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8.3 HIPAA’s Privacy and Security Rules 185 11.3 Genetic Engineering 265
8.4 Controlling Health Care Fraud and Abuse 192 11.4 Conception and the Beginning of Life 270
Chapter Review 200 11.5 Rights of Children 273

9
Chapter Review 281

12
Chapter 9
Public Health Responsibilities of Chapter 12
Health Care Practitioners 205 Death and Dying 286
9.1 Vital Statistics 206 12.1 Attitudes Toward Death and the Determination of
Death 287
9.2 Public Health Functions 209
12.2 Legal Documents for Terminally Ill Patients 290
9.3 Reportable Diseases and Injuries 210
12.3 Health Care Services for Terminally Ill
9.4 Drug Regulations 220
Patients 293
Chapter Review 226

10
12.4 The Right to Die Movement 296
12.5 The National Organ Transplant Act 301
Chapter 10 12.6 The Grieving Process 304
Workplace Legalities 232 Chapter Review 309

10.1 Basic Employment Law 233
10.2 OSHA’s Workplace Priorities 240
10.3 OSHA, CDC, and CLIA Guidelines and
­Regulations 241
10.4 Workers’ Compensation and Unemployment
­Insurance 247
10.5 Hiring and the New Employee 248
Chapter Review 252
13
Chapter 13
Stakeholders, Costs, and Patients’
Rights 316
13.1 The Stakeholders 317
13.2 Cost of Health Care 321
13.3 Access and Quality 326

11
13.4 Paying for Health Care 332
Chapter 11 13.5 Patients’ Bill of Rights 335
Chapter Review 340
The Beginning of Life and
­Childhood 258 Glossary 345
11.1 Family History as a Predictor 260 Index 352
11.2 DNA Testing 262

Contents vii
This page intentionally left blank
About the Authors
Karen Judson, BS
Karen Judson has taught college and high school sciences and grades kindergarten, one, and
three. Judson has also worked as a laboratory and X-ray technician and completed 2 years of
nursing while earning a degree in biology. Judson has also published numerous science and
relationship articles and books for adult and young adult readers.

Carlene Harrison, EdD, CMA (AAMA)

Carlene Harrison was an administrator in a variety of outpatient health care facilities for 20
years in Colorado, Texas, and Florida. She became a full-time faculty member at Hodges Uni-
versity in 2000 serving first as a professor and program chair in both medical assisting and
health administration. In 2007, she was named Dean of the School of Allied Health. During
her 15 years at Hodges, she was responsible for adding six academic programs to the School
of Allied Health, retiring in 2015. Even though she is retired from full-time academia, she
continues to work part time at a local public health department, coordinating with universities
and colleges to provide a variety of internships and clinicals for students in the fields of pub-
lic health, nursing, medicine, health information technology, dietetics, and social work.

About the Authors ix

 Preface
Law and Ethics: For Health Professions explains how to
navigate the numerous legal and ethical issues that
health care professionals face every day. Topics are based
upon real-world scenarios and dilemmas from a variety
of health care practitioners. Through the presentation
of Learning Outcomes, Key Terms, From the Perspective
of . . ., Ethics Issues, Chapter Reviews, Case Studies,
Internet Activities, Court Cases, and Videos, students
learn about current legal and ethical problems and sit-
uations. In the ninth edition, material has been revised
to reflect the current health care environment. As stu-
dents progress through the text, they will get the oppor-
tunity to use critical thinking skills to learn how to
resolve real-life situations and theoretical scenarios and
to decide how legal and ethical issues are relevant to the
health care profession in which they will practice.
New to the Ninth Edition
A number of updates have been made in the ninth edi-
tion to enrich the user’s experience with the product,
including revisions to most of the “From the Perspective
Of ...” features in each chapter:
• Chapter 5, “Professional Liability,” now includes the
book’s coverage of informed consent.
• Chapter 7, “Medical Records and Health Informa-
tion Technology,” provides more information about
electronic health records and updated information
about social media applications in health care.
• Chapter 10, “Workplace Legalities,” contains the
updated OSHA priorities.
• Chapter 11, “The Beginning of Life and Childhood,”
includes updated information about genetic testing.
• Chapter 13, “Stakeholders, Costs, and Patients’
Rights,” discusses the changing face of health care
from a business perspective and includes a review
of the basic types of insurance coverage. It also con-
tains a discussion of patients’ rights.
• All statistics and court cases have been updated, as
well as content relevant to laws passed since the
eighth edition.
x Preface
• Connect has been updated to reflect updates in the
chapters and feedback from customers. It contains
all Check Your Progress questions, all end-of-
chapter questions, additional Case Studies with
related questions, and simple interactives.
• MHE Application-Based Activities are highly inter-
active, automatically graded online exercises that
provide students a safe space to practice using
problem-solving skills to apply their knowledge to
realistic scenarios. Each scenario addresses key
concepts and skills that students must use to work
through and solve course specific problems, result-
ing in improved critical thinking and relevant work-
place skills.
• Connect Law and Ethics for Health Professions
Application-Based Activities: Video Cases
▪▪ Students watch different scenarios and are
instructed on the different laws and ethical
considerations that are relevant to those
scenarios. Students apply their knowledge
of the subject by answering periodic ques-
tions throughout each video.
▪▪ For the 9th edition, 5 of the 13 videos con-
tain brand-new scenarios.
For a detailed transition guide between the eight and
ninth editions of Law & Ethics, visit the Instructor
Resources in Connect!
To the Student
As you study to become a health care provider, you
have undoubtedly realized that patients are more than
the sum of their medical problems. In fact, they are
people with loved ones, professions, worries, hobbies,
and daily routines that are probably much like your
own. However, because patients’ lives and well-being
are at stake as they seek and receive health care, in
addition to seeing each patient as an individual, you
must carefully consider the complex legal, moral, and
ethical issues that will arise as you practice your pro-
fession. And you must learn to resolve such issues in
an acceptable manner.
 Law & Ethics provides an overview of the laws and
ethics you should know to help you give competent,
compassionate care to patients that is also within accept-
able legal and ethical boundaries. The text can also serve
as a guide to help you resolve the many legal and ethical
questions you may reasonably expect to face as a student
and, later, as a health care provider.
To derive maximum benefit from Law & Ethics:
• Review the Learning Outcomes and Key Terms at
the beginning of each chapter for an overview of the
material included in the chapter.
• Complete all Check Your Progress questions as they
appear in the chapter, and correct any incorrect answers.
• Review the legal cases to see how they apply to top-
ics in the text, and try to determine why the court
ruled as it did.
• Study the Ethics Issues at the end of each chapter,
and answer the discussion questions.
• Complete the Review questions at the end of the
chapter, correct any incorrect answers, and review
the material again.
• Review the Case Studies, and use your critical
thinking skills to answer the questions.
• Complete the Internet Activities at the end of the
chapter to become familiar with online resources
and to see what additional information you can find
about selected topics.
• Complete the Connect assignments from your
instructor, including any SmartBook modules
assigned, as well as additional Case Studies and the
Application-Based Activities (Video Cases).
• Study each chapter until you can answer correctly
questions posed by the Learning Outcomes, Check
Your Progress, and Review questions.
Instructor Resources
You can rely on the following materials to help you and
your students work through the material in this book.
All of the resources in the following table are available
in the Instructor Resources under the Library tab in
­Connect (available only to instructors who are logged into
Connect).

Supplement
Instructor’s Manual
PowerPoint Presentations
Electronic Test Bank
Tools to Plan Course
Features
Each chapter includes:
• Learning Outcomes
• Overview of PowerPoint Presentations
• Teaching Points
• Answer Keys for Check Your Progress and End-of-Chapter Questions
• Key Concepts
• Accessible
• Computerized and Connect
• Word version
• Questions are tagged with learning outcomes, level of difficulty, level of
Bloom’s taxonomy, feedback, topic, and the accrediting standards of ABHES and
CAAHEP, where appropriate
• Transition Guide, by chapter, from Law & Ethics, 8e to 9e
• Correlations by learning outcomes to ABHES and CAAHEP
• Sample syllabi
• Asset Map—a recap of the key instructor resources, as well as information on the
content available through Connect

Want to learn more about this product? Attend one of
our online webinars. To learn more about the webinars,
please contact your McGraw-Hill Learning Technology
Representative. To find your McGraw-Hill representative,
go to www.mheducation.com and click “Get Support,”
select “Higher Ed,” and then click the “GET STARTED”
button under the “Find Your Sales Rep” section.
Need help? Contact McGraw-Hill Education’s Cus-
tomer Experience Group (CXG). Visit the CXG Web site
at www.mhhe.com/support. Browse the FAQs (Fre-
quently Asked Questions) and product documentation
and/or contact a CXG representative.
Preface xi
 ®

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Top: Jenner Images/Getty Images, Left: Hero Images/Getty Images, Right: Hero Images/Getty Images Preface xiii
 Guided Tour
Chapter Openers
The chapter opener sets the stage for what will be learned in the chapter. Key terms are first introduced in
the chapter opener so the student can see them all in one place; they are defined in the margins throughout
the chapter for easy review, as well as in the glossary. Learning Outcomes are written to reflect the revised
version of Bloom’s taxonomy and to establish the key points the student should focus on in the chapter. In
addition, major chapter heads are structured to reflect the Learning Outcomes, and the Learning Outcomes for
easy reference. From the ­Perspective of . . . boxes illustrate real-life experiences related to the text. Each
quotes health care providers as they encounter problems or situations relevant to the material about to be
presented in the chapter.

FROM THE PERSPECTIVE OF. . .

LINDA AND CAROL HAVE BEEN FRIENDS FOR ABOUT 4 YEARS.
THEY ARE BOTH RETIRED from careers in health care. Linda had been
a medical records supervisor in a 500-bed hospital and Carol had been
an LPN in a family practice and was married to a physician who had
retired, but still had an active license in another state. They met at the

1
©Stockbyte/Getty Images local gym after retirement. They get together every few weeks for either

Introduction to Law
and Ethics
LEARNING OUTCOMES
After studying this chapter, you should be able to:
LO 1.1 Explain why knowledge of law and ethics is
important to health care practitioners.
LO 1.2 Define law, ethics, and moral values as used in
health care by health care practitioners.
LO 1.3 Discuss the characteristics and skills most likely
to lead to a successful career in one of the
health care professions.
COURT CASE Patients Sue Hospitals
In 2018, lawsuits against a variety of hospitals, phy-
sicians, lawyers, nursing homes, and even power
companies that were moving through various courts
included:
• A dermatologist posted videos of herself sing-
ing and dancing during cosmetic surgery. Four
malpractice suits have already been settled,
including one by a woman who suffered perma-
nent brain damage following surgery. Several
other lawsuits are expected to be filed in the
coming months. Source: www.abajournal.com
• Frightened into surgery by a medical litigation
law company, an Arkansas woman had surgery
to remove vaginal mesh. She has filed a lawsuit
against her former law firm and the litigation
funding company that financed the operation as
lunch or a movie. Over time, a friendship developed.
One day at lunch, the conversation was about health issues. Carol
talked about the variety of her chronic health problems that required
medication. She was a Medicare insured patient. Initially, several medi-
cations cost over $1,000 a month. Carol had them filled in Canada for
$400 a month, but the Canadian company went out of business. She
Key Terms began to use her Medicare plan at $1,000 a month. In the meantime,
she discovered that her sister’s health plan would cover all but $50 of
bioethicists the monthly cost of any medication. Her sister had private insurance.
bioethics Carol admitted to Linda that her husband had written a prescription for
codes of ethics
her sister for one of the expensive medications. Her sister lived in the
common sense
compassion state where Carol’s husband still had a medical license. Carol’s sister
courtesy filled the prescription and sent it to her.
critical thinking Linda recently was diagnosed with endometrial cancer. She had a
defendant
radical hysterectomy and then began chemotherapy. Her oncologist
ethics
ethics committees prescribed Zofran for any nausea or vomiting. Linda had used only 3
ethics guidelines of the 30 tablets when she finished chemotherapy. She mentioned that
etiquette to Carol.
fraud
health care practitioner
The lunch discussion changed to other topics and Linda decided to
Hippocratic oath forget about the conversation, as she knew what Carol’s husband had
liable done was illegal. Carol’s sister had also violated the law.
litigious The next time Linda and Carol got together, the conversation was
law
medical ethicists
about vacations. Carol was going on a 3-week cruise, and she mentioned
moral values that she sometimes got a little seasick. She asked Linda if she could have
plaintiff
precedent
her remaining Zofran tablets. Linda quickly changed the subject and
Carol did not bring it up again.
protocol
From Carol’s perspective, it was all about saving money. She knew
she now has permanent incontinence.
summary judgment Source: what her husband had done was wrong, but felt justified in having
www.abajournal.com her husband and sister commit a minor crime. She thought that since
• In Florida, family members of nursing home no one was harmed, and she was helped, that her behavior was not
patients who died during Hurricane Irma are that bad.
suing nursing home administrators and staff From Linda’s perspective, she was uncomfortable about learning what
for failing to evacuate the facility after the air
Carol and her family had done, but decided to ignore it as the end result
was that Carol had her needed medication. She did a bit of research and
conditioning crashed and the temperature learned that Zofran was not used to treat seasickness, and she already
spiked. The families are also suing Florida
knew that it wasn’t all that expensive. She decided that if Carol brought
Power and Light for failing to prioritize nursing it up again, she was going to tell Carol that she had thrown the medi-
home power restoration. Source: www.miamiherald cation away, since she no longer needed it.
.com
(All of the above cases were still in litigation as the
1
ninth edition of Law & Ethics for Health Professions
As you progress through Law & Ethics for the Health Professions, try to
was prepared for publication, but perhaps the interpret the court cases, laws, case studies, and other examples or sit-
underlying reasons for filing the lawsuits are already uations cited from the perspectives of everyone involved.
apparent to you.)
2 Chapter 1 | Introduction to Law and Ethics

COURT CASE 911 Operators Sued Court Cases

In 2006, just before 6 pm, a 5-year-old boy called The boy’s older sister sued the two 911 operators on Several court cases are presented
911. He told the 911 operator that his “mom has behalf of the dead woman’s estate and on behalf of
passed out.” When the operator asked to speak her son. The lawsuit alleged gross negligence causing in every chapter. Each summarizes
to the boy’s mother, he said, “She’s not gonna a death and intentional infliction of emotional distress.
talk.” The operator scolded the boy and logged
the call as a child’s prank. Three hours later, the
The 911 operators argued that they were entitled
to government immunity, that they owed no duty to
a lawsuit that illustrates points
boy called 911 again. A different operator answered,
and she also scolded the boy for playing a prank,
provide assistance to the woman who died, and that
their failure to summon medical aid was not gross
made in the text and is meant to
but she did send a police officer to the boy’s
home. The officer discovered the boy’s mother
negligence.
A trial court and an appeals court found for the
encourage students to consider
lying unresponsive on the floor and summoned
emergency medical services. The EMS workers
plaintiff, and the case was appealed to the Michigan
Supreme Court, where in January 2012, the court
the subject’s relevance to their
arrived 20 minutes later and determined that the
woman was dead and had probably died within
denied further appeals.
Source: Estate of Turner v. Nichols, 807 N.W.2d 164, 490 Mich.
health care specialty. The legal
the past 2 hours. 988 (2012).
citations at the end of each case
indicate where to find the com-
material fact. In other words, a motion for summary judgment states that
one party is entitled to win as a matter of law. Summary judgment is
plete text for that case. “Land-
available only in a civil action. (Chapter 4 distinguishes between criminal
and civil actions.)
mark” cases are those that
The following court cases illustrate that a wide variety of legal ques-
tions can arise for those engaged directly in providing health care ser- established an ongoing precedent.
vices, whether in a hospital, in a medical office, or in an emergency
situation. Health care equipment and product dealers and manufacturers

Chapter 1 | Introduction to Law and Ethics 5

xiv Guided Tour

 In the American cultural environment, however, acting morally toward
another usually requires that you put yourself in that individual’s place.
For example, when you are a patient in a physician’s office, how do you
like to be treated? As a health care provider, can you give care to a
person whose conduct or professed beliefs differ radically from your
own? In an emergency, can you provide for the patient’s welfare without
reservation?

Check Your P
­ rogress Check Your Progress
Questions 1. Name two important reasons for studying law and ethics.
These questions appear at 2. Which state laws apply specifically to the practice of medicine?
various points in the chapters 3. What purpose do laws serve?
4. How is the enforcement of laws made possible?
to allow students to test their
5. What factors influence the formation of one’s personal set of ethics and values?
comprehension of the material 6. Define the term moral values.
they just read. These ques-
Learning Outcome Summary
7. Explain how one’s moral values affect one’s sense of ethics.
LO 2.3 Define the What are the basic principles of health care ethics?
tions can also be answered
basic principles of
health care ethics.
in • Autonomy or self-determination
• Beneficence
Connect. • Nonmaleficence
Chapter 1 | Introduction to Law and Ethics 9

• Justice
•
End-of-Chapter
Confidentiality
• Role fidelity
• Veracity
What are social determinants of health? Resources
• Living conditions that affect health, such as shelter, food, income, education, a stable environment,
sustainable resources, social justice and equity. The Chapter Summary is in a
What is health disparity?

• Living conditions that affect health, such as shelter, food, income, education, a stable environment,
tabular, step-by-step format orga-
sustainable resources, social justice and equity.
What is health equity?
nized by Learning Outcomes to
• Striving for the highest possible standard of health for all people and giving special attention to the
needs of those at greatest risk of poor heath, based on social conditions.
help with review of the material.
Ethics Issues are issues and
related discussion questions
based on interviews conducted
Chapter 2 Review
with ethics counselors within the
Applying Knowledge professional organizations for
25. A medical assistant greetsLOa patient
2.1 and states “I am Jonathan and I will be your medical assistant today.”
This is an example of 1. What is another term for your personal concept of right and wrong?
health care providers, as well as
a. Empathy a. Utilitarianism c. Common sense with bioethics experts. Each
b. Trustworthiness d. Courtesy
b. Beneficence Chapter Review includes Apply-
c. Moral values
Ethics ISSUE 3:
d. Role fidelity
ing Knowledge questions that
Ethics Issues Martha is the
Introduction
2. Why did Tomto administrative
End-of-Chapter assistant to Valerie,
Ethics
and Bill, in this chapter’s
the practice manager in a five-physician practice. Salaries of
Discussions
opening scenario, come to different
staff are confidential. Since payroll is handled by an outside company, only the practice manager has knowledge
reinforce the concepts the stu-
ofdecisions?
who makes what salary. Valerie has gone to lunch and left her door open. Several people have been in and
Learning Outcomes for the out
Ethics Issues
of Valerie’s
a. Because Feature
office
of their at theoffEnd
dropping
age differences of Each
reports Chapter
or other information. Martha goes in the office to place a report on dents have just learned. These
Valerie’s deskEthics
and notices that a budget worksheet
be ablelisting
to: all staff salaries is in clear view. It would be easy to
After studying the material in each
take
chapter’s
b. Because
a quick of look,
Issues feature,
differences
especiallyinsince
you should
theirMartha
societal,believes
cultural,
sheand family
is paid lessinfluences
than other employees with fewer responsibil- questions can be answered in
1. Discuss current ethical issuesities.
of concern
Marthaof to health care
backs practitioners.
c. Because theirout of the
different office and locks
relationships withValerie’s door without looking at the sheet. She thinks to herself,
their supervisor Connect. Case Studies are sce-
2. Compare ethical guidelines to If the
I should
law asnotdiscussed
know what in everyone else isofbeing
each chapter paid, then no one else should either.
the text.
d.Curtis
None isofone theseof the employees who had left information on Valerie’s desk before Martha closed the door. He
3. Practice critical thinking skills as you consider medical, legal, and ethical issues for each situation presented.
3. also
Howsees the budgetMaslow’s
is Abraham sheet buttheory
does not stop to look at
of needs-based it. It did not
motivation bestoccur to him to look at it, although it would
defined?
narios with exercises that allow
have been
4. Relate the ethical issues presented in thegreat
texttotoknow that hecare
the health wasprofession
being paidyou more thantoother
intend employees. He puts his file down on Valerie’s
practice.
a. It and
desk is a thinks
five-stepto progression
himself, I will that
warnseesValerie
pleasure
that as
shethe primary
needs motivation
to be more careful for all what
about humanshe leaves on her desk students to practice their critical
Health care practitioners are bound behavior.
by state and federal laws, but they are also bound by certain ethical stan-
for anyone to see.
dards—both personal standards and those set forth by professional codes of ethics and ethical guidelines and by
b. It is a progression
bioethicists. Many professional organizations for healthcalled beneficence. employ an ethics consultant who is
care practitioners
thinking skills to decide how to
Discussion Question
available to speak with organization members who need help with an ethical dilemma. “We serve as a third
c. ItAccording
19.
party who can stand outside a situation
is a theory to that
virtue
and facilitate
says human
ethics, whobehavior
communication,” is says
moreDr.is based on specific
ethical—Martha,
Carmen Paradis, thean human
one needstothat
tempted
ethics
must often be met in a
con- look but doesn’t, or Curtis,
resolve the real-life situations
specific
who isn’t order.
even tempted toAtlook? Defend your answer.
sultant with the Cleveland Clinic’s Department
available to health care practitioners,
d. Itpatients,
is a system
of Bioethics.
family members,
of moral
the Cleveland Clinic, ethics consultations are
and others involved with patient decisions.
values.
and theoretical scenarios pre-
Medical facility ethics committees can also serve as consultants. In larger health care facilities, such commit-
tees usually deal with institutional matters, but in smaller communities where ethics consultants may not be
sented. Internet Activities
available, members of an ethics40 committeeChaptermay2 | Making
Case Studies
Ethical Decisions
also function as ethics consultants.
Keep in mind as you read the Ethics Issues feature for each chapter that ethical guidelines are not law but
include exercises designed to
deal solely with ethical conduct for health care practitioners. Most guidelines published for professional health
care practitioner organizations emphasize
Use your this difference.
critical thinkingFor example,
skills as stated
to answer in Guidelines
the questions thatfor Ethical
follow Conduct
each case study.
increase students’ knowledge of
for the Physician Assistant Profession:
the chapter topics and help
Physician Assistants are expected
LO 2.3to behave both legally and morally. They should know and understand
the laws governing their practice. Likewise, they should understand the ethical responsibilities of being
Susan, a nursing student, is arguing with her friend Linda, also a nursing student, over the benefits of getting
a health care professional. Legal requirements and ethical expectations will not always be in agreement.
them gain more internet
a flu shot.
Generally speaking, the law describes minimum standards of acceptable behavior, and ethical principles
“I’m not
delineate the highest moral standards getting a flu shot this year,” Linda declares. “I paid $14 for one last year, and I still got sick. I had
of behavior. research expertise.
a horrible sinus infection that kept me out of school for days.”
Source: www.aapa.org/wp-content/uploads/2017/02/16-EthicalConduct.pdf, ©American Academy of PAs.
“I remember, but that wasn’t the flu,” Susan argues. “Since we see so many people in the clinic—especially
Internet Activities
The ethical guidelines for variousolder
is that health care practitioners are
healthpeople with weakened
care professions
the obligated
flu?”
have immune systems—don’t
several points in common, youbut
think
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to provide the best care possible for every patient and to protect
andofforemost
all people, should be immunized against

the safety, privacy, and welfare of every The argument

patient. continues at length, with Linda finally raising her voice and stomping off.
LOState
2.3 and federal laws may differ somewhat from an ethical principle. For example, a state’s law may not
20. In your opinion, is the question of whether or not the nursing students should get a flu vaccination an
require
Complete physicians to routinely
the activities inquire
and answer theabout physical,
questions that sexual, and psychological abuse as part of a patient’s
follow.
ethics question? Explain your answer.
medical history, but the physician may feel an ethical duty to his or her patients to do so.
25.Furthermore,
Locate the Web site that
the fact for the organization
21.
a healthIf care
you deciderepresenting whothe
that this
practitioner anprofession
ishas you with
ethicscharged
been plan
question, to
which practice.
theory
illegal Check
of
conduct moral the orga- best applies?
reasoning
is acquitted
nization’s code of ethics. Does the code conform to
or exonerated does not necessarily mean that the health care practitioner the seven principles
actedofethically.
health care ethics? Explain
your answer. Ethan is an orderly in a skilled nursing care facility. He is charged with supervising patients in the dining room
The term ethical as used here refers to matters involving the following:
on a day when two of his coworkers have called in sick, leaving the facility shorthanded. On this day, several
26. Visit the
1. Moral Web site
principles or for the National
practices patients Center
seem more for Ethics
irritablein than
Health Careand
usual, at www.ethics.va.gov. In the list of
Ethan is kept busy preventing outbursts and calming them. He also
resource publications, click worrieson any of the patients
about subjects prone
listed. toWhich linkepisodes
choking did you choose?
and findsHow might
himself theseharried and stressed.
feeling
2. Matters of social policy involving issues of morality in the practice of medicine
resources prove useful to you?Wallace, an 80-year-old confined to a wheelchair, demands that Ethan help him back to his room. “It’s a
The term unethical refers to professionalmadhouse conduct
in here that fails to
today,” heconform to these
shouts. Ethan moralhestandards
knows or policies.
cannot leave his post and panics when Wallace heads for
27.The
Visit Santaissues
ethical Clararaised
University’stheWeb
are from thesite:www.scu.edu/ethics/practicing/decision/.
door. real-life experiences of a variety of health care Under “What is ethics?”
practitioners and are
list three
recounted things that,
throughout according
the text to raisetoawareness
Ethan the site,ahead
runs ethics
of theofare not. Do
ethical
Wallace, you the
dilemmas
shuts agree?
manyExplain
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face
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daily
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stimulate longer available, do a Web search for “framework for thinking ethically.” What was the number one
result for this search, and how 22. might
Has Ethan acted use
you make ethically?
of the Explain
source?)your answer.
22 23.
Chapter 1 | Introduction to Law andWhat
Ethics wouldyou do in a similar situation? Use steps one through five for ethical decision making to reach
a solution. Describe how each step was used.
24. Do you believe your solution is more ethical than Ethan’s? Why or why not?

Chapter 2 | Making Ethical Decisions 43

Guided Tour xv
Acknowledgments
Author Acknowledgments
Karen Judson
Thank you to the editorial team and pro-
duction staff at McGraw-Hill and all the
reviewers and sources who contributed
their time and expertise to making the
ninth edition of Law & Ethics for Health
Professions the best ever. Thank you, too,
Carlene, for your hard work on this ninth
edition.
Carlene Harrison
A big thank you to Karen Judson for get-
ting me started on this marvelous adven-
ture called textbook writing over 14 years
ago.
To our reviewers, your contributions really
make a difference. The editorial and pro-
duction staff at McGraw-Hill did a great
job. And last, to my husband, Bill, your
support and love keep me going.
Reviewer Acknowledgments
Suggestions have been received from fac-
ulty and students throughout the country.
This is vital feedback that is relied on for
product development. Each person who
has offered comments and suggestions
has our thanks. The efforts of many peo-
ple are needed to develop and improve a
product. Among these people are the
reviewers and consultants who point out
areas of concern, cite areas of strength,
and make recommendations for change. In
this regard, the following instructors pro-
vided feedback that was enormously help-
ful in preparing the book and related
products.
xvi Acknowledgments
9e Technical Editing/Accuracy
Panel
A panel of instructors completed a
technical edit and review of the content
in the book page proofs to verify its
accuracy.
Erika Bailey, MBA, RHIA
Grand Valley State University
Denese Davis, BSN, Med, RHIT
Wiregrass Georgia Technical College
Susan Holler, MSEd, CPC, CCS-P,
CMRS
Bryant & Stratton College
Tylette Lloyd, MS RT®
Ivy Tech Community College
Beverly Marquez, MS, RHIA
State Fair Community College
Amie L. Mayhall, MBA, RHIA, CCA
Olney Central College
Jillian McDonald, BS, RMA(AMT), EMT,
CPT(NPA)
Goodwin College
Victoria L. Mills, MBA, RHIA
Gordon State College
Michelle Ruggiero, MsEd
Bryant & Stratton College
Sharon Turner, MS, CMC, CMIS, CHI,
CBS, CEHRS, CMAA
Brookhaven College
Erica Wilson, MS, MHA, RHIA, CPC
Southern Regional Technical College
Digital Tool Development
Special thanks to the instructors who
helped with the development of
Connect and SmartBook, especially
with review feedback. They include:
Julie Alles, DHA, RHIA
Grand Valley State University
Angela M. Chisley, AHI, RMA, CMA,
AMCA
Gwinnett College
Latoya Dennard Davis, RHIT
Albany State University
Laura Diggle, MS, CMA
Ivy Tech Community College
Terri Fleming, EdD
Ivy Tech Community College
Debra Glover, RN, BSN, MSN
Goodwin College
Janis A. Klawitter, AS, CPC, CPB,
CPC-I, Provider Audits/Analytics
Bakersfield Family Medical Center
Samuel Newberry DC
Bryant & Stratton College
Janna Pacey, DHA, RHIA
Grand Valley State University
Kristi Perillo-Okeke, DC, CMRS
Bryant & Stratton College
Shauna Phillips, RMA, AHI, CCMA,
CMAA, CPT
PIMA Medical Institute
Kemesha Spears, CUTAIL
Albany State University
 1
©Stockbyte/Getty Images

Introduction to Law
and Ethics
Key Terms
bioethicists
bioethics
LEARNING OUTCOMES codes of ethics
common sense
After studying this chapter, you should be able to: compassion
courtesy
LO 1.1 Explain why knowledge of law and ethics is critical thinking
important to health care practitioners. defendant
ethics
ethics committees
LO 1.2 Define law, ethics, and moral values as used in
ethics guidelines
health care by health care practitioners. etiquette
fraud
LO 1.3 Discuss the characteristics and skills most likely health care practitioner
to lead to a successful career in one of the Hippocratic oath
liable
health care professions.
litigious
law
medical ethicists
moral values
plaintiff
precedent
protocol
summary judgment

1
 FROM THE PERSPECTIVE OF. . .
LINDA AND CAROL HAVE BEEN FRIENDS FOR ABOUT 4 YEARS.
THEY ARE BOTH RETIRED from careers in health care. Linda had been
a medical records supervisor in a 500-bed hospital and Carol had been
an LPN in a family practice and was married to a physician who had
retired, but still had an active license in another state. They met at the
local gym after retirement. They get together every few weeks for either
lunch or a movie. Over time, a friendship developed.
One day at lunch, the conversation was about health issues. Carol
talked about the variety of her chronic health problems that required
medication. She was a Medicare insured patient. Initially, several medi-
cations cost over $1,000 a month. Carol had them filled in Canada for
$400 a month, but the Canadian company went out of business. She
began to use her Medicare plan at $1,000 a month. In the meantime,
she discovered that her sister’s health plan would cover all but $50 of
the monthly cost of any medication. Her sister had private insurance.
Carol admitted to Linda that her husband had written a prescription for
her sister for one of the expensive medications. Her sister lived in the
state where Carol’s husband still had a medical license. Carol’s sister
filled the prescription and sent it to her.
Linda recently was diagnosed with endometrial cancer. She had a
radical hysterectomy and then began chemotherapy. Her oncologist
prescribed Zofran for any nausea or vomiting. Linda had used only 3
of the 30 tablets when she finished chemotherapy. She mentioned that
to Carol.
The lunch discussion changed to other topics and Linda decided to
forget about the conversation, as she knew what Carol’s husband had
done was illegal. Carol’s sister had also violated the law.
The next time Linda and Carol got together, the conversation was
about vacations. Carol was going on a 3-week cruise, and she mentioned
that she sometimes got a little seasick. She asked Linda if she could have
her remaining Zofran tablets. Linda quickly changed the subject and
Carol did not bring it up again.
From Carol’s perspective, it was all about saving money. She knew
what her husband had done was wrong, but felt justified in having
her husband and sister commit a minor crime. She thought that since
no one was harmed, and she was helped, that her behavior was not
that bad.
From Linda’s perspective, she was uncomfortable about learning what
Carol and her family had done, but decided to ignore it as the end result
was that Carol had her needed medication. She did a bit of research and
learned that Zofran was not used to treat seasickness, and she already
knew that it wasn’t all that expensive. She decided that if Carol brought
it up again, she was going to tell Carol that she had thrown the medi-
cation away, since she no longer needed it.

As you progress through Law & Ethics for the Health Professions, try to
interpret the court cases, laws, case studies, and other examples or sit-
uations cited from the perspectives of everyone involved.

2 Chapter 1 | Introduction to Law and Ethics

1.1 Why Study Law and Ethics?
There are two important reasons for you to study law and ethics:
• To help you function at the highest possible professional level, pro-
viding competent, compassionate health care to patients
• To help you avoid legal entanglements that can threaten your ability
to earn a living as a successful health care practitioner health care practitioners
Those who are trained to administer
We live in a litigious society, in which patients, relatives, and others are medical or health care to patients.
inclined to sue health care practitioners, health care facilities, manufac- litigious
turers of medical equipment and products, and others when medical Prone to engage in lawsuits.
outcomes are not acceptable. This means that every person responsible
for health care delivery is at risk of being involved in a health care–
related lawsuit. It is important, therefore, for you to know the basics of
law and ethics as they apply to health care, so you can recognize and
avoid those situations that might not serve your patients well or that
might put you at risk of legal liability.
In addition to keeping you at your professional best and helping you
avoid litigation, knowledge of law and ethics can also help you gain
perspective in the following three areas:
1. The rights, responsibilities, and concerns of health care consumers.
Health care practitioners not only need to be concerned about how
law and ethics impact their respective professions but they must
also understand how legal and ethical issues affect the patients they
treat. With the increased complexity of medicine has come the
desire of consumers to know more about their options and rights
and more about the responsibilities of health care providers. Today’s
health care consumers are likely to consider themselves partners
with health care practitioners in the healing process and to question
fees and treatment modes. They may ask such questions as, Do I
need to see a specialist? If so, which specialist can best treat my
condition? Will I be given complete information about my condi-
tion? How much will medical treatment cost? Will a physician treat
me if I have no health insurance?
In addition, as medical technology has advanced, patients have
come to expect favorable outcomes from medical treatment, and
when expectations are not met, lawsuits may result.
2. The legal and ethical issues facing society, patients, and health care prac-
titioners as the world changes. Nearly every day the media report news
events concerning individuals who face legal and ethical dilemmas
over biological/medical issues. For example, a grief-stricken husband
must give consent for an abortion in order to save the life of his
critically ill and unconscious wife. Parents must argue in court their
decision to terminate life-support measures for a daughter whose
injured brain no longer functions. Patients with HIV/AIDS fight to
retain their right to confidentiality.
While the situations that make news headlines often involve
larger social issues, legal and ethical questions are resolved daily, on
a smaller scale, each time a patient visits his or her physician,
dentist, physical therapist, or other health care practitioner. Ques-
tions that must often be resolved include these: Who can legally
give consent if the patient cannot? Can patients be assured of

Chapter 1 | Introduction to Law and Ethics 3


plaintiff
The person bringing charges in a
lawsuit.
defendant
The person or party against whom
criminal or civil charges are brought in
a lawsuit.
liable
Legally responsible or obligated.
precedent
Decisions made by judges in the vari-
ous courts that become rule of law and
apply to future cases, even though they
were not enacted by a legislature; also
known as case law.
summary judgment
A decision made by a court in a lawsuit
in response to a motion that pleads
there is no basis for a trial.
4 Chapter 1 | Introduction to Law and Ethics
confidentiality, especially since computer technology and online
access have become a way of life? Can a physician or other health
care practitioner refuse to treat a patient? Who may legally examine
a patient’s medical records?
Rapid advances in medical technology have also influenced laws
and ethics for health care practitioners. For example, recent court
cases have debated these issues: Does the husband or the wife have
ownership rights to a divorced couple’s frozen embryos? Will a sur-
rogate mother have legal visitation rights to the child she carried to
term? Should modern technology be used to keep those patients
alive who are diagnosed as brain-dead and have no hope of recovery?
How should parenthood disputes be resolved for children resulting
from reproductive technology?
3. The impact of rising costs on the laws and ethics of health care delivery.
Rising costs, both of health care insurance and of medical treatment
in general, lead to questions concerning access to health care ser-
vices and allocation of medical treatment. For instance, should the
uninsured or underinsured receive government help to pay for health
insurance? And should everyone, regardless of age or lifestyle, have
the same access to scarce medical commodities such as organs for
transplantation or very expensive drugs?
COURT CASES ILLUSTRATE RISK OF LITIGATION
As you will see in the court cases used throughout this text, sometimes
when a lawsuit is brought, the trial court or a higher court must first
decide if the plaintiff has a legal reason to sue, or if the defendant is
liable. When a court has ruled that there is a standing (reason) to sue
and that a defendant can be held liable, the case may proceed to reso-
lution. Often, once liability and a standing to sue have been established,
the two sides agree on an out-of-court settlement. Depending on state
law, an out-of-court settlement may not be published. For this reason,
the final disposition of a case is not always available from published
sources. The published cases that have decided liability, however, are
still case law, and such cases have been used in this text to illustrate
specific points.
In addition, sometimes it takes time after the initial trial for a case to
be settled. For example, perhaps a patient dies after surgery in 2018, and
the family files a wrongful death suit soon after. The case may go through
several appeals and finally be settled in 2022.
It is also important to remember that while the final result of a case
is important to the parties involved, from a legal standpoint, the most
important aspect of a court case is not the result but whether the case
represents good law and will be persuasive as other cases are decided.
Although recent cases published have been sought for illustration in
this text, sometimes a dated case (1995, 1970, 1980, 1991, etc.) is used
because it established important precedent.
Court cases appear throughout each chapter of the text to illustrate
how the legal system has resolved complaints brought by or against
health care service providers and product manufacturers. Some of these
cases involve summary judgment. Summary judgment is the legal term
for a decision made by a court in a lawsuit in response to a motion that
pleads there is no basis for a trial because there is no genuine issue of
 COURT CASE Patients Sue Hospitals
In 2018, lawsuits against a variety of hospitals, phy-
sicians, lawyers, nursing homes, and even power
companies that were moving through various courts
included:
• A dermatologist posted videos of herself sing-
ing and dancing during cosmetic surgery. Four
malpractice suits have already been settled,
including one by a woman who suffered perma-
nent brain damage following surgery. Several
other lawsuits are expected to be filed in the
coming months. Source: www.abajournal.com
• Frightened into surgery by a medical litigation
law company, an Arkansas woman had surgery
to remove vaginal mesh. She has filed a lawsuit
against her former law firm and the litigation
funding company that financed the operation as
she now has permanent incontinence. Source:
www.abajournal.com
• In Florida, family members of nursing home
patients who died during Hurricane Irma are
suing nursing home administrators and staff
for failing to evacuate the facility after the air
conditioning crashed and the temperature
spiked. The families are also suing Florida
Power and Light for failing to prioritize nursing
home power restoration. Source: www.miamiherald
.com
(All of the above cases were still in litigation as the
ninth edition of Law & Ethics for Health Professions
was prepared for publication, but perhaps the
underlying reasons for filing the lawsuits are already
apparent to you.)

COURT CASE 911 Operators Sued

In 2006, just before 6 pm, a 5-year-old boy called
911. He told the 911 operator that his “mom has
passed out.” When the operator asked to speak
to the boy’s mother, he said, “She’s not gonna
talk.” The operator scolded the boy and logged
the call as a child’s prank. Three hours later, the
boy called 911 again. A different operator answered,
and she also scolded the boy for playing a prank,
but she did send a police officer to the boy’s
home. The officer discovered the boy’s mother
lying unresponsive on the floor and summoned
emergency medical services. The EMS workers
arrived 20 minutes later and determined that the
woman was dead and had probably died within
the past 2 hours.
The boy’s older sister sued the two 911 operators on
behalf of the dead woman’s estate and on behalf of
her son. The lawsuit alleged gross negligence causing
a death and intentional infliction of emotional distress.
The 911 operators argued that they were entitled
to government immunity, that they owed no duty to
provide assistance to the woman who died, and that
their failure to summon medical aid was not gross
negligence.
A trial court and an appeals court found for the
plaintiff, and the case was appealed to the Michigan
Supreme Court, where in January 2012, the court
denied further appeals.
Source: Estate of Turner v. Nichols, 807 N.W.2d 164, 490 Mich.
988 (2012).

material fact. In other words, a motion for summary judgment states that
one party is entitled to win as a matter of law. Summary judgment is
available only in a civil action. (Chapter 4 distinguishes between criminal
and civil actions.)
The following court cases illustrate that a wide variety of legal ques-
tions can arise for those engaged directly in providing health care ser-
vices, whether in a hospital, in a medical office, or in an emergency
situation. Health care equipment and product dealers and manufacturers

Chapter 1 | Introduction to Law and Ethics 5


fraud
Dishonest or deceitful practices in
depriving, or attempting to deprive,
another of his or her rights.
can be held indirectly responsible for defective medical devices and prod-
ucts through charges of the following types:
• Breach of warranty
• Statements made by the manufacturer about the device or product
that are found to be untrue
• Strict liability, for cases in which defective products threaten the
personal safety of consumers
• Fraud or intentional deceit (Fraud is discussed in further detail in
Chapters 4 and 8.)

LANDMARK COURT CASE  upreme Court Shields Medical Devices

S
from Lawsuits
An angioplasty was performed on a patient, Charles
Riegel, in New York. During the procedure, the cath-
eter used to dilate the patient’s coronary artery
failed, causing serious complications. The patient
sued the catheter’s manufacturer, Medtronic, Inc.,
under New York state law, charging negligence in
design, manufacture, and labeling of the device,
which had received Food and Drug Administration
(FDA) approval in 1994. Medtronic argued that Riegel
could not bring state law negligence claims because
the company was preempted from liability under
Section 360k(a) of the Medical Device Amendments
(MDA) of the U.S. Food, Drug, and Cosmetic Act.
State requirements are preempted under the MDA
only to the extent that they are “different from, or in
addition to” the requirements imposed by federal
law. Thus, 360k(a) does not prevent a state from
providing a damages remedy for claims premised on
a violation of FDA regulations; the state duties in
such a case “parallel,” rather than add to, federal
requirements (Lohr, 518 U.S., at 495, 116 S.Ct. 2240).
The Riegel case reached the U.S. Supreme Court,
where the question to be decided was this: Does
Section 360k(a) of the Medical Device Amendments
to the Food, Drug, and Cosmetic Act preempt state
law claims seeking damages for injuries caused by
medical devices that received premarket approval
from the Food and Drug Administration?
In February 2008, the U.S. Supreme Court held
in this case that makers of medical devices are
immune from liability for personal injuries as long as
the FDA approved the device before it was mar-
keted and it meets the FDA’s specifications.
Source: Appeals Court Case: Riegel v. Medtronic, Inc., 451 F.3d
104 (2006); Supreme Court Case: Riegel v. Medtronic, Inc., 552
U.S. 312, 128 S.Ct. 999, 2008.

The extent of liability for manufacturers of medical devices and prod-

ucts may be changing, however, since a 2008 U.S. Supreme Court deci-
sion held that makers of medical devices such as implantable
defibrillators or breast implants are immune from liability for personal
injuries as long as the Food and Drug Administration (FDA) approved
the device before it was marketed and it meets the FDA’s specifications.
(See the previous Medtronic Inc. case.)
Drugs and medical devices are regulated under separate federal laws,
and an important issue in deciding drug injury cases is whether or not
the drug manufacturer made false or misleading statements to win FDA
approval. For example, the case Warner-Lambert Co. v. Kent, filed in 2006,
involved a group of Michigan residents who claimed injury after taking
Warner-Lambert’s Rezulin diabetes drug. The case was brought under a
Michigan tort reform law that said a drug company could be liable for
product injury if it had misrepresented the product to win FDA approval.
In this case, the question before the court was: Does a federal law pro-
hibiting fraudulent communications to government agencies preempt a

6 Chapter 1 | Introduction to Law and Ethics

 Table 1-1 Damage Awards Can Be Substantial
• Drug: Talcum Powder (2018) A jury in Missouri found that Johnson and Johnson should
pay 22 women a total of $4.69 billion for causing ovarian cancer. There are over
9,000 more lawsuits involving other talc-based products in state and federal courts
• Drug: Juxtapid (2017) Aegerion Pharmaceuticals will pay more than $35 million to
settle criminal and civil charges related to the cholesterol drug Juxtapid. The sales
staff continued to distribute samples as a general treatment for high cholesterol.
Juxtapid was approved to treat just those patients who have a rare genetic disease
call homozygous familial hypercholesterolemia.
• Drug: Epipen (2017) The Department of Justice brought charges against Mylan and
Mylan, makers of the Epipen for classifying the Epipen as a generic drug. Mylan
and Mylan did this to avoid paying Medicaid rebates. The company is paying
$465 million to settle allegations.

Source: www.drugwatch.com.

state law permitting plaintiffs to sue for faulty products that would not
have reached the market absent the fraud?
A federal appeals court eventually heard the case and ruled that the
Michigan “fraud on the FDA” law was preempted by a federal law that
allowed the FDA itself to punish misrepresentations. This decision was
appealed to the U.S. Supreme Court, and in a March 2008 decision, the
Supreme Court affirmed the appeals court, thus leaving the previous
state of the law unchanged and unclarified.
In this case, the people who sued the drug manufacturer were not
allowed to collect damages. But when courts find that drugs are misrep-
resented so that developers can win FDA approval, drug manufacturers
could be held legally responsible and forced to pay damages. Table 1-1
lists several settlements.

COURT CASE Patient Sues over Drug-Labeling Issue

In 2000, Diana Levine, a Vermont woman in her
fifties, sought medical help for migraine headaches.
As part of the treatment, the anti-nausea drug Phen-
ergan, made by Wyeth, was injected in her arm. An
artery was accidentally damaged during the injec-
tion, gangrene set in, and Levine’s right arm was
amputated. The amputation was devastating for
Levine, a professional musician who had released
16 albums, and she filed a personal injury action
against Wyeth in Vermont state court.
Levine asserted that Wyeth should have included
a warning label describing the possible arterial inju-
ries that could occur from negligent injection of the
drug. Wyeth argued that because the warning label
had been deemed acceptable by the FDA, a federal
agency, any Vermont state regulations making the
label insufficient were preempted by the federal
approval. The Superior Court of Vermont found in
favor of Levine and denied Wyeth’s motion for a
new trial. Levine was awarded $7 million in dam-
ages for the amputation of her arm. The Supreme
Court of Vermont affirmed this ruling on appeal,
holding that the FDA requirements merely provide
a floor, not a ceiling, for state regulation. Therefore,
states are free to create more stringent labeling
requirements than federal law provides.
The U.S. Supreme Court eventually heard the
case and issued a decision in March 2009. Wyeth
had argued that because the warning label had
been accepted by the FDA, any Vermont state
regulations making the label insufficient were
preempted by the federal approval. The U.S.
Supreme Court affirmed the Vermont Supreme
Court, holding that federal law did not preempt
Levine’s state law claim that Wyeth’s labeling of
Phenergan failed to warn of the dangers of intra-
venous administration.
Source: Wyeth v. Levine, 555 U.S. 555, 173 L.Ed.2d 51 (2009).

Chapter 1 | Introduction to Law and Ethics 7

 Federal preemption—a doctrine that can bar injured consumers from
suing in state court when the products that hurt them had met federal
standards—has become an important concern in product liability law.
One such case, Wyeth v. Levine, decided by the U.S. Supreme Court in
2009, will become precedent for future cases involving drug manufactur-
ers and consumers.

1.2 Comparing Aspects of

Law and Ethics
To understand the complexities of law and ethics, it is helpful to define
and compare a few basic terms. Table 1-2 summarizes the terms described
in the following sections.

law
Rule of conduct or action prescribed or
formally recognized as binding or
enforced by a controlling authority.
LAW
A law is defined as a rule of conduct or action prescribed or formally
recognized as binding or enforced by a controlling authority. Govern-
ments enact laws to keep society running smoothly and to control behav-
ior that could threaten public safety. Laws are considered the minimum
standard necessary to keep society functioning.

Table 1-2 Comparing Aspects of Law and Ethics

Law Ethics Moral Values

Definition Set of governing rules Principles, standards, Beliefs formed through the influence
guide to conduct of family, culture, and society

Main purpose To protect the public To elevate the standard To serve as a guide for personal
of competence ethical conduct

Standards Minimal—promotes smooth Builds values and ideals Serves as a basis for forming a
functioning of society personal code of ethics

Penalties of Civil or criminal liability. Upon Suspension or eviction Difficulty in getting along with
violation conviction: fine, imprisonment, from medical society others
revocation of license, or other penalty membership, as decided
as determined by courts by peers

Bioethics Etiquette Protocol

Definition Discipline relating to ethics Courtesy and manners Rules of etiquette applicable to
concerning biological research, one’s place of employment
especially as applied to medicine

Main purpose To allow scientific progress in a To enable one to get To enable one to get along with
manner that benefits society in all along with others others engaged in the same
possible ways profession

Standards Leads to the highest standards Leads to pleasant Promotes smooth functioning of
possible in applying research to interaction workplace routines
medical care

Penalties of Can include all those listed under Ostracism from chosen Disapproval from one’s professional
violation “Law,” “Ethics,” and “Etiquette”; as groups colleagues; possible loss of
current standards are applied and as business
new laws and ethical standards evolve
to govern medical research and
development, penalties may change

8 Chapter 1 | Introduction to Law and Ethics

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Instead of going to Nineveh he set out in a boat for Tarshish; during
a storm he was thrown overboard, swallowed by a fish, and again
brought to the shore. He then carried out the Divine mission, the
result of which was that the Ninevites repented of their evil deeds
and [82]obtained a respite. Jonah, disappointed that the threat of
which he was the bearer was not fulfilled, was rebuked by God, and
taught by his own grief at the destruction of a plant “that had come
up in a night” how wrong it was to wish that God should not show
mercy upon the inhabitants of Nineveh, and to neglect anything that
could lead to their repentance and consequent salvation.

(6.) Micah (‫‏מיכה‬‎).—Micah of Moresha was likewise a contemporary

of Isaiah. He prophesied in Judah.

1. (i.–iii.) He raises his voice especially against the princes,

magistrates, and false prophets, who unite in oppressing and ruining
the people. When Micah tells them their sins and the coming
punishment, they say to him, “Do not preach; they do not preach for
such things; they do not offend” (ii. 6). But the prophet of the Lord is
not deterred from his mission, but continues to denounce their
wickedness: “Her chiefs judge for bribery, and her priests teach for
payment, and her prophets decide for silver; yet will they lean upon
the Lord, and say, Is not the Lord in our midst? no evil shall come
upon us. Therefore shall Zion be plowed into a field, and Jerusalem
shall become heaps, and the mountain of the Temple as the high
places of a forest” (iii. 11, 12).

2. (iv.–v.) Like Isaiah, he depicts the Messianic period, in which the

house of Jacob will be an example of true faith in God to all nations;
in which Israel will be restored to his land, under the rule of a
descendant of David. But a period of trials and troubles must
precede those happy days, in order to punish Israel, and to purify
and prepare him for his future greatness. [83]
3. (vi.–vii.) The same principles are taught in the next part (vi. and
vii.) in the form of a controversy (‫‏ריב ליי עם עמו‬‎) between the Lord and
His people. The latter are reminded of the benefits God has
bestowed on them; and when they ask how they are expected to
show their gratitude, the prophet says, “O man, He has told thee
what is good; and what does the Lord require of thee but to do
justice, love kindness, and to walk humbly with thy God?” (vi. 8).

(7.) Nahum (‫‏נחום‬‎).—The fall of Nineveh is predicted. The power of

the mighty Assyrian Empire, hitherto a terror to Judah and other
kingdoms, will come to an end; no remedy can save her any more.

(8.) Habakkuk (‫‏חבקוק‬‎).—Habakkuk prophesied at the time when the

Casdim or Chaldeans were about to occupy the place of the
Assyrians as conquerors of Syria, Palestine, and Egypt, and to
become the rod in the hand of God for the punishment of Israel.
Habakkuk, on receiving the mission to announce the Casdim as the
executors of the Divine decree, is at a loss to understand why these
wicked and cruel people should be chosen to chastise those who are
far less wicked; why the evil-doer should swallow him who is more
righteous. The answer he receives is, “But the just shall live by his
faith.” The evil-doer will in due time receive his full punishment.
Habakkuk then gives expression to his implicit faith in the justice of
God, in a hymn which is superscribed, “Prayer (‫ )‏תפלה‬of the prophet
Habakkuk on account of errors;” for in it he rectifies, as it were, his
previous groundless doubt.

(9.) Zephaniah (‫‏צפניה‬‎).—He prophesied in the days [84]of King

Josiah. He proclaims the approach of the great day of the Lord, on
which all those who turned away from Him will receive their
punishment, all the rich and powerful who say the Lord does neither
good nor evil. He appeals to the humble in the land (‫ )‏ענוי ארץ‬to seek
the Lord in prayer, in order to be saved on “the day of the anger of
the Lord.” For the Philistines, the Phœnicians, Moab, Ammon, and
Assyria will be punished, nor will Jerusalem escape free. “I will then
turn,” he says in the name of God, “a pure language to the nations,
that all of them will call by the name of God, and serve Him with one
accord” (iii. 9). “In that day shalt thou not be ashamed for all thy
doings wherein thou hast transgressed against me; for then I will
take away out of the midst of thee them that rejoice in thy pride, and
thou shalt no more be haughty on my holy mountain. And I will leave
in thy midst a poor and humble people, and they shall trust in the
name of the Lord. The remnant of Israel shall not do iniquity, and
they shall not speak falsehood, and a tongue of deceit shall not be
found in their mouth” (iii. 9, 11–13).

(10.) Haggai (‫‏חגי‬‎)—The Israelites, who by the command of Cyrus

had discontinued the rebuilding of the Temple after the foundation
had been laid by his permission, were exhorted by Haggai, in the
second year of the reign of Darius, to resume the work. Guided by
Zerubbabel and Joshua, son of Jehozadak, they obeyed, and the
prophet describes to them the blessing which they will henceforth
enjoy.

(11.) Zechariah (‫‏זכריה‬‎):—

1. (i. to vii.) Zechariah, a contemporary of Haggai, [85]exhorts the

Israelites to listen to the words of the prophets, seeing that the words
of former prophets have been fulfilled. The Divine scheme for the
restoration of Israel and the rebuilding of the Temple in spite of all
obstacles, is shown to the prophet in various visions. In one vision
Joshua is appointed high-priest, notwithstanding the aspersions of
his adversary (‫‏השטן‬‎), and Zerubbabel or Zemach, the political chief
of the community. Joshua is exhorted “to walk in the ways of the
Lord, to keep the charge entrusted to him, and to guard the House of
God and His courts;” and Zerubbabel is reminded that success is not
obtained “by might and strength, but by the spirit of the Lord.” “Thus
the one—Zemach by name—shall sit on his throne and be ruler, and
the other—Joshua—shall sit on his throne and be priest, and a
counsel of peace shall be between the two” (vi. 13).

2. Chap. viii.—The prophet is asked whether the day of mourning in

the fifth month is to be continued. The prophetic answer is as
follows: The reason for the mourning was, that your fathers did not
listen to the word of God, and were punished for their disobedience.
Now, as the time of punishment is over, it is for you to prevent a
recurrence of these sad experiences. What you have to do is this:
Speak the truth one to another; truth and judgment of peace judge in
your gates. Let no one plan in his heart the ruin of his neighbour, and
do not love to swear falsely. Let the fasts of the fourth, fifth, seventh,
and tenth months be to the house of Judah for rejoicing, joy, and
good seasons; love truth and peace (viii. 16, 17, 19). At the same
time the promise is given [86]that the time will come when nations will
seek the Lord in Jerusalem, and say to the Jews, “We will go with
you, for God is with you” (viii. 23).

3. (ix.–xi.) The prophet encourages Zion to rejoice in her future

mission; her enemies round about will be brought to silence, and her
king, meek and humble, “poor and riding on an ass,” “will speak
peace to the nations, and his rule will extend from sea to sea, and
from the river to the ends of the earth” (ix. 9, 10). Judah and Ephraim
will unite, and both will enjoy the Divine protection. If this has not yet
taken place, it is the fault of the “bad shepherds,” i.e., the bad
leaders of the people.

4. (xii.–xiv.) The prophet foretells troubles which will come upon

Jerusalem when the nations will make the last effort to take that city.
They will be defeated, and Judah will be filled on that occasion with
“a spirit of grace” (‫‏רוח חן ותחנונים‬‎), and will pray to God for the safety
of his enemy; the very Jews, “whom the enemy desired to pierce,”
will pray for him, and mourn for his death as a father mourneth for
the loss of his only child. Judah will then be free from false prophets
and bad shepherds. God will make Himself known to all: “And the
Lord will be a King over the whole earth; on that day will the Lord be
One and His name One” (xiv. 9). All will come to Jerusalem “to
worship the King, the Lord Zebaoth, and to celebrate the feast of
Succoth” (Ibid. 16), expressing thereby their conviction that God
alone is able to afford protection and blessing.

(12.) Malachi (‫‏מלאכי‬‎).—Malachi, the last of the prophets, exhorts the

priests to true reverence of the [87]sanctuary, and to conscientious
fulfilment of their duties. The distinction of the priest was based on
the distinction of his conduct: “The law of truth was in his mouth, and
iniquity was not found on his lips; in peace and uprightness he
walked with me, and many turned he back from iniquity. For the lips
of the priest shall keep knowledge, and instruction shall they seek of
his mouth, for he is a messenger of the Lord Zebaoth” (ii. 6, 7).
Judah is then rebuked for his faithlessness. Both, the Levites
(including the priests) and Judah, will pass through a process of
refining; the wicked will be removed, whilst for “those who fear the
name of God” the sun of salvation will shine. Those who desire to
obtain a place among these latter must “remember the law of Moses,
the servant of God, which God commanded him on Horeb for all
Israel; statutes and judgments” (iii. 22). Before the great day of the
Lord, the day of judgment, the Lord will send “the prophet Elijah, who
will cause the hearts of fathers and children to unite in returning to
God.”
[Contents]

3. The Hagiographa (‫‏כתובים‬‎).

The Hagiographa form the last collection of holy writings, composed

by men who, although they were not prophets, were filled with the
spirit of the Lord (‫‏רוח יי‬‎). They include the three larger works: (a)
‫‏תהלים‬‎(or ‫‏תלים‬‎) Psalms, ‫‏משלי‬‎Proverbs, and ‫‏איוב‬‎Job; (b) the Five
Scrolls (‫‏חמש מגלות‬‎), viz., ‫‏שיר השירים‬‎Song of Songs, ‫‏רות‬‎Ruth, ‫‏איכה‬‎
Lamentations, ‫‏קהלת‬‎Ecclesiastes, ‫‏אסתר‬‎Esther; (c) the historical
books: ‫‏דניאל‬‎Daniel, ‫‏עזרא‬‎Ezra, ‫‏נחמיה‬‎Nehemiah, and ‫‏דברי הימים‬‎the
two books of Chronicles.

1. Psalms (‫‏תהלים‬‎).—The Psalms are hymns containing [88]praises of

God’s greatness, prayers for His mercy, and meditations on His
wisdom, power, justice, and goodness. However various the Psalms
are in form and contents, they have this in common, that they all are
based on the purest and sincerest trust in God’s justice and
goodness. “The mighty and proud, ‫‏זדים‬‎who rely on their own
strength and are guided by the dictates of their own will, cannot
succeed for ever; the poor and humble, ‫‏ענוים‬‎who rely on God’s
mercy and are guided by the word of God, will not suffer for ever.”
This is the truth which the Psalmist proclaims in his songs over and
over again. Yet there is a great variety in the contents of the Psalms.
Some are simply praises of God’s greatness, e.g., viii., xix., xxxii.,
xcii., xcv. to xcix., ciii., civ., &c. Others are the expression of
gratitude, e.g., ix., xviii., xxxiv., lxvi., lxviii., &c. Many are prayers in
time of trouble; in most of these the suppliant feels sure that God will
accept his prayer, and is confident that help will come. Such psalms
are iii., iv., v., vi., xii., xiii., &c. To this class belong also all the psalms
which refer to the troubles of David during the reign of Saul, as lii.,
liv., lvi., lix., lxiii., &c.; some of the Asaph-psalms, lxxiii., lxxvii., lxxix.,
lxxx.; the penitential psalms, in which the sinner prays for mercy, as
xxv., xxxii., xxxviii., li.; and those in which a longing is expressed for
the House of God, e.g., xxvii., xlii., xliii., lxv., lxxxiv. Some psalms are
a protest against those who rely on human force and human cunning
instead of having faith in God, a protest of the ‫‏ענוים‬‎against the view
and creed of the ‫‏זדים‬‎and ‫‏גאים‬‎or ‫‏גוים‬‎e.g., ix. and x., xi., xiv., xvi.,
xvii., &c. Some psalms are of a more [89]didactic character, showing
the way of true happiness (Ps. i.), depicting a truly pious life (xv.,
xxiv.), or the excellence of the word of God, as xix., cxix.; or the
uselessness of sacrifice without purity of heart (xl., l., li.).

The poetical form of the Psalms, as of Hebrew poetry in general, is

parallelism. The sentences are formed in such a manner that the
psalm can be arranged in lines divisible into two parts, which are
either two elements of a single idea, or a double expression of the
same idea, or a combination of two ideas or things opposed to each
other, illustrating an idea by its antithesis. In some of the Psalms the
parallelism is perfect throughout, in others it is partly abandoned,
probably in order not to slavishly subordinate the idea to the form of
its expression. The same is to be noticed as regards other forms of
the Psalms. Some are arranged alphabetically, that is, the
successive verses begin with successive letters of the alphabet; but
deviations from the plan are met with almost in all such psalms.
There are psalms which are divided into a certain number of parts or
strophes, each part beginning or ending with the same phrase or
verse; but almost invariably these phrases or verses undergo some
modification.
The style is naturally poetical, and figurative language is employed
throughout. God is a Rock (‫‏צור‬‎), an habitation (‫‏מעון‬‎), a Shepherd
(‫‏רועה‬‎), who feeds His flock with great care and love; He is an eagle,
under whose wings (‫‏אברתו‬‎, ‫‏כנפיו‬‎) the weak find protection; He rides
in the heavens of the heavens of old (‫‏רכב בשמי שמי קדם‬‎). Man is
compared to “grass that withers,” to a “flower that blossoms in the
morning, and in the [90]evening it is withered and dried up;” the life of
man is but a breath (‫‏הבל‬‎); a lie (‫‏כזב‬‎); light in the balance (‫‏במאזנים‬
‫לעלות‬‎); he changes like a garment, like a raiment. The days of a long
life are like the days of the heavens, the sun or the moon (‫‏כימי שמים‬‎,
‫‏לפני שמש‬‎, ‫‏עם שמש‬‎or ‫‏לפני ירח‬‎). The mighty are mountains with many
peaks (‫‏הרים גבנונים‬‎), they have horns like those of the unicorns,
whilst the weak are “a wall bent” (‫‏קיר נטוי‬‎), “a fence thrust down” (‫‏גדר‬
‫הדחויה‬‎); “they have sunk in deep mire;” “they have come into fire and
into water;” “the waters have come unto the soul.” The meek are
“broken in heart,” “crushed in spirit.” The wicked and unjust are like
lions and dogs; they have poison “like the poison of a serpent, like a
deaf adder that stoppeth its ears, that does not listen to the voice of
charmers, to the clever sorcerer.” Their words are smooth like cream
and oil, whilst in the heart there are war, daggers, sharp swords. The
threatened one runs like a hind, escapes like a bird. Those who have
no higher aim than material enjoyments are like “sheep driven to
death;” “man in his dignity, without understanding, is like cattle that
perish.” Mishaps come upon man like the waves of the sea. The
Divine judgment visits the wicked like a thunderstorm; it shakes the
earth like an earthquake or volcano. Sinners receive “the cup of
confusion” (‫‏כוס התרעלה‬‎) at the hand of God; for “a cup is in the hand
of the Lord, and the wine therein is red; it is full with drink, and He
pours out from it, but its dregs all the wicked of the earth will suck
and drink.”

The sinner is punished by his own deed; “he digs a pit and falls into
it;” he feels like a sick person [91]whose “bones are troubled, and
wither;” his purification is toe healing of the soul; he is purified with
hyssop; he becomes whiter than snow (li. 9). When man sins he
feels as if he had become a changed creature, as if he had now
been born and conceived in sin (ver. 7); when he repents and
improves, God creates in him a new heart, and renews a firm spirit
within him (ver. 12). The wife of the God-fearing man is compared to
the fruitful vine, his children to young olive-trees (cxxviii.). The
righteous will flourish like a palm-tree, will grow high like a cedar
upon Lebanon (xcii. 13). Whilst the righteous is like a tree planted by
the brook of water, the wicked are like chaff which the wind drives
away (i. 3, 4). Israel is likened to a vine brought from Egypt and
planted in Palestine (lxxx. 9). Peacefulness and brotherly love,
between high and low, the mighty and the weak, the rich and the
poor, the wise and the simple, are illustrated by the fine oil that flows
down from the head to the beard, the beard that descends over the
garments, and the dew of the high Hermon that comes down to the
lower mountains of Zion (cxxx.).

There are some instances of play upon words (lvi. 9), and of rhymes
(cxlv. 11; xxxiv. 6); the latter are apparently not intentional.

Although we generally speak of the Psalms of David, only a portion

of them was composed by King David; the headings ascribe also
one psalm to Moses, two to King Solomon, twelve to Asaph, one to
Heman, and one to Ethan; and some have no author mentioned in
the heading. Many have no superscription at all, and most of these
seem to belong to a later period. [92]

The individual psalms have various names. The most general of

them is ‫‏מזמור‬‎a poem, set in music. Of some it is distinctly stated that
they were intended to be sung; this is expressed in the heading by
the word ‫‏שיר‬‎“song,” which either precedes or follows the title ‫‏מזמור‬‎
or stands alone without ‫‏מזמור‬‎. The term, ‫‏שיר‬‎“song,” is further
qualified by ‫‏חנוכת הבית‬‎“of the dedication of the house,” ‫“‏ידידות‬of
love,” and ‫‏המעלות‬‎or ‫‏למעלות‬‎“of degrees leading upward,” i.e.,
towards God. Another name occurring in twelve psalms is ‫‏משכיל‬‎
“instructive song;” the maschil proclaims the lesson that God is King
of the universe, and that those are happy who trust in His justice and
mercy. A similar meaning attaches to ‫‏ללמד‬‎the word superadded to
‫‏משִכ ל‬‎in Ps. lx.; lit. “to teach,” i.e., that the song be learnt by all, in
order that people may strengthen their confidence in God in times of
trouble (comp. 2 Sam. i. 18). The meaning of ‫‏להזכיר‬‎which occurs in
two psalms (xxxviii. and lxx.), is “for prayer.” There is one psalm
‫‏לתודה‬‎(c.), “for thanksgiving;” another “for the Sabbath-day,” ‫‏ליום‬
‫השבת‬‎(xcii.). Four psalms are called ‫‏תפלה‬‎“prayer” (xvii., lxxxvi., xc,
cii.); one (cxlv.), ‫‏תהלה‬‎“praise;” one (vii.), ‫‏שגיון‬‎“an error,” 6 referring to
the miscalculation of the wicked in preparing weapons against the
innocent, which weapons are turned against themselves; and six are
superscribed ‫‏מכתם‬‎“a jewel.” Such a jewel is the Psalmist’s “faith in
God,” that inspires him with hope and pure joy in the midst of
misfortune.

The headings include also instructions for the singers and references
to the musical instruments which are to [93]be used. The most
general term is ‫‏למנצח‬‎“to the chief,” scil., of the singers or Levites; it
refers to the chief of a particular division of the Levites if it is followed
by a qualifying phrase, and to the chief of all the Levites if it is not
followed by any qualification. The term ‫‏למנצח‬‎describes the psalm as
a Temple-song, although this may not have been its original object.
Even poems which have been composed by David on certain
personal events became—perhaps slightly modified—national
songs, and formed part of the public service. The adaptation was
easy, because these historical psalms rarely contain any allusion to
the particular event mentioned in the superscription.
The term ‫‏למנצח‬‎is qualified by ‫‏על נגינת‬‎“on a stringed instrument,”
‫‏נגינת‬‎being the particular instrument of the Levites, of whom this ‫‏מנצח‬‎
was the master. The term ‫‏בנגינות‬‎which in several psalms follows the
word ‫‏למנצח‬‎is grammatically unconnected with the latter; it means
“on stringed instruments,” and is the instruction for the ‫‏מנצח‬‎. There
were several kinds of such instruments; two kinds are named ‫‏שמינית‬‎
and ‫‏גתית‬‎“the neginath with eight strings” or “chords,” and “the gittith”
coming from Gath, a town in the land of the Philistines. Other kinds
of musical instruments are ‫‏נהילות‬‎(v.), ‫‏מחלת‬‎(liii.), and ‫‏עלמות‬‎(xlvi.);
these are hollow flute-like instruments, also called ‫‏נבלים‬‎(1 Chron. xv.
20). In some cases the division of Levites is named instead of the
instrument: ‫‏ידותון‬‎“Jeduthun” (xxxix., lxii. and lxxvii.; comp. 1 Chron.
xxv. 3); ‫‏לבני קרח‬‎“to the sons of Korah” (xlii. to xlix., and lxxxiv. to
lxxxviii.); once the direction occurs ‫‏לענות‬‎(lxxxviii.), “to sing
alternately,” referring to [94]the two divisions of Levites headed by
‫‏הימן האזרחי‬‎and ‫‏איתן האזרחי‬‎“the Ezrahite Heman,” and “the Ezrahite
Ethan” (lxxxviii. and lxxxix.).

A few terms are met with in the headings which describe the
contents of the psalm in a poetical style. Such are (a.) ‫‏שושן עדות‬‎,
‫‏ששנים עדות‬‎and ‫‏ששנים‬‎(lx., lxxx., xlv., and lxix.), “Testimony for the lily
or lilies,” or “for lilies.” The poet calls by this name the flower of the
nation, the meek and God-fearing, who are under the special
protection of God, and are destined to be crowned in the end with
glory and victory, (b.) ‫‏אילת השחר‬‎(xxii.), “The strength of the dawn.”
The phrase refers to the strength given to the sufferer in the
darkness of his despair by the awakening of his faith in God, which is
compared by the poet to the dawn as the forerunner of daylight, (c.)
‫‏אל תשחת‬‎“Do not destroy” (lvii., lviii., lix., and lxxv.). By this heading
the author indicates that the psalm is a protest against the self-
confidence of the wicked in the success of their wickedness, either
with reference to their evil designs against the author himself, or to
their plans in general. (d.) ‫‏יונת אלם רחקים‬‎“Dove in the force of those
far,” scil., from God (lvi.). The psalm contains the expression of
David’s faith in God when he was caught by the Philistines in Gath.

In some of the headings the event is mentioned which prompted the

Psalmist to compose the psalm: David’s flight from Jerusalem when
Absalom rebelled against him (iii.); the slander of the Benjamite
Kush (vii.); the death of Labben (ix.); rescue from the hands of Saul
and other enemies (xiii.); dedication of the house (xxx.); David’s
escape from Abimelech, king [95]of the Philistines (xxxiv.); his capture
by the Philistines in Gath (lvi.); his stay in the cave of Adullam (lvii.,
cxlii.); danger of being put to death by the servants of Saul (lix.); war
with Aram and Edom (lx.); sojourn in the wilderness of Judah (lxiii.).

The order of the Psalms is not chronological; e.g., chap. iii. refers to
the rebellion of Absalom, whilst chap, cxlii. was composed before the
death of Saul. The principle which guided the collector in fixing the
place of each psalm is not known. But it is certainly not the result of
mere chance that the first two psalms speak of the Law of God, and
of the punishment of those who rebel against God and against His
anointed; and that the last psalm calls upon all to praise God with all
their soul: “Let every thing that hath breath praise the Lord,
Hallelujah!” Nor is it mere chance that the psalms are divided, like
the Law, into five groups or books, each one ending with a doxology.
It is possible that the psalms were recited or sung at the public
service in a manner corresponding to the reading of the Law and the
Prophets.

The first two books contain most of the psalms superscribed ‫‏לדוד‬‎“by
David,” but there are also some in the other books (one in III., two in
IV., fourteen in V.). At the end of the second book (lxxii. 20) the
following words are added: “The prayers of David, the son of Jesse,
are ended;” i.e., the hope which has just been expressed in the
words ‫‏וימלא כבוד יי את כל הארץ‬‎“And the whole earth shall be filled
with the glory of God,” forms the aim and end of all the prayers of
David, the son of Jesse. The verse does not mean that the first
seventy-two chapters of the Psalms contain all the [96]prayers of
David, as there are several psalms of David between chaps, lxxiii.
and cl.

The Psalms were composed by David and other authors partly for
private use, partly for the public service in the Temple and other
places of worship. Of those that were originally for private use some
were subsequently adapted for public service, and even those
intended from the beginning for public worship were adapted to the
different modes of recitation or singing. The Book of Psalms
includes, therefore, two recensions of several chapters; e.g., xiv. and
liii.; xviii. and 2 Sam. xxii.; lx. 7–14 and cviii. 7–14; lvii. 8–12 and cviii.
2–6; cv. 1–15 and 1 Chron. xvi. 8–22; xcvi. and 1 Chron. xvi. 23–33;
cxxxv. and cxxxvi.

A considerable portion of our daily prayers consists of psalms. We

distinguish the following groups:—(a.) ‫‏פסוקי דזמרא‬‎“Verses of song,”
Ps. cxlv. to cl.; to which the following are added on Sabbaths and
Festivals: xix., xxxiv., xc, xci., cxxxv., cxxxvi. (called ‫‏הלל הגדול‬‎“the
great Hallel”), xxxiii., xcii., and xciii. (b.) ‫‏שיר של יום‬‎“Song of the day;”
a different psalm is recited each day of the week after the morning
prayer in the following order: xxiv., xlviii., lxxxii., xciv., lxxxi., xciii.,
xcii. (c.) ‫‏קבלת שבת‬‎“Friday evening psalms,” xcv. to xcix. (d.) Sabbath
afternoon psalms: civ., cxx. to cxxxiv. (e.) ‫‏הלל‬‎“Praise,” cxiii. to cxviii.
(f.) Penitential psalms after evening prayer on week-days, in the
following order: xxv., xxxii., xxxviii., li., lxxxvi.

2. ‫‏משלי‬‎Proverbs of Solomon, the son of David, king of Israel. The

Book of Proverbs belongs to those Biblical books which are called
‫‏ספרי חכמה‬‎“books of wisdom.” [97]They appeal to the reason of man,
and do not support their words by the authority of Revelation,
although the authors and those who gave them the final shape were
inspired and guided by the ‫‏רוח ה׳‬‎“the divine spirit.” The
commandments of God and His ways are referred to as the safest
guide for man in all conditions of life. Three books are included in
this class: Proverbs, Job, and Ecclesiastes.

“The Proverbs of Solomon” are divided into the following six

sections:—(A.) Introduction, i. to ix.; (B.) Collection of Proverbs: (a.)
Proverbs of Solomon, x. to xxii. 16; (b.) Words of the Wise, xxii. 17 to
xxiv. 22; (c.) Second group of Words of the Wise, 23 to 34; (d.)
Proverbs of Solomon collected by the men of Hezekiah, xxv. to
xxviii.; (e.) Words of Agur-bin-yakeh, xxx.; (f.) Words of Lemuel, xxxi.

The fourth section (chaps, xxv. to xxix.) is introduced by the following

superscription:—“Also these are the Proverbs of Solomon, which the
men of Hezekiah, king of Judah, had removed.” The men of
Hezekiah seem to have been uncertain whether this section should
form part of the book, because of the seeming contradiction between
the fourth and fifth verses of the twenty-sixth chapter. The men of the
Great Synagogue decided the question in favour of its incorporation
in the book, and reconciled the seeming contradiction by their
interpretation.

The fifth collection of proverbs is ascribed to Agur-bin-yakeh, an

allegorical phrase meaning “collection deserving respect.” The
collection is further called “the burden”—the usual heading of
prophecies—in order to give it more weight. Also the rest of the
[98]superscription, “The saying of the man Leïthiel,” Leïthiel ve-
ucchal, is of an allegorical character, signifying, “God—i.e., the word
of God—is my task, and I shall prevail.” The phrase is set forth more
clearly in the succeeding verses: human knowledge is insufficient,
but “All the word of God is pure; he is a shield to those who trust in
him” (xxx. 5). The second half of this collection has the heading La-
alukah, “For a necklace” (comp. i. 9), similar in meaning to the
heading ‫‏מכתם‬‎“Jewel,” in the Psalms. The form of these proverbs,
based on the numbers two, three, and four, is similar to that of the
prophecies of Amos (chaps, i. and ii.). The last collection is headed,
“Words to Lemuel, the king; the burden wherewith his mother
instructed him.” The contents of the instruction is, “Be not licentious
and intemperate; help the poor and oppressed.” The name Lemuel is
likewise allegorical, meaning “God-ward.” The book concludes with
the praises of a virtuous woman.

(A.) Introduction.—The object of the book is set forth in verses 2 to 7

of the first chapter as follows: “To make man know wisdom and
instruction, comprehend words of understanding, and take the
instruction of acting wisely, with justice, judgment, and
righteousness; to give skill to the simple; to the young knowledge
and discretion; that the wise may hear and increase doctrine, and
the prudent acquire cleverness to understand proverb and figure, the
words of wise men and their allegories. The beginning of knowledge
is the fear of the Lord; wisdom and instruction fools despise.” This
last sentence is the basis of the book. Without fear of the Lord all
knowledge and wisdom will prove [99]insufficient for establishing
man’s true happiness. The Introduction consists of several
connected addresses, in which the author persuades the reader to
listen to his advice, and keep away from wicked people before it is
too late. He exhorts man to entrust himself to the guidance of the
Lord, and not to rely on his own understanding. “Be not wise in thine
eyes, fear the Lord, and depart from evil” (iii. 7). He warns against
bad society, against becoming security for debtors, and against
idleness. The two ways open to man are allegorically represented by
two women, the one wise, the other foolish; the one leading to
happiness, the other to ruin; each one inviting man to her house, and
displaying in the very act of invitation her full character.

(B.) The collections of proverbs begin with the tenth chapter. The
proverbs have the form of parallelism, each verse being divided into
two parts, mostly containing an antithesis illustrating the difference
between the wise and the foolish, the good and the bad, the just and
the unjust, the industrious and the idle, the rich and the poor, and the
like. Each verse is a proverb by itself, and is independent of the
verses which precede and follow. There are only a few passages in
which several verses are connected, and these occur in the later
collections, e.g., xxii. 22–23, 24–25, 26–27; xxiii. 1–3, 4–5, 6–9, 10–
11, 12–13, 20–21, 29–35; xxiv. 3–7, 10–12, 30–34; xxvii. 23–27. The
whole of the thirtieth chapter consists of small paragraphs of three or
four verses, and the last chapter consists of two continuous parts.

In these collections of proverbs we find advice for [100]every condition

of our life. Our relation to God is shown; how He loves the good and
just:—

“The way of the wicked is an abomination of the Lord; but he loveth him
who pursues righteousness” (xv. 9).

“The sacrifice of the wicked is an abomination of the Lord, but the prayer
of the righteous is his pleasure” (xv. 8).

“The Lord is far from the wicked, but he heareth the prayer of the
righteous” (xv. 29).

“To do justice and judgment is more acceptable to the Lord than sacrifice”
(xxi. 3).

He protects the poor, the weak, the widow, and the orphan:—

“He who oppresseth the poor, blasphemeth his Maker; and he who is
gracious to the needy, honoureth him” (xiv. 31).
 “He who is gracious to the poor, lendeth to the Lord, and he will repay him
his reward” (xix. 17).

“Do not rob the poor because he is poor; and do not crush the poor in the
gate, for the Lord will plead their cause, and will take the soul of those who
rob them” (xxii. 23).

“The Lord will pull down the house of the proud, and will establish the
border of the widow” (xv. 25).

“The rich and the poor meet; the Maker of them all is the Lord” (xxii. 2).

He punishes the evil-doer and rewards the righteous:—

“Do not say, I will repay evil; hope in the Lord, and he will help thee” (xx.
22).

“He who closeth his ear because of the crying of the [101]poor, he also will
call and will not be answered” (xxi. 13).

“He who keepeth a command, keepeth his soul; he who despiseth his
ways shall die” (xix. 16).

“When the Lord is pleased with the ways of man, he will cause even his
enemies to make peace with him” (xvi. 7).

“The Lord will not let the soul of the righteous be hungry, but the desire of
the wicked will he thrust back” (x. 3).

He knows the heart of man:—

“There is a test for silver, and a refining pot for gold; but God trieth the
hearts” (xvii. 3).

He directs all events:—

“Man’s heart planneth his way, but the Lord directeth his step” (xvi. 9).
 “The horse is prepared for the day of war, but the victory is the Lord’s” (xxi.
31).

His blessing is a true blessing:—

“The blessing of the Lord, it maketh rich, and doth not increase trouble
with it” (x. 22).

His Will alone must be obeyed:—

“There is no wisdom, and no understanding, and no counsel against the

Lord” (xxi. 30).

“Whoso despiseth a word will be punished, but he who feareth a

commandment will be rewarded” (xiii. 13).

“Without a vision the people cometh into disorder; but he who keepeth the
Law, happy is he” (xxix. 18).

[102]

The fear of the Lord is the basis of a virtuous and happy life:—

“The fear of the Lord is the beginning of knowledge (i. 7); the fountain of
life (xiv. 27); the fear of the Lord adds days, but the years of the wicked
will be short” (x. 27).

According as we display wisdom or folly we make others and

ourselves happy or unhappy:—

“A wise son giveth joy to his father, and a foolish son is the sorrow of his
mother” (x. 1).

“The wisdom of woman buildeth her house, and folly pulleth it down by her
hands” (xiv. 1).
 “Eat, my son, honey, for it is good, and honeycomb, which is sweet for thy
palate; know that thus is wisdom for thy soul; if thou hast found it, there is
a future, and thy hope will not be cut off” (xxiv. 13, 14).

“The prudent seeth evil, and is hidden; the ignorant pass by, and are
punished” (xxvii. 12).

“As a jewel of gold in a swine’s snout, so is a fair woman without

discretion” (xi. 22).

“The simple believeth every word; but the prudent man looketh well to his
going” (xiv. 15).

The ways of wisdom and folly are frequently displayed in our words:
—

“In the multitude of words there wanteth not sin, but he who spareth his
words acts wisely” (x. 19).

“A soft answer turneth back wrath, but a harsh word raiseth anger” (xv. 1).

“Also a fool when silent is considered wise; he who closeth his lips is
prudent” (xvii. 28). [103]

“He who keepeth his mouth and his tongue, keepeth his soul from
troubles” (xxi. 23).

“By long-suffering the prince is persuaded; and a soft tongue breaketh a

bone” (xxv. 15).

“Answer not a fool like his folly, lest thou be equal to him. Answer a fool
according to his folly, lest he be wise in his eyes” (xxvi. 4, 5).

The principal virtues recommended to man are righteousness

(‫‏צדקה‬‎), honesty (‫‏אמונה‬‎), truthfulness (‫‏אמת‬‎), meekness (‫‏ענוה‬‎),
industry, thrift, temperance, contentment, and moderation:—

“Treasures of wickedness are of no profit, but righteousness delivereth

from death” (x. 2).
“Better a little in the fear of the Lord than a large treasure, and confusion
therewith” (xv. 16).

“The righteousness of the upright maketh his way straight, but the wicked
falleth by his wickedness” (xi. 5).

“The remembrance of the righteous is for blessing; but the name of the
wicked will rot” (x. 7).

“Guilt is the interpreter of fools, but favour that of the straightforward” (xiv.
9).

“To do justice is joy to the righteous, and a terror to evil-doers” (xxi. 15).

“Like a fountain made turbid and a well that is corrupted, is the righteous
that yieldeth in the presence of the wicked” (xxv. 26).

“Where a man of honesty is, there is multitude of blessings; but he who

hasteneth to become rich will not be guiltless” (xxviii. 20).

“The lip of truth will be established for ever, but the tongue of falsehood for
a moment” (xii. 19).

“A witness of faithfulness is he who does not lie, [104]but he who uttereth

falsehood is a false witness” (xiv. 5). 7

“A lip of excellency becometh not a low man; how much less doth a lip of
falsehood a noble man!” (xvii. 7).

“Pride came, and shame came; but with the meek is wisdom” (xi. 2).

“Meekness cometh before honour” (xv. 33). “Pride cometh before the fall,
and haughtiness of spirit before the stumbling” (xvi. 18). “Let another
praise thee, and not thy mouth; a stranger, and not thy lips” (xxvii. 2).

“He is poor who worketh with a slack hand, but the hand of the industrious
maketh rich” (x. 4).

“Better is he who thinketh little of himself, and is a slave to himself, than

he who thinketh much of himself and lacketh bread” (xii. 9).

“The hand of the industrious shall rule, but the slack hand shall be
tributary” (xii. 24).