This is a bit of a burning issue for me. I tend to take this very personally, especially within Judaism, since within Judaism, it should be crystal clear that the health, well-being, quality of life, and life of the patient takes precedence over any kind of halachic consideration whatsoever, with the exception of Murder, Adultery, and Idolatry (
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The Talmud, sure, but they got most of their medical knowledge from the Ancient Greeks, not from the Torah.
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On the other side, those who believe the halacha does not change are either being idiots or are recognizing the value of maintaining a tradition while still keeping in mind that the underlying reason for the law no longer applies. Which one it is depends on the situation. (There's an occasional third option in which a different reason can be found to maintain the same law and sidestep the issue.) But in no case does halacha actively state that the world is other than we find it to be.
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Consider this: The word "melacha" means "work" - yet you're allowed to rearrange the furniture in your house on Shabbos but not flick a light switch. The way the word is used in a halachic context is very different from the straight meaning of the word.
Halacha doesn't pretend to provide a definition of the word "cooking" in a scientific context. If you need to cook something to ensure you kill off bacteria (in raw meat, for instance), halacha doesn't offer any pretensions, it doesn't try to tell you "use the halachic definition of cooking!" - you cook like a normal person would define it. Halacha doesn't change reality; it just creates legal definitions of certain words for use in a specific context. It recognizes that these do not necessarily have the same effects on the real world, and doesn't try to pretend that they do.
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I've asked pikuach nefesh questions multiple times.
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