:223.

40.  Gittin  61,  Y.D.  335:9.

41.  Igros Moshe Y.D.  4:49 (end), see  Medrash Tanchuma Metzorah  (2).