[Medicine and Judaism--a patient is forbidden to endanger his life in order to fast on Yom Kippur].

Dr. Israel Katz and his colleagues discuss the theoretical possibility of allowing type-1 diabetes patients to fast on Yom Kippur despite the danger that fasting might lead to a life-threatening state of hypoglycemia. For those diabetics who insist on fasting, the authors recommend more frequent monitoring of their glucose levels, changing their medications and arranging that expert medical advice and treatment be available to them over the course of the fast. In this editorial, the authors argue that most Halakhic authorities (experts in Jewish law) absolutely forbid a type-1 diabetes patient to fast on Yom Kippur, because he is defined as "a patient whose life may be in danger," and is therefore forbidden to fast. This is true even if fasting will only aggravate his medical situation, and even if the patient wishes to fast! While Lantus insulin may be an effective solution for those who have already stabilized their sugar Levels without complications with that drug, a patient who is not already on the drug is forbidden to change his medications, just for Yom Kippur, in order to fast. The authors conclude with a brief survey of the cLassical Halakhic sources regarding the prohibition of endangering one's life in general and the prohibition of endangering one's life by fasting on Yom Kippur in particular. Close collaboration between physicians and rabbis in this and many other issues might contribute substantially to improve patients' care including psychological and ethical aspects of medical practice.