COSMETIC SURGERY

QUESTION:

A young, unmarried Orthodox girl wants a nose plastic operation and her face lifted. She realizes that according to Halacha she must not inflict unnecessary injury to herself. Should she have these operations? (Asked by Dr. Abraham Bernstein, San Francisco, California.)

ANSWER:

IN TRADITIONAL LAW there is ground for debate whether any operation which cuts the human body can be freely consented to. Of course if it is a question of saving an endangered person’s life, then no prohibition among the commandments is allowed to stand in the way of the necessary operation. All commandments are waived in cases of pikuach nefesh (danger to life). But suppose the operation is not one for saving a person from real danger but is for a relatively minor purpose, such as improving the shape of the nose, are such operations permitted by Jewish law?

In order to answer that question, we must first look into the question of a person giving consent to an op eration. The law is fairly clear that just as a person may not wound another (chovel, “to wound, to injure”) so he may not wound himself (or arrange for someone else to wound him—in this case, the surgeon). This law is stated clearly by Maimonides in his Code in Hilchos Chovel V, l. However, where the law is stated in the Shulchan Aruch in Choshen Mishpot 420:31, it is not stated as positively as Maimonides does. The Shulchan Aruch says: “He who injures himself is free [from punishment] although it is not permitted to do so.” The reason for this ambiguous statement of the law in the Shulchan Aruch, which seems to say you may and you may not injure yourself, is that Rabbi Akiba, who is the chief authority for this law, himself seems to have two diverse opinions. In the Mishnah (Baba Kama 8:6), he states the law just as the Shulchan Aruch quotes it, namely: “You should not injure yourself, but if you do so, you are free from punishment.” But in a boraita quoted in the Talmud (Baba Kama 91 a at the bottom), Akiba says flatly that a man is free to injure himself. Clearly this vagueness in the law of self-injury leaves room for discussion of the question asked here and of many analogous questions.

An interesting recent discussion was made by Moshe Feinstein, the prime contemporary Orthodox authority (in his Igros Moshe, Choshen Mishpot #103). The specific question with which he was dealing was the following: May a man give his blood to a blood bank for pay? On the face of it, this should be prohibited because the man is arranging for his self-injury. After a minute analysis of the two semi-contradictory state ments of Rabbi Akiba, Moses Feinstein comes to the conclusion that it is permitted, first because they used to do bloodletting in Talmudic times; second, because the injury is slight and painless; and third, because the man may, of course, need the money.

On the basis of the law, the line of our inquiry must be as follows: First, how dangerous is the cosmetic surgery as a procedure? What risks does the patient incur? Second, how important a benefit is the beautification of the woman? Is it important enough to justify whatever danger there is in the surgery?

It may be assumed that cosmetic surgery deals mostly with the outer parts of the body and does not generally involve disturbing the vital organs. As for the benefit derived by whatever risk this surgery entails, this question has a remarkable place in Jewish traditional literature. The Bible and the Talmud pay a surprising amount of attention to cosmetic matters. First of all, the various spices and lotions used in women’s beautification are mentioned many times in Scripture. In the Song of Songs 3:6 and 4:10, and in Esther 2:12, various spices are mentioned. Also in the Talmud (Baba Kama 82a) we are told that when Ezra brought the people back from Babylonian captivity, among his special ordinances was one permitting peddlers of cosmetics to travel freely throughout the country so that these ointments, etc., would be readily available.

The law permits a woman to go through extensive beauty treatment on the half-holidays (see Orah Hayyim 346:5). The husband must provide means of his wife’s beauty material (see b. Ketubos 64b). One of the most touching narratives in the Mishnah (Nedarim 9:10) concerns Rabbi Ishmael. A man had made a vow that he would not marry a certain woman on the ground that she was homely. Rabbi Ishmael then took the girl into his house and beautified her. Then he presented her to the young man who had made the vow and said to him: “Is this the girl you vowed you would not marry because you said she was homely?” The young man looked at the beautiful girl and said: “No, I would gladly marry her.” Then follows the saying: “The daughters of Israel are beautiful. It is their poverty which makes them homely.” Then we are told that when Rabbi Ishmael died, all the daughters of Israel sang a dirge for him.

It is clear from Jewish tradition that the right of a woman to beautify herself is one that is honored in Scripture and in Talmud. It is not at all to be considered as a trivial matter. It is clearly the spirit of the tradition that a woman has the right to strive for beauty.

Since, therefore, the cosmetic purpose is an honored one and an important one, and since the operation is not likely to be a dangerous one, then the ambiguous law of chovel against self-injury does not apply here, and this woman is not prohibited by Jewish law from undergoing cosmetic surgery.