Charging for Life Saving Medicine

Isn’t it taught in a baraita: One who was running away from captivity and came upon a ferry. He said to the ferry man: Take a dinar, i.e., he offered to pay an amount much larger than the standard fee, and take me across the river. Despite the escapee’s commitment, it is ruled in the baraita that the ferryman receives nothing other than his usual rate, as the escapee is legally exempt from paying the higher amount he had agreed to pay. Apparently, one could have said in such a case: I was deceiving you and never really intended to live up to my side of the agreement, and therefore it is not an actual debt.

... This law that he only pays the typical fee is only in matters that usually people for not pay a lot for it. However, in matters that it is usual to pay a lot for it, such as a sooth sayer or a for healing, he must pay what he agreed to pay.

(1) The Torah has granted the physician permission to heal, and it is a religious duty. If he withholds [treatment] he is regarded as one who sheds blood; and even if there is someone else who can heal him; for not from every one does one merit to be healed. Nevertheless, on should not occupy himself with medical treatment unless he is an expert and there is none other greater than he; for if not so, he is regarded as one who sheds blood. If one administered medical treatment without the permission of the Jewish Court, he is subject to payment of indemnities, even if he is an expert; and if he administered medical treatment, having the permission of the Jewish Court, and erred, causing [thereby] injury [to the patient], he is exempt by the laws of man and is held responsible by the laws of Heaven. If he caused death and it became known to him that he acted inadvertently, he is exiled.

(3) One who has medical ingredients and his neighbor is sick and requires them, is forbidden to raise the price above the standard value. Furthermore, even if they agreed to pay him an excessive amount, due to the need of the hour, — for they found that only he possessed the medical ingredients, — he is entitled only to the [standard] price. However, if one stipulated an excessive sum as payment to the physician, he is obligated to give it to him, for he sold him his learning which cannot be valued in [terms of] money. Gloss: Although he is required on account of the religious duty to heal him, — for every positive command which rests upon every person [to fulfil], — [yet] if it chances to come to one's hand and he agrees to execute it only for money, — [the law is that] we do not claim the money from him,¹⁷If the physician had already received the money — BaḤ. The same applies to the medical ingredients if already paid for — R. A. Eger. Although the physician is forbidden to receive payment, it is different, however, if the patient had obligated himself to pay. For the physician may put forth a valid claim that it was not only his own duty to study medicine, since everyone has the opportunity to master this field. Nevertheless, in the case of the man who escaped from prison and offered the ferryman an exorbitant fee to take him across the river, the law is that he was obliged to pay only the normal rates, despite the fact, that in this case too, the ferryman may claim that every person has the opportunity to learn his type of work, for in the latter case there exists an established rate, whereas in the former case the knowledge of the physician cannot be measured in terms of money. Consequently the stipulation must be fulfilled — TaZ.

Come and hear the following incident: Rabbi Yoḥanan suffered from the illness tzafdina, which affects the teeth and gums. He went to a certain matron who was a well-known healer. She prepared a medicine for him on Thursday and Friday. Rabbi Yoḥanan said to her: What shall I do tomorrow, on Shabbat, when I cannot come to collect the medicine from you? She said to him: You will not need it. Rabbi Yoḥanan asked her: If I do need it, what shall I do? She said to him: Take an oath to me that you will not reveal the remedy, and I will tell you, so that you can prepare it yourself should you need it. Rabbi Yoḥanan took an oath to her: To the God of the Jews, I will not reveal it. She revealed the remedy to him. On the following day Rabbi Yoḥanan went out and taught it publicly, revealing the secret of the remedy. The Gemara challenges: But Rabbi Yoḥanan took an oath to her that he would not reveal her secret. The Gemara explains that his vow meant: I will not reveal it to the God of the Jews, which indicates: But I will reveal it to His people, the Jews. The Gemara challenges: But even so, isn’t there a desecration of God’s name, as the matron now thinks that a great man of Rabbi Yoḥanan’s stature violated his vow? The Gemara answers that he revealed it to her at the outset. As soon as she disclosed the remedy to him, he informed her that his vow would not prevent him from publicizing it. With regard to the issue at hand, the Gemara infers: Apparently, an affliction that affects the gums is similar to an internal injury, as it was permitted for Rabbi Yoḥanan to prepare the remedy on Shabbat. Rav Naḥman bar Yitzḥak said: Tzafdina is different, since it begins in the mouth, and ends in the intestines, i.e., the disease spreads until it infects one’s intestines, and therefore it is considered an internal affliction even while it is only in the mouth.