CCAR RESPONSA
Contemporary American Reform Responsa
10. Silent Partners in a Medical Practice
QUESTION: What is the attitude of Jewish law to a partnership which provides the money for a medical practice? The individuals involved are not physicians, and therefore they would, on an indefinite basis, benefit from the income of that practice. Is it considered ethical to form a partnership in which the non-participating partners provide the funds for the medical practice which is carried out by a physician? May these individuals benefit from the healing which will occur through the medical practice? (Rabbi M. Staitman, Pittsburgh, PA)ANSWER: Let us divide this question into two segments. The first will deal with partnerships and loans, and the second with medical ethics. It is clear that Biblical and Talmudic laws were opposed to interest bearing loans. This prohibition was absolute when Jews dealt with co-religionists within the community (Lev. 25.35 ff; Deut. 23.20 ff). The prohibition was amplified and expanded by the Mishnah and Talmud (M. B. M. 5.1, 60b ff, 75b; Yad Hil. Malveh 4.2 ff, 7.11, 10.1 ff; Shulhan Arukh Yoreh Deah 161.1 ff). These restrictions, however, proved unrealistic in an economy which functioned on a monetary basis, and so a legal device known as heter isgah was invented and became common (Pisqei Harosh to B. M. 5.23; Mordekhai B. M. 3.19; Nahalat Shivah #40). In modern business transactions, the phrase al pi heter isqah remains sufficient, even if no formal document of this kind has been drawn up. Interest from aliens or foreigners was permitted even in Biblical times (Lev. 25.35; M.B.M. 5.6, 70b f), but was frowned upon and discouraged in the Talmudic period (Mak. 24a). During the Middle Ages in Christian northern Europe, when money lending was among the few avenues of livelihood open to Jews, the taking of interest from non-Jews was defended because of the heavy financial burdens placed upon Jews by the non-Jewish authorities (Tos. to B. M. 70b; Shulhan Arukh Yoreh Deah 159.1). Furthermore, as the monetary economy developed, moral restrictions against lending to non-Jews were voided through reasoningsimilar to that described above with the heter isqah. Some feel that loans to a teacher, physician or any other individual who helps the community should be considered in a highly positive manner. They are an investment which make it possible for him to continue in his profession, which he may otherwise abandon (Nathanson, Hoel Umeshiv Mahadurah Kamma, III, 160). Other authorities limit loans to capital advanced for goods and not for services or the employment of an individual (Imrei Yosher, I, 108; Meir Arak; Kitzur Shulhan Arukh 66.10; Shulhan Arukh Harav, Hilkhot Ribit #42). Let us now turn to the question of partnerships. Various forms of partnerships were reported in the Mishnah and Talmud (M. Ket. 10.4, etc.), and became widely accepted and used by the eleventh and twelfth century, particularly in Northern Europe (Mordekhai to B. K. 176; Rosh Responsa 89.13; Elon Hamishpat Haivri II, pp. 744 ff). Frequently one partner furnished the capital and the other performed the work. In such instances, some difference in remuneration is stipulated by law, so that the working partner receives a greater benefit than the others (M. B. M. 5.4, 104 b; Yad Hil. Sheluhin 6.1 ff; Tur Yoreh Deah 177). Furthermore, the active working partner is protected, because he can withdraw more readily from the arrangement (Tur Hoshen Mishpat 176.28). It is clear from the above statements that silent partners are permitted, and funds earned in this fashion are perfectly acceptable under Jewish law. A variety of provisions have been made for such arrangements. We must now ask whether there are any special restrictions on forming these kinds of arrangements for medical purposes. Fees were part of the acknowledged life of a physician, and the Biblical phrase, “cause him to be thoroughly healed,” was interpreted by the Targum (Ex. 21.19) to indicate that a fee should be paid. It was considered normal and proper for services rendered. The service of those who took no fees was not considered to be worth much (B. K. 85a). Various arrangements were made for the payment of fees, sometimes in advance, and sometimes for a completed treatment, etc. (Ket. 52b, 105a). The skill and knowledge of a physician has been highly praised, and appropriate compensation is suggested (Shulhan Arukh Yoreh Deah 336.3). Although a physician may be motivated by humanitarian concerns, he should also receive a salary for his efforts. That portion of his life is governed by the same standards as any commercial venture. A physician’s business arrangements and fees are treated as any other business venture. There is some difference of opinion on the role of loans, as well as silent partners, in some types of commercial enterprise. This would hold true for our case as well, but it would generally be permitted. A permissive stance has made it possible for modern traditional Jews to participate in the stock market, various forms of partnerships and other enterprises previously not known by the traditional literature. Jewish law does not distinguish between the employment of funds in a general partnership or a medical partnership. Nothing in Jewish law would prohibit silent partners in a medical practice.June 1984
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