Although the first mitzvah mentioned in the Torah with regard to Avraham Avinu is bris milah, Chazal inform us that, in fact, Avraham upheld the entire Torah (Mishnah, Kiddushin 82a). Whereas we learn the Torah from written material, Avraham learned Torah from within himself, drawing it from the depths of his own person (Bereishis Rabbah 95:3).
Based on Avraham’s adherence to the entire Torah, several commentators raised a simple question. If Avraham kept the entire Torah , why did he not perform the mitzvah of bris milah even before he was instructed to do so? Surely, he ought to have circumcised himself before receiving the Divine instruction, just as he kept all the other mitzvos even though he had not received a Divine command.
A number of answers have been offered for this question. ((One suggested answer is that Avraham knew that he would be instructed in the mitzvah, and therefore waited for the Divine instruction, because the performance of a mitzvah that one is obligated in, is greater than the performance of a mitzvah that one is not obligated in. Another possibility is that Avraham only began to perform the mitzvos of the Torah after his circumcision, which made him “perfect” (in the words of the verse) and allowed him to learn Torah from his inner self.)) We would like to focus on the suggestion of the Panim Yafos. According to his explanation, the reason Avraham did not circumcise himself before he was commanded to do so is because of the prohibition of injuring oneself. Avraham was unable to fulfill the mitzvah of circumcision because, without an explicit instruction, he was forbidden to injure himself.
The prohibition of injuring oneself has many halachic ramifications and, based on the interpretation of Panim Yafos, we take the opportunity to investigate it. One important ramification, for instance, is the question of cosmetic surgery which has become widespread in recent decades. A highly relevant question for our times is whether cosmetic surgery is permitted, or forbidden on account of the prohibition of self‐injury.
Healing and not Injury
The basic prohibition of injuring oneself emerges from a teaching of a Mishnah: “One who injures himself, even though it is forbidden, is exempt [from payment]” (Bava Kama 90b). The Gemara proceeds to mention a dispute among tanaim over whether or not one may injure oneself. The conclusion, according to the vast majority of authorities, is that there is a prohibition.
Both Rambam (Chovel U’mazik 5:1) and Shulchan Aruch (Choshen Mishpat 420:31) rule that it is forbidden for a person to injure himself. Moreover, many authorities have opined that the prohibition is a Torah Law (see Rashba 1:647; Tumim 27:1), though some maintain that self‐injury is prohibited only by rabbinic enactment.
After having established the existence of a prohibition, we need to ascertain under which circumstances the act of self‐injury is prohibited: is it always prohibited or are there circumstances under which it is permitted for a person to injure himself?
By way of introduction, it appears clear that when the injury is a means of curing an illness or ailment, it is not prohibited. The reason for this is that an injury that is required for healing is not considered an injury, but rather a remedy. For example, the practice of blood‐letting (a method of healing that was common until recent times) is mentioned in numerous places in the writings of Chazal, without any mention of the concern of causing oneself injury. An act of healing, it seems clear, cannot be considered an act of injury.
For a similar reason, no question of causing injury is raised with regard to a father hitting his son, or a teacher hitting his pupil. These instances of hitting which, quite plausibly, may cause slight physical injury, are also mentioned by Chazal in numerous places, without ever raising the question of causing injury. As Rabbi Elchanan Wasserman has noted (Kovetz He’aros, Yevamos 655), the Gemara (Kesuvos 32a) implies that such actions would not fall under the category of injuries.
Our question, however, applies to cases in which the person who wishes to cause himself injury is not ill, such as somebody who wishes to improve his physical appearance by undergoing cosmetic surgery. ((Mishnah Halachos (6:246) suggests that cosmetic surgery can also fall under the category of healing, and would therefore not involve any prohibition. However, other authorities do not consider somebody who wishes to perform surgery for cosmetic reasons as being ill (or, at the very least, as requiring a form of healing). Presumably, the classification would also depend on the severity of the need for surgery.)) Is this, or any other need or desire, sufficient to permit self‐injury, or must we be more discerning in deciding when, and when not, it is permitted for a person to injure himself?
The ruling of Rambam concerning causing oneself (or someone else) bodily harm indicates that the prohibition does not apply to every form of injury. To quote: “It is forbidden for a person to injure both himself or others, and one who does so… in a destructive manner, ((Some replace “in a destructive manner” with “in a degrading manner”. In most cases, the two would go together: an injury that is destructive is generally degrading, and an injury that is constructive is generally not degrading. However, there might be some halachic ramifications in borderline cases.)) transgresses a Negative Commandment” (emphasis added).
The wording of Rambam implies that only those injuries that are destructive—meaning violent or harmful—are prohibited. Injuries that are constructive and purposeful would, therefore, not be prohibited.
Tosafos (Bava Kama 91b), however, appear to disagree with this ruling, stating, “a person may not cause himself injury even for a purpose.” Rashba concurs with the ruling of Tosafos, stating that a person may not cause himself bodily harm under any circumstances—even when the injury would bring him emotional relief. According to these Rishonim, it emerges that even “constructive injury,” which Rambam permits, falls under the prohibition of self‐injury.
Cosmetic Surgery in Responsa
Based (partially) on the ruling of Rambam, Rav Moshe Feinstein (Iggros Moshe, Yoreh De’ah, vol. 2, no. 66) ruled that it is permitted to undergo cosmetic surgery. Iggros Moshe notes the dissenting opinion of Tosafos, yet brings several Talmudic proofs to Rambam’s position, and rules that the injury caused in plastic surgery, which is not a “destructive” (or “degrading”—see footnote 3) injury, is permitted.
Moreover, even according to the stringent position of Tosafos, P’nei Yehoshua suggests that the prohibition of self‐injury depends on the degree of the need for it. Tosafos, in his view, prohibits the act of self‐injury only in cases of a slight need; where the need is more pressing, Tosafos would agree that there is no prohibition.
Although Rav Feinstein, after raising the distinction between a small and great need, wrote that the distinction is strained, a number of poskim uphold the distinction, ruling that there is no prohibition in cases of great need (see Yabia Omer, vol. 8, no. 12, sec. 1). Moreover, Rav Feinstein himself concludes that cosmetic surgery is permitted according to all opinions, because it is a tikkun for the person undergoing the surgery.
It is interesting to note that Rabbi Eliezer Waldenberg (Tzitz Eliezer, vol. 11, no. 41) ruled that cosmetic surgery is prohibited. The rationale behind his ruling is that the Divine permission given to doctors to interfere with a person’s body is limited to issues of health and illness. Where the issue is not health but only physical appearance, no permission is given for doctors to interfere, and the act of cosmetic surgery is therefore prohibited.
However, his viewpoint is a minority opinion, and many poskim—including Rav Elyashiv, shlita (as quoted by Rabbi Ovadya Yosef, Yabia Omer, op. cit.), rule that is it permitted to perform cosmetic surgery. (Some authorities, such as Minchas Yitzchak (6:105), question the permissibility of cosmetic surgery based on the danger involved in the surgery. It is possible that today, the level of danger involved is so slight that all authorities would concur that this is not a relevant issue.)
Self‐Injury in Milah
Did Avraham Avinu refrain from performing bris milah on account of the prohibition of self‐injury? According to Rambam, certainly not. In his view, only a destructive act of self‐injury is prohibited, and the act of bris milah, even before the instruction was given, cannot be deemed destructive.
According to Tosafos, however, it is possible that the act would be prohibited. Based on P’nei Yehoshua, this would depend on how great was Avraham’s ‘need’ to comply with Torah law, even before the Torah was given.
It is interesting to note that some (see Avi Ezri, Chovel U’mazik 5:1) have tied the question of self‐injury to the general inquiry concerning whether or not a person owns his own body. If a person’s body is his property, it follows that it would be permitted to cause oneself injury. If, however, our bodies remain the property of Hashem, and a person is only the custodian over his body, it follows that self‐injury is prohibited—no less than injury of someone else.
For a broad analysis of this issue, see the article by Rabbi Asher Flegg in Umka Dedina, vol. 3.