In our previous essay, we examined the laws of Birchos haNehenin for people without a sense of taste and whether tube feedings require Birchos haNehenin. Continuing the topic, this essay will discuss a related subject – do medications with sweet or pleasant taste require a Bracha?
In the past, many medications tasted bitter. However, the modern pharmaceutical industry has invested heavily in improving their taste, for several reasons:
- It is difficult to get children to take bitter-tasting medications.
- Although adults will generally be willing to take essential medications despite their taste, they may not take bitter-tasting supplements or vitamins.
- Patients with chronic conditions are more likely to comply with their regimen if the medications do not have an unpleasant taste.
Medications are sweetened in several ways. Flavors and sweeteners are often added to syrups and certain tablets. [This is particularly common in the case of dissolvable tablets or vitamins for children that are marketed as candies.] In other cases, tablets are covered in a sweetened capsule which masks the bitter taste while the medication is swallowed.
Is there an obligation to recite a Bracha on sweet-tasting medications?
The Gemara in Brachos states (44b): “One who drinks water to quench his thirst…[recites Shehakol]”. What case does this come to exclude? R’ Idi bar Avin said: “It excludes one [who drinks water because he] is choking on a bone.” Tosfos add (45a, s.v. “d’Chanaktei”):
This is only true of water, which engenders no pleasure unless he is drinking it to quench his thirst. The pleasure of [relieving the] choking is not considered “pleasure”. However, with regard to other beverages from which the body always experiences pleasure – he must recite a Bracha in all cases, even if he [is drinking them because he] is choking on a bone. This is implied above [by the Gemara] –“even though it is coming for Refua, he must recite a Bracha…”
In other words, the Halacha that one only recites a Bracha when drinking something to quench his thirst only applies to water which has no taste and does not give any pleasure unless one is thirsty. Other liquids, which are pleasurable to drink, always require a Bracha even if they are drunk for Refua and not for pleasure (such as relieving choking).
Tosfos adduce proof for this concept from a Gemara in an earlier Sugya (36a). The Gemara records several Amoraim who hold that one recites Borei Pri haEitz on olive oil. It discusses the case in which this would apply and concludes that Borei Pri haEitz would be recited when olive oil is drunk as “Anigron” – a brew that is drunk for Refua. The Gemara asserts: “One might have thought that since his intention is for Refua, he should not recite a Bracha at all. It therefore teaches us that since he has pleasure from it, he needs to recite a Bracha”.
In other words, if something is purely ingested for Refua and produces no pleasure, one does not recite a Bracha. If, however, it has a pleasant taste that he enjoys, he must recite a Bracha even though his intent is only for Refua.
We will pause here for a moment to compare this conclusion with the definition of “Hana’as Achila” according to HaGaon Rav Asher Weiss Shlit”a as we quoted at the conclusion of the previous essay:
Hana’as Achila (the benefit derived from eating), which is, as stated, subject to a Machlokes Amora’im. This does not refer to the pleasure of tasting the food, but to a feeling of satiation, either that of the stomach or that of the palate (which exists even if somebody cannot taste the food).
At first glance, Rav Asher’s contention that the Hana’as Achila that generates the obligation to recite a Bracha is not the pleasing taste of the food appears to run counter to the Sugya in Brachos that states that Refua alone is not a basis for a Bracha. However, Rav Asher defines the Hana’ah that generates the obligation to recite a Bracha as the sense of satiation that comes from eating. The Gemara in Brachos is referring to a food that only has medicinal benefit, which does not constitute “Hana’ah” (physical pleasure) that would require a Bracha.
This distinction is based on the premise that Birchos haNehenin are recited because “it is forbidden to derive pleasure from this world without reciting a Bracha”.
Returning to our Sugya of sweet-tasting medications, Tosfos (Brachos 36a s.v. Keivan d’Is Lei Hana’a Minei Ba’ei B’ruchei) also comment on the Sugya regarding olive oil:
It would appear that if a person drinks beverages – if [they] are foul-tasting and he derives no pleasure from them – he does not need to recite a Bracha. But if he does derive pleasure from them – aside from the Refua [benefit] – he needs to recite a Bracha.
Other Rishonim concur with Tosfos – see Rabbenu Yona (ibid. 32b), the Rosh (ibid. 6:43), and the Mordechai (151). This forms the basis for the Shulchan Aruch’s ruling (204:8):
Any foods or beverages that a person eats or drinks for Refua – if they have a good taste and the palate derives pleasure from them, one must recite a Bracha on them beforehand and afterwards.
The Mishna Berura clarifies (ibid. 43):
…even if the person has no desire for them at all [and] he is only eating them because he is compelled by his illness, [he nevertheless recites a Bracha] since his palate derives pleasure from them. This excludes a case when they are foul-tasting and he derives no pleasure from them – though he is cured through them, he does not recite any Bracha.
Thus far this Halacha seems clear; a Bracha is required for every sweet-tasting medication and not for bitter-tasting ones. However, the Poskim question whether this rule can be applied to modern medicine. Medications discussed by the Gemara and Rishonim were natural (i.e., plant-based), and their taste was their own. It thus makes sense that if one derived pleasure from their taste a Bracha was required. However, modern medications are artificially sweetened by means of synthetic substances. Should they be considered foodstuffs that are “sweet-tasting” and thus require a Bracha?
This question (among other important points) was examined in detail by Rav Shlomo Zalman Auerbach zt”l. His Talmid, Rav Yehoshua Neuwirth zt”l rules (Shemiras Shabbos Kehilchasa 40:97) that one should recite a Bracha on vitamins “that the palate enjoys and aren’t bitter, such as those that are like candies” but not on a medication “even if it sweet”. He explains that the sweetener that is added to a bitter medication is Tafel and one therefore cannot recite a Bracha on it.
However, he reports that Rav Shlomo Zalman contended that there is a basic difference between the usual case of Ikar v’Tafel and this case. In the usual case we have two foods that each require a Bracha; the question is only on which food the Bracha should be recited. By reciting a Bracha on the Ikar, the Tafel is exempted. However, in this case where no Bracha will be recited on the Ikar (the bitter-tasting medication) why should the Tafel be exempt from a Bracha? Since one may not derive pleasure from this world without reciting a Bracha, he may surely not derive pleasure from the sweetener of the medication. (This question was also raised by Rav Elyashiv zt”l.)
In the third edition of Shemiras Shabbos Kehilchasa, Rav Neuwirth attested that Rav Shlomo Zalman retracted this Psak in his later years and ruled that one should not recite a Bracha on a sweetened medication. Rav Neuwirth attributed this to the Nishmas Avraham (O.C. 204:5:2) but it is recorded there slightly differently. Rav Shlomo Zalman reportedly drew a distinction between two sorts of medications (as described at the start of this essay). Regarding medications with a sweet coating, Rav Shlomo Zalman agreed that a Bracha should be recited on them, as he is deriving pleasure from the taste before he tastes the actual medicine. However, regarding those medications that have been mixed with a sweetener (e.g., dissolvable tablets or syrups), one should not recite a Bracha on them “because a healthy person would not use them for pleasure”.
We can likely assume – and this is also implied in other Sefarim that cite this ruling – that even after Rav Shlomo Zalman retracted his original Psak, he still did not agree with Rav Neuwirth’s position (distinguishing between medicines and vitamins and invoking the Halachos of Ikar v’Tafel). Rather, he held that there is a distinction between the medicines referred to by the Shulchan Aruch that were plant-based and had inherent (natural) taste (and therefore do require a Bracha) and modern medicines that are never used by healthy people and are only sweetened to help people swallow them (thus they cannot be considered an “Ochel” in any way and do not require a Bracha).
The Nishmas Avraham also cites Rav Moshe Feinstein zt”l and Rav Ovadia Yosef zt”l who drew no distinctions between the various cases and ruled that one must recite a Bracha on any sweet-tasting medication.
Finally, he cites the Tzitz Eliezer who recommended reciting the Yehi Ratzon that is commonly recited prior to taking a medication in order to address this concern: “May it be Your will, Hashem my God, that this act should be a Refua for me, for You are a Healer without charge.” According to the Tzitz Eliezer, reciting the Yehi Ratzon is sufficient to eliminate the Isur of deriving pleasure from this world without reciting a Bracha.
 In most cases no Bracha would be recited when drinking olive oil, either because it is harmful to one’s health (when consumed on its own –Ed.) or because it is Tafel to another liquid with which it is ingested.
 In several places (e.g., Minchas Asher – Corona p274), Rav Asher discusses the essence of “Achila” as composed of three components: 1) “Ma’ase Achila” 2) “Hana’as Achila” 3) “Derech Achila”. See last week’s essay for further discussion.
 Implying that pleasant taste is not necessary in order to obligate the recital of Bracha, and even food without any taste at all would require a Bracha.
 See footnote 231.