Part I: General Introduction
In the next several chapters, we address issues related to piku’ach nefesh (saving a life) on Shabbat. We begin our discussion by outlining the basic parameters of piku’ach nefesh. In later chapters, we address specific issues that commonly arise.
Introduction
Any discussion of piku’ach nefesh on Shabbat must open with the Shulchan Aruch’s celebrated words (Orach Chaim 328:2):
It is a mitzvah to violate Shabbat for one who is dangerously ill. Furthermore, one who acts quickly in such circumstances is worthy of praise, whereas one who poses a question [to a rabbi to see if it is permissible to violate Shabbat to preserve life], sheds blood.
The Mishnah Berurah (Orach Chaim 328:6) notes that the Yerushalmi (Yoma 8:5) condemns Torah scholars who are posed with the question of whether danger to life warrants the desecration of Shabbat. He explains that a Torah scholar should publicize the fact that one must desecrate Shabbat in case of piku’ach nefesh, so that, if such a situation were to arise, people would not hesitate to do whatever is necessary to save human lives. The Mishnah Berurah also cites the Radbaz’s ruling (Teshuvot 4:67) that anyone who refuses to desecrate Shabbat in order to save his own life may be coerced to do so. Before trying to coerce him, however, one should try to convince such an individual to desecrate Shabbat, presumably because coercion may further traumatize him.1See, for example, Teshuvot Igrot Moshe (Choshen Mishpat 2:73:5) and Rav Yigal Shafran’s essay in Techumin (14:333-351).
Moreover, the Rambam (Hilchot Shabbat 2:3) denounces as heretics (minim) those who believe that one may not violate Shabbat in order to save a life. He accuses those who expound such views as degrading the Torah by erroneously implying that “Torah laws are evil edicts according to which one cannot live,” whereas, in truth, “the Torah’s laws are not mean-spirited, but rather merciful and kind, and they promote peace in the world.”
Rav Yosef Dov Soloveitchik (in a 1984 lecture at Yeshiva University) recounted a personal anecdote that illustrates the importance of preserving life even if it involves violating Shabbat. As a young boy, Rav Soloveitchik fell ill on Shabbat and his illustrious father and grandfather were at his side. His grandfather, Rav Chaim Soloveitchik, asked the doctor who had come to see the young boy if turning on a light would assist him. The doctor replied, “That would not be a bad idea.” Rav Chaim immediately instructed his son, Rav Moshe Soloveitchik, to turn on the light to aid the doctor in his work. Rav Moshe hesitated, because the doctor never stated that the light was unquestionably necessary, so Rav Chaim called him an apikores (heretic). When Rav Chaim was asked how he could treat Shabbat so lightly, he responded that he was not acting leniently regarding Shabbat, but strictly regarding the laws of piku’ach nefesh.
Talmudic Background
The Gemara (Yoma 82a) asserts that piku’ach nefesh overrides every Torah law except for the prohibitions of idolatry, sexual immorality, and murder. A few pages later (85a-85b), it offers numerous sources for why piku’ach nefesh overrides Shabbat. Rabbi Elazar ben Azariah reasons that if circumcision overrides Shabbat despite affecting only one organ of the body, so the vital needs of the entire human body surely override Shabbat.2The Gemara thoroughly discusses the laws of circumcision on Shabbat in the nineteenth chapter of Shabbat. Rabbi Shimon Ben Menasya presents the famous principle, "Violate one Shabbat for [the endangered individual’s] sake so that he will observe many future Shabbatot.”3The Gemara derives this principle from the verse “And the Jewish people shall guard Shabbat” (Shemot 31:16). Rashi (s.v. Veshamru) explains that “guarding” any particular Shabbat includes ensuring that future Shabbatot will also be observed. (The same Hebrew word - “lishmor” - means both “to guard” and “to observe.”)
Although this reason implies that we may save only a Jew’s life on Shabbat in order that he will observe future Shabbatot, the Biur Halachah (329 s.v. Ela) writes that in practice one should violate Shabbat even to save a Jew who clearly will not observe Shabbat in the future (see, also, Halichot Olam 4:226 and Teshuvot Minchat Shlomo 2:34:39 and 40). Shmuel adds that the Torah (Vayikra 18:5) urges us to “live” by its laws (“Vachai bahem”), implying that observing the Torah should not cause death (“Velo sheyamut bahem”).
One could ask why one sage after another continued to seek additional sources for asserting that piku’ach nefesh overrides Shabbat. Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 8:15:1:2) suggests that since the Talmud equates desecration of Shabbat with idolatry,4See, for example, Eruvin 69b and Chulin 5a. one might think that piku’ach nefesh does not override Shabbat, just as one may not worship idols even in order to save a life (Pesachim 25a; Rambam, Hilchot Yesodei Hatorah 5:2,6). Hence, the Talmud emphasizes that one may nevertheless violate Shabbat in order to preserve human life.
Spiritual Danger
Interestingly, the Shulchan Aruch (Orach Chaim 306:14) rules that one must violate Shabbat in order to save someone from forced conversion to another religion. However, if a Jew is willingly converting out of Judaism, the Mishnah Berurah (306:56) writes that no halachic authority permits violating Biblical prohibitions to save such a person. He cites two opinions about the permissibility of violating rabbinic prohibitions to try saving such a person, and he is inclined to rule leniently.5The issue of violating Shabbat to save Jews from spiritual danger is very complex in practice. See Rav Shaul Yisraeli’s essay in Techumin (2:27-34) and Prof. Nachum Rakover’s essay in Techumin (17:25-34). Also see Teshuvot Vehanhagot (4:38 of the Rav Chaim Soloveitchik section), where Rav Moshe Shternbuch records a tradition that Rav Chaim Soloveitchik would violate Shabbat himself in order to save Jewish children from the draft, because the non-Jewish army would compel them to abandon Judaism.
The Observant or Non-Observant Physician?
Rav Shlomo Zalman Auerbach (cited by Rav Yehoshua Neuwirth, Shemirat Shabbat Kehilchatah, Chapter 32 note 125) rules that it is preferable to call an observant doctor to a medical emergency on Shabbat rather than a non-observant one.6It is important to note that despite Rav Shlomo Zalman’s position, Rav Neuwirth nonetheless concedes that one should call the non-observant Jewish doctor if he is a bigger expert in the case at hand (32:45). Also see Teshuvot Minchat Shlomo 2:34:35, where Rav Shlomo Zalman rules that an observant doctor may not switch a Shabbat shift with a non-observant Jewish colleague, as the latter violates Shabbat due to his apathy towards it rather than violating Shabbat for the express purpose of saving a life. Presumably, one who does not accept Rav Shlomo Zalman’s position would actually prefer to have non-observant Jews take the Shabbat shifts, since they would otherwise violate Shabbat for no valid reason. As we discuss later in this chapter, Rav Moshe Feinstein (Teshuvot Igrot Moshe, Orach Chaim 4:79) adopts such a position. Also see Teshuvot Vehanhagot (3:309). He argues that the non-observant doctor drives on Shabbat in any event, so his driving to an emergency desecrates Shabbat.7As support for his view, Rav Shlomo Zalman cites the Beit Halevi’s commentary to Shemot 2:25. The Beit Halevi claims that one who commits a sin accidentally or under coercion, such as desecrating Shabbat, receives gentler treatment than a deliberate sinner only if one would not have willingly committed the same sin. However, one who would have committed the same act without any duress is viewed as a sinner regardless of the circumstances under which he actually does it. Rav Hershel Schachter (personal communication to Rav Ezra Frazer) questioned whether the Beit Halevi’s idea applies in the case of a non-observant doctor. Rav Schachter argued that the Beit Halevi's concern applies when one would have done this specific act anyway, such as a non-observant Jew who planned to drive to a specific place on Shabbat, and someone then forced him at gunpoint to drive to that same place. In such a case, the non-observant Jew would be considered a deliberate sinner, despite the fact that he was coerced to drive, because he intended to do the very same act of driving even before he was threatened. By contrast, a non-observant doctor is driving to a particular emergency only for the purpose of saving a life. Thus, even if the doctor might have driven elsewhere on Shabbat had he not been called to this emergency, the driving that he now does to the patient’s home or to the hospital is for the purpose of piku’ach nefesh. According to this logic, summoning a non-observant doctor to an emergency situation on Shabbat violates lifnei iver (causing another to sin; see Pesachim 22b). Nevertheless, Rav Shlomo Zalman elsewhere writes that one may call a non-observant doctor, if necessary, for just as one may violate Shabbat in order to save a life, so too may he violate lifnei iver (Teshuvot Minchat Shlomo 2:34:41).
Rav Zalman Nechemia Goldberg (Halachah Urefu’ah 4:181-191) cites a Talmudic passage that appears to disprove the argument against calling a non-observant doctor. The Gemara (Menachot 64a) records a dispute regarding actions that intend to violate Shabbat but turn out to save a life. For example, the Gemara describes a case in which someone, despite hearing that a child was drowning, spread his fishing nets in the river with the sole intention of catching fish (tzad, a prohibited activity on Shabbat), without intending to save the child. When he raised the net, it both saved the child and caught some fish. Rabah believes that such a person has not desecrated Shabbat, for we ignore his intentions and consider only his concrete action (which saved a life). Rava maintains, however, that the person has violated Shabbat because intent determines the character of one’s actions. The Rambam (Hilchot Shabbat 2:16) rules like Rabah that such an action does not desecrate Shabbat, while the Ra’avad (ibid.) appears to rule that it does.8The Ra’avad agrees that the Halachah should follow Rabah, because Rabah was Rava’s teacher. However, the Ra’avad’s text was apparently reversed, so he believed that Rabah ruled that the fisherman desecrated Shabbat (see Magid Mishneh, ad loc.).
Rav Zalman Nechemia derives from this passage that even if a doctor routinely desecrates Shabbat, he is not considered a sinner when his actions save a life (in accordance with the Rambam’s view).9Although the Ra’avad disagrees with the Rambam, Rav Zalman Nechemia asserts that the Rambam’s opinion better corresponds to other halachic concepts and should thus be followed (p. 182). In fact, Rav Moshe Feinstein (Teshuvot Igrot Moshe, Orach Chaim 4:79), favors having non-observant Jewish doctors take the Shabbat shift of being on call, because they would violate Shabbat anyway, but this way they will violate Shabbat for the sake of piku’ach nefesh (which is permitted). Rav Moshe writes explicitly that there is no problem of lifnei iver (causing another to sin) in such a situation.10For more on the topic of summoning a non-observant doctor on Shabbat, see Rav Eliyahu Schlesinger’s essay in Techumin 21:189-192 and Rav Shlomo Min-Hahar’s responsum (published in Techumin 22:85).
When Is There Danger to Life?
Contemporary authorities discuss the precise definition of a life-threatening situation.11See Teshuvot Tzitz Eliezer (22:23) regarding violating Shabbat in order to save someone from blindness. Rav Moshe Feinstein (Igrot Moshe, Orach Chaim 1:129) posits that it is difficult to give an arbitrary definition of such a case. Instead, he writes that “anytime someone feels he has excessive fever we may violate Shabbat [to heal him].” One is forbidden to violate Shabbat only if it is clear that the fever poses no danger.12Rav Moshe permits the use of a mercury thermometer to measure fever on Shabbat (Teshuvot Igrot Moshe, Orach Chaim 1:128), as does Rav Ovadia Yosef (Halichot Olam 4:194-196). Rav Ovadia similarly permits measuring one’s blood pressure with mechanical (non-electronic) equipment, as caring for one’s health constitutes a mitzvah, and measuring for the purpose of a mitzvah is permitted on Shabbat (see Shulchan Aruch, O.C. 306:7 and Mishnah Berurah 306:36). Rav Ovadia notes that some authorities do, however, prohibit shaking the thermometer in order to lower the mercury (see Teshuvot Sheivet Halevi 1:61:2), but he challenges their reasoning and cites many poskim who permit lowering the mercury. For further support of the view that one may use a thermometer on Shabbat, see Halachah Urefu’ah (1:113-115). Of course, these authorities all address mercury thermometers, which do not use electricity and are not digital.
Nevertheless, Rav Moshe does offer some guidelines regarding how to determine when a situation warrants violating Shabbat. He writes that 102.F constitutes excessive fever and thus demands violating Shabbat to help the patient. Additionally, one may violate Shabbat if the sick individual’s temperature is approaching 101 F but he feels that he is in danger. Also, if an infant is quite distressed and appears to be ill, and has a temperature even slightly above 100gF, Shabbat should be violated. Rav Moshe concludes that while Shabbat may not be violated for a low-grade fever in the case of a common cold, it may be violated for a low-grade fever if the fever results from a respiratory infection or an infection of another internal organ.
Rav Moshe’s precise parameters have engendered criticism. Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 8:15:7:3) recounts that he once told Rav Moshe’s rulings to a group of doctors, and they responded with astonishment. Rav Waldenberg questions whether one whose fever is currently approaching 101oF faces any danger that cannot be treated on Shabbat with medicines that do not violate any Biblical transgressions. It is difficult to give definitive guidelines in these types of cases. If one is unsure, it is advisable at the very least to seek a physician’s advice by telephone, since the use of a telephone most often does not violate a Biblical prohibition according to most authorities.13Rav Shlomo Zalman Auerbach (Teshuvot Minchat Shlomo 1:11) argues that using electric appliances does not violate Shabbat on a Biblical level unless a filament is heated until it glows (Rav Chaim Ozer Grodzinsky, Teshuvot Achiezer 3:60, seems to agree). Rav Yehuda Amital (personal communication), Rav David Cohen of Brooklyn, New York (personal communication), Rav Moshe Heinemann (in a lecture to a Young Israel rabbinical convention), Rav Shlomo Levy (personal communication) and Rav Hershel Schachter (in a lecture to the Rabbinical Council of America) have reported that this position is generally accepted.
It should be noted that even one who has no fever may still be dangerously ill.14See Shemirat Shabbat Kehilchatah 32:11 for many examples of ailments that warrant desecrating Shabbat. Thus, at the very least a physician should be contacted even if the sick individual has no fever, whenever reason exists to assume that he is severely ill. Indeed, the Gemara (see Shabbat 129a) resolves questions as to whether a situation is sufficiently dangerous to warrant chillul Shabbat in the direction of leniency. The stated principle is “safek nefashot l’hakeil,” one should be lenient when one is unsure as to whether there is danger to life.
Calming an Ill Individual
Sometimes, tending to an ill individual’s psychological needs is essential to preserving his welfare. The Gemara (Shabbat 128b) permits lighting a candle in the room of a blind pregnant woman, while delivering the baby. Although the woman herself cannot see even with the light, the light helps calm her, as she knows that the candle will enable others to see. Putting her mind at ease constitutes piku’ach nefesh.15In the above example, the Gemara addresses the psychological well-being of a woman who also faces a physical danger (childbirth). Also see Rav Yisrael Rozen’s and Rav Mordechai Goodman’s essays in Techumin (23:73-88 and 24:359-369) regarding whether social workers and family members may travel on Shabbat to the site of a terrorist attack in order to cope with the attack’s tremendous psychological impact.
Based on this principle, poskim discuss the propriety of relatives traveling to a hospital on Shabbat when a patient requests their presence.16Also see Teshuvot Yabia Omer (O.C. 10:29). While the poskim whom we cite in this chapter address the patient’s emotional well-being, it is important to note that one must also assess whether the patient would face physical danger by entering the hospital unaccompanied. In a busy hospital, a patient might need an advocate to ensure that the hospital staff does not neglect him. Rav Moshe Feinstein (Teshuvot Igrot Moshe, O.C. 1:132) permits a husband to accompany his pregnant wife to the delivery room on Shabbat if she fears traveling alone.17Rav Moshe notes that his case is less straightforward than the Gemara’s case. In the Gemara’s case, the blind woman has good reason to fear the darkness. Although she cannot see even in the light, she worries that the midwife will encounter difficulty delivering the baby in the dark. By contrast, Rav Moshe writes that the woman does not have any serious reason to fear riding to the hospital alone. Nevertheless, Rav Moshe concludes that we should not make such fine distinctions in matters of life and death. Thus, while we might think that the fear of traveling alone to the hospital is unfounded, a woman who experiences this fear may be accompanied by her husband. Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 8:15 Kuntres Meshivat Nafesh 9) raises the possibility of permitting travel on Shabbat in a manner that constitutes only a rabbinic prohibition, to be with a dangerously ill relative if circumstances clearly indicate that one’s arrival will calm the relative. As an example, Rav Waldenberg mentions someone who falls ill in a remote village, where he does not know anyone. This person likely feels extremely unsettled, because he is being treated by people whom he does not recognize. Hence, his relative’s presence would calm him and hopefully expedite his recovery. Of course, both these authorities emphasize that one must assess each given situation, in order to gauge the severity of the prohibitions involved, in addition to determining whether the patient’s emotional state is indeed so unsettled that it is actually harming his health.18See, for example, Tosafot (Shabbat 128b s.v. Ka Mashma Lan), who distinguish between the impact of emotional stress on a woman during childbirth (which is presumed to be quite severe) and the effects of only partially feeding an ill individual on Yom Kippur.
I was once told about an elderly Jewish woman who was rushed to the hospital, and subsequently released, all on Yom Tov. Circumstances dictated that she could not remain in the hospital for the remainder of the Yom Tov, so Rav Hershel Schachter permitted asking a non-Jew to drive her home. He reasoned that the woman was still sick enough to be considered ill, and it is permitted to ask a non-Jew to violate Shabbat on behalf of an ill individual (even if the illness is not life-threatening).19See Shulchan Aruch (O.C. 328:17) and Mishnah Berurah (328:47). Rav Schachter also stated that it seems clear that just as the woman’s grandson was permitted to accompany her to the hospital, so, too, may he accompany her home (if necessary for her emotional welfare), as the non-Jewish driver does nothing extra on behalf of the grandson.20See Teshuvot Har Tzvi (Y.D. 233), Teshuvot Igrot Moshe (O.C. 1:132), and Contemporary Halakhic Problems (1:137-138).
It should be noted that in the situation regarding which Rav Schachter issued his ruling, all of the traveling occurred within the techum (the area within which one is permitted to walk on Shabbat and Yom Tov). Rav Schachter rendered his decision only in regard to the questions of asking a non-Jew to drive a car and riding in the car on Shabbat and Yom Tov. Rav Schachter told me that there is no distinction between Shabbat and Yom Tov in such a situation.
Part II: Minimizing Prohibited Activity (Hutrah vs. Dechuyah)
In the previous chapter, we established that piku’ach nefesh (saving a life) overrides the restrictions of Shabbat. We now explore whether one must attempt to minimize desecration of Shabbat in such situations. In technical terms, this discussion is called hutrah or dechuyah. Hutrah (literally, “permitted”) means that, due to the life-threatening circumstances, the acts are not viewed as desecration of Shabbat at all. Dechuyah (literally, “superceded”) means that the acts are always viewed as fundamentally prohibited, but they are permitted to the extent that they must be done to save a life.1For additional sources on this topic, see Teshuvot Yabia Omer (vol. 1 Orach Chaim 22).
Talmudic Background
The Gemara never explicitly discusses whether violating Shabbat to save a life is hutrah or dechuyah, but the terms hutrah and dechuyah do appear in the Gemara in other contexts.2The Gemara and Rishonim distinguish between hutrah and dechuyah in several contexts. For example, the Gemara discusses the difference regarding the nature of the permission, in certain circumstances, to offer sacrifices despite the presence of tumah (ritual impurity). Rav Nachman and Rav Sheishet (Yoma 6b) debate whether offering sacrifices despite the impurity is unreservedly permissible (tumah hutrah betzibur) or the allowance is of a limited nature (tumah dechuyah betzibur). Rashi (s.v. dechuyah) explains that the opinion that maintains that the impurity is dechuyah requires doing anything possible to minimize offering sacrifices in such a state. A possible ramification is how hard one must search for ritually pure Kohanim (priests), despite the fact that, if necessary, even impure Kohanim could bring the sacrifices (also see Encyclopedia Talmudit 19:578-579). Although the Talmud does not address piku’ach nefesh explicitly, four sources implicitly address this issue in the context of Shabbat, with two sources seeming to support each possibility.
The Gemara (Shabbat 128b) rules that one may light a lamp on Shabbat in a room where a blind woman is giving birth if the blind woman requests that a lamp be lit. Although she will not directly benefit from the light, the Gemara explains that kindling the lamp soothes her mind. Many argue that this source demonstrates that piku’ach nefesh is hutrah. Otherwise, such a violation of Shabbat would not be permissible, for it does not directly contribute towards saving her life.
Moreover, the Gemara (Yoma 84b) states that when Shabbat must be violated, gedolei Yisrael (literally, “big ones of the Jews”)3The Beit Yosef (O.C. 328 and Shulchan Aruch, O.C. 328:12) interprets this term as referring to adults, rather than children. The Taz (328:5) disagrees, asserting that term means respected Torah scholars, and the Gemara is teaching that scholars should make a point of desecrating Shabbat themselves in life-threatening cases so that everyone else will learn to emulate their behavior. should perform the act, rather than a non-Jew or a Jewish minor. If piku’ach nefesh were dechuyah, asking a child or a non-Jew to violate Shabbat would appear to be preferable, since their desecration of Shabbat is far less severe than that of an adult Jew.4It should be emphasized, though, that under normal circumstances the Mishnah (Shabbat 121a) explicitly prohibits asking a child to violate Shabbat on behalf of adults. Thus, piku’ach nefesh seems to be hutrah. However, those who maintain that it is merely dechuyah counter that ideally it would be preferable to request from a non-Jew to violate Shabbat instead of a Jew, but this behavior would lead people to mistakenly believe that Jews may not violate Shabbat even for piku’ach nefesh. Such a mistake would likely lead to deaths in situations where no non-Jew is available, as the Jews present would not realize that they should violate Shabbat in order to save the endangered person. Chazal therefore commanded Jews to violate Shabbat in all life-threatening emergencies, even when a non-Jew could save the life and spare the Jews from desecrating Shabbat.5See Teshuvot Yabia Omer (vol. 8 O.C. 37:12), who explains the Shulchan Aruch’s view in this manner.
In contrast to the last two sources, the Gemara elsewhere (Shabbat 128b) teaches that whenever possible, one should violate Shabbat in case of emergency by using a shinui (a deviation from the normal way of doing something, which is only rabbinically forbidden). This qualification implies that saving a life on Shabbat is dechuyah, so one must try to lower the prohibited act to a rabbinic prohibition.
Furthermore, the Gemara (Menachot 64a) presents a scenario where one has two options for how to act in a life-threatening situation, and he must choose the option that entails the least possible desecration of Shabbat. In the Gemara’s case, two dates have been prescribed as a remedy for a critically ill individual. These dates could be obtained either by cutting one date from each of two branches or by cutting one branch that holds three6The Gemara presents a case where the lone branch contains more dates (three) than the other two branches combined in order to teach that it is better to cut the lone branch even when this act detaches more dates than two acts of cutting one date each. In technical terms, this means that minimizing ribui ma’aseh (a greater number of acts) is preferable to minimizing ribui shiur (a greater number of fruits). dates. The Gemara concludes that one should cut the lone branch containing three dates in order to reduce the number of prohibited acts of pruning (ketzirah). This source implies that even while aiding a dangerously ill person, we must limit Shabbat violations as much as possible.
The Rishonim
The Rosh (Yoma 8:14) cites a dispute that appears to highlight the difference between hutrah and dechuyah. In the case that arose, a dangerously ill person needed to eat meat on Shabbat, but no kosher meat was available. Either he could eat non-kosher meat, which happened to be readily available, or another Jew could violate the laws of Shabbat by slaughtering a kosher animal for him.
The Rosh quotes some Rishonim who deem it preferable to eat the non-kosher meat, for eating non-kosher meat entails a less severe prohibition (a regular Biblical negative commandment) than desecrating Shabbat (a capital offense). Their position implies that even when acting to save a life, the act of slaughtering is merely dechuyah, so its severity must be weighed against alternative methods of saving the sick individual.
However, the Maharam of Rothenburg (cited by the Rosh) writes that it is preferable to slaughter the animal for the ailing person on Shabbat. He compares slaughtering an animal for a sick person to cooking or lighting a fire on Yom Tov (festivals). Just as cooking and lighting a fire constitute melachot (prohibited activities on Shabbat and Yom Tov), yet the Torah completely permits them under most circumstances7Even permitted melachot may not be done under all circumstances on Yom Tov. For a brief English summary of the parameters, see Rav Simcha Bunim Cohen’s Laws of Yom Tov (pp. 17-22). on Yom Tov - “like on a weekday” - so, too, the act of slaughtering constitutes a melachah but “any melachah done for a dangerously ill individual on Shabbat is as if it is being done during the week.” Interestingly, the Maharam does state that the prohibition of eating non-kosher meat is merely dechuyah in the case of piku’ach nefesh.8See Yoma 83a, which teaches that one whose life depends on eating forbidden foods should first eat those that entail less severe prohibitions. The Mabit (Kiryat Sefer, Maachalot Asurot 14:16) claims that on a Biblical level one need not be concerned about the level of a food’s prohibition when it can save a life, so the Gemara requires seeking the lightest prohibition only on a rabbinic level. His understanding would allow one to argue that eating prohibited foods is hutrah in life-threatening situations, so on a Biblical level, the Halachah even permits violating a more severe prohibition than is absolutely necessary. However, Rav Shlomo Zalman Auerbach (Teshuvot Minchat Shlomo 1:7:1) cites many authorities who disagree with the Mabit and view the Gemara in Yoma as speaking on a Biblical level. Interestingly, the Rif omits this passage from the Gemara, leading some to believe that he considers all prohibitions to be hutrah in the face of piku’ach nefesh (see Teshuvot Yabia Omer, vol. 8 O.C. 37:12). Apparently, he views desecrating Shabbat as hutrah but eating prohibited foods as dechuyah.9The Rosh cites other Rishonim who also prefer slaughtering the kosher animal to eating the non-kosher meat, but for reasons other than Shabbat being hutrah. The Ra’avad believes that it is better to slaughter the meat because cooking the non-kosher meat would anyway violate Shabbat. Consequently, the Ra’avad acknowledges that slaughtering the animal constitutes a prohibition (implying that Shabbat is merely dechuyah for emergencies), but he argues that it is better to increase the violations of Shabbat, which anyway must be desecrated by cooking, than to introduce the additional prohibition of non-kosher food. Others posit that it is preferable to slaughter the meat because the patient will likely find the non-kosher meat revolting and may refuse to eat it, endangering himself further. The Ran (Beitzah 9b in pages of Rif, s.v. Umiha), though, asserts that while cooking on Yom Tov is not a transgression at all, Shabbat or Yom Tov is merely dechuyah when a life must be saved.10The Ran even rules that one should try to avoid to violating Shabbat twice when it is possible to violate it only once. He thus appears to disagree with the opinion of the Ra’avad (cited in the previous footnote), who seems to believe that once Shabbat is violated for piku’ach nefesh, it does not matter how many times it is violated for this purpose.
The Rambam (Hilchot Shabbat 2:1-2) introduces the topic of life-threatening emergencies on Shabbat by positing that Shabbat is “dechuyah” in cases of danger to human life. On the other hand, he writes that Shabbat should be viewed “as a weekday” when treating the gravely ill. It seems that he intends one of these two expressions in a non-technical manner, but he does not clarify which one, so the Acharonim thus debate whether he considers Shabbat to be hutrah or dechuyah when saving a life.11See Teshuvot Yechaveh Da’at (4:30), Halichot Olam (4:145-146), and Rav Yosef Kafich’s commentary to the Rambam (ad loc.) for a summary of this debate.
Practical Halachic Ramifications
When only non-kosher meat is available on Shabbat, the Shulchan Aruch (Orach Chaim 328:14) rules that it is preferable to violate Shabbat and slaughter kosher meat. The Mishnah Berurah (328:39) adds that if the food is only rabbinically prohibited (such as certain foods cooked by a non-Jew - bishul akum) then one should eat it rather than violate Shabbat. Based on the Shulchan Aruch’s ruling, Rav Yehoshua Neuwirth (Shemirat Shabbat Kehilchatah 40:17) notes that one may similarly violate Shabbat in order to bring kosher food to a dangerously ill patient in a hospital that does not serve kosher food. However, he cites Rav Shlomo Zalman Auerbach’s opinion that if the hospital food has a reliable kashrut endorsement,12Of course, one must determine in each individual situation whether the supervision is in fact reliable. One wonders how Rav Shlomo Zalman would rule concerning reliable supervision that openly admits to permitting a type of food that certain communities prohibit, such as a reliable Ashkenazic rabbi who certifies that the meat is kosher but not glatt. (Ashkenazic practices regarding glatt vary, but Rav Ovadia Yosef rules that Sephardic Jews may not eat non-glatt meat; see Teshuvot Yechaveh Daat 3:56. Regarding Sephardic Jews who visit Ashkenazic Jews and wish to eat meat with them, see Yalkut Yosef, Isur V’heter vol. 1 pp. 119-120). which the patient normally chooses not to accept, then one may not violate Shabbat to bring him food that meets his personal halachic standards (ad loc. note 48).13Rav Shlomo Zalman adds that one may not mislead the patient into believing that food meets his kashrut standards when in reality it does not, lest he later find out the truth and be disgusted by the food, thus ultimately causing his condition to worsen.
Two more major issues arise in the Shulchan Aruch and its commentaries that may depend on this dispute. It should be noted, though, that each case also entails additional considerations. Thus, a poseik who fundamentally believes Shabbat to be dechuyah when a life is in danger might sometimes rule leniently in a manner that seems to indicate that it is hutrah, and vice versa. In fact, Rav Yitzchak Isaac Liebes (Halacha Urefu’ah 3:83) comments that it is quite difficult to find a practical case that truly depends on the question of hutrah versus dechuyah (also see Halichot Olam 4:157-158).
The Shulchan Aruch (Orach Chaim 328:12) writes that a Jewish adult should be the one to violate Shabbat in case of emergency, rather than a non-Jew or a minor. On the other hand, the Rama adds that if no delay would result from doing the action with a shinui, or asking a non-Jew to do it, then one should utilize either of these alternatives.14Also see the Rama’s Teshuvot (76), where he indicates that Shabbat is hutra in cases of piku’ach nefesh. The Taz (O.C. 328:5) rejects asking a non-Jew even when doing so requires no additional effort, but he does not challenge the Rama’s ruling regarding a shinui. The Mishnah Berurah (328:37) thus rules that a shinui should be used whenever possible,15See Teshuvot Minchat Shlomo 1:7:3. but one should not summon a non-Jew. However, Rav Moshe Feinstein (Orach Chaim 4:80) limits the Taz’s position to the precise act that will save a life (“inyan hahatzalah mamash”). Rav Moshe claims that even the Taz would encourage using a non-Jew for an act such as driving in an emergency (provided that this will not take any extra time), because the driving itself does not save the victim’s life.
Poskim also debate whether one may violate Shabbat in order to take care of the non-emergency needs of a dangerously ill person. The Shulchan Aruch seems to permit such acts, “We do for him what would be done for him on a weekday” (328:4).16Assuming that this issue and the previous one both depend on the question of hutrah or dechuyah leads to the conclusion that the Shulchan Aruch undoubtedly considers Shabbat to be hutrah when saving a life, for the Shulchan Aruch both permits a Jew to violate Shabbat despite the presence of non-Jews and permits violating Shabbat even for all an ill individual’s needs. However, Rav Ovadia Yosef argues that the Shulchan Aruch actually considers Shabbat to be dechuyah. We have already mentioned that Rav Ovadia explains the Shulchan Aruch’s first ruling as a special measure to prevent people from erroneously concluding that Jews may not violate Shabbat themselves, but may only ask non-Jews to do so for them, even in life-threatening situations (Teshuvot Yabia Omer, vol. 8 O.C. 37:12). Elsewhere, Rav Ovadia questions whether only one who considers Shabbat to be hutrah in cases of piku’ach nefesh would permit violating Shabbat for an ill individual’s other needs, or whether one could argue that all his needs override Shabbat, yet they are viewed as prohibited acts that must nevertheless be performed, as opposed to permitted acts (Teshuvot Yechaveh Da’at 4:30). The Mishnah Berurah (Biur Halachah, 328 s.v. Kol) extensively reviews the approaches to this issue and notes that many Rishonim forbid violating Shabbat to take care of the non-emergency needs of a dangerously ill person. He concludes (328:14) by suggesting a compromise approach, recommending to refrain from Biblical prohibitions that do not directly contribute to saving his life, but allowing rabbinic prohibitions of this type. On the other hand, Rav Chaim Soloveitchik (quoted in Rav Yitzchak Ze’ev Soloveitchik’s commentary on Rambam, Hilchot Shevitat Asor 2:8) and Rav Ovadia Yosef (Teshuvot Yechaveh Daat 4:30) rule that one may even violate a Torah prohibition in order to care for the non-emergency needs of a dangerously ill person, in accordance with the Shulchan Aruch.
Many questionable situations today involve the use of electric appliances. Most authorities appear to agree with Rav Shlomo Zalman Auerbach’s assertion (Teshuvot Minchat Shlomo 1:11) that completing a circuit does not involve a Biblical prohibition (except in the case of an incandescent light bulb, or other appliance in which a filament is heated until it glows).17Rav Chaim Ozer Grodzinsky (Teshuvot Aciezer 3:60) appears to agree with Rav Shlomo Zalman’s approach. Rav Yehuda Amital (personal communication), Rav David Cohen of Brooklyn, New York (personal communication), Rav Moshe Heinemann (in a lecture to a Young Israel rabbinical convention), Rav Shlomo Levy (personal communication) and Rav Hershel Schachter (in a lecture to the Rabbinical Council of America) have reported that this position is generally accepted. According to this view, the Mishnah Berurah would thus agree that one may turn appliances on or off for the patient’s sake, even if they are not essential for saving his life. For example, Rav Hershel Schachter and Rav Mordechai Willig both told me that they believe one may turn on an air conditioner on Shabbat for a dangerously ill patient who feels unusually hot, although they ruled that it must be turned on in an unusual manner (shinui).18For an explanation for why a Shinui is necessary in this situation, see Rav Schachter’s Eretz HaTzvi (chapter six).
It is important to note that even the Mishnah Berurah (ibid.) warns against refraining from prohibited acts only if one is certain that the illness will not worsen as a result. He concludes with a citation from the Meiri, that if the action that violates Shabbat will strengthen the dangerously ill person, it should be performed.
Part III: Putting Oneself in Piku’ach Nefesh Situations
This section addresses steps that one should take in order to avoid a entering a life-threatening situation, which would necessitate desecrating Shabbat.
Background
The Gemara (Shabbat 19a) prohibits embarking on a boat that will travel through Shabbat if the trip begins within three days of Shabbat.1The Mishnah Berurah (248:4) cites a dispute regarding whether this prohibition applies on Wednesday, or whether the phrase “within three days” includes Shabbat itself as one day. However, the Gemara limits this restriction to trips taken for one’s own needs (devar hareshut), whereas one may set out for the sake of a mitzvah even in the latter half of a week.2The Shulchan Aruch (Orach Chaim 248:4) mentions a trip to Israel as an example of a trip for the sake of a mitzvah. See Mishnah Berurah 248:28 and Teshuvot Chelkat Yaakov (1:81) regarding whether this includes a temporary visit to Israel. The Shulchan Aruch codifies the Gemara’s rulings (Orach Chaim 248:1). The Steipler Rav (Kehilot Yaakov, Shabbat 14) writes that the Gemara’s prohibition is merely a rabbinic enactment. The Shulchan Aruch Harav (248:7) appears to agree with his view,3Rav Yisrael Rozen (Techumin 16:42) infers this position from the Shulchan Aruch Harav’s words. and Rav Moshe Feinstein (Teshuvot Igrot Moshe, Orach Chaim 1:127) asserts that most authorities indeed consider this prohibition to be rabbinic.4Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 12:43:4) cites many authorities who indicate that this prohibition is merely a rabbinic enactment. See, however, B’ikvei Hatzon (p. 153), where Rav Hershel Schachter offers an explanation for why he believes it to be a Biblical prohibition.
The Rishonim offer a number of explanations for the prohibition against beginning a trip too close to Shabbat.5In this chapter, we discuss only the two explanation that appear in the Shulchan Aruch. For a summary and analysis of these and other opinions, see Ritva (Shabbat 19a s.v. Tanu Rabanan). The Rif (Shabbat 7b, in pages of Rif) explains that people generally need three days until they adjust to sea travel. Hence, one who embarks within three days of Shabbat will probably experience an unpleasant Shabbat due to seasickness. The Rabbis thus prohibited such trips in order to ensure that people properly enjoy Shabbat (oneg Shabbat).
The Baal Hama’or (Shabbat 7a, in pages of Rif) claims that the three days immediately before Shabbat are considered “prior to Shabbat,” so one who embarks on a voyage within that period intentionally enters a situation that will require violating Shabbat in case of piku’ach nefesh (saving a life).6Travel was dangerous at that time, so it was likely that the crew would need to perform forbidden activities on Shabbat in order to insure the passengers’ safety. The Shulchan Aruch (Orach Chaim 248:2 and 248:4) appears to codify both explanations.
Defining “For the Sake of a Mitzvah”
The Gemara permits embarking on a trip during the latter half of a week “for the sake of a mitzvah.” Rabbeinu Tam (cited approvingly by the Tur, O.C. 248) interprets this concept in an extraordinarily lenient manner. He argues that traveling for business purposes or to visit a friend is considered a mitzvah, while only a purely recreational trip would constitute a devar reshut (trip for one’s own needs). The Rama (248:4) accepts Rabbeinu Tam’s view.
Belated Circumcisions
When a brit milah (circumcision) takes place later than the eighth day of a boy’s life (such as a baby who could not tolerate a brit on the eighth day due to health reasons, or a non-Jew who wishes to convert),7Of course, none of these concerns applies when circumcising a baby on the eighth day of his life, as circumcision on the eighth day overrides Shabbat. The Gemara discusses the laws of a circumcision on Shabbat at great length in the nineteenth chapter of Masechet Shabbat. the Tashbetz (1:21) forbids performing it on a Thursday. He notes that on the third day after a brit (including the day of the brit), the baby is presumed to be in tremendous pain (see Bereishit 34:25 and Rashbam ad loc.). Thus, a baby who underwent a brit milah on Thursday may require medical treatment that will entail transgressing Shabbat (see Shabbat 86a). According to the Taz (Yoreh Deah 262:3), this problem exists when circumcising on Friday, too, as the baby suffers pain every day through the third day.8The Taz indicates concern for the baby’s pain and suffering per se, not for the desecration of Shabbat that it might necessitate. Apparently, he understands the problem of circumcising close to Shabbat in the same manner that the Rif explains the prohibition against traveling before Shabbat - concern for causing unnecessary discomfort during Shabbat (see Teshuvot Tzitz Eliezer 12:43). The Shach (Yoreh Deah 266:18) notes that some Rishonim do indeed assume that the baby suffers through the third day, but the Tashbetz explicitly permits circumcising on Friday even when it is not the eighth day.9See, however, Teshuvot Yabia Omer, Y.D. 5:23.
The Shach himself rejects even the Tashbetz’s position. He asserts that circumcising constitutes a mitzvah, so one may perform it even when it will later require violating Shabbat to save a life, just as one may embark on a trip for the sake of a mitzvah even during the latter half of the week. The Chacham Tzvi (Teshuvot Nosafot 14) and Mishnah Berurah (331:33) rule in accordance with the Shach. The Chacham Tzvi’s son, Rav Yaakov Emden (Sh’eilat Yaavetz 2:95), distinguishes between the late circumcision of a Jewish boy and the circumcision of a non-Jew who wishes to convert. A mitzvah already exists to circumcise the Jewish child, so Rav Emden agrees with the Shach that the brit should not be delayed. By contrast, the potential convert does not delay any mitzvah by pushing off his brit milah, for he is not bound by mitzvot prior to the conversion process.10For more on this topic, see Pitchei Teshuvah (Y.D. 266:15) and Teshuvot Tzitz Eliezer (12:43). In practice, the Magen Avraham (331:9) notes that nowadays we rarely need to violate Shabbat in order to save a circumcised baby, so circumcising on Thursday should undoubtedly be permitted. Indeed, common practice among Ashkenazic Jews is to circumcise on Thursday and Friday under all circumstances, but Rav Ovadia Yosef (Teshuvot Yabia Omer, Y.D. 5:23) rules that Sephardic Jews should not perform a belated circumcision on Thursday or Friday unless their community has a custom to do so. Rav Shmuel Khoshkerman reports that the accepted custom of all Sephardic Jews is to prohibit belated circumcisions on Thursday and Friday.
Elective Surgery Prior to Shabbat
Rav J. David Bleich (Contemporary Halakhic Problems 2:19-20) cites the opinions of Rav Moshe Feinstein (Hapardes, Tamuz 5738) and the Lubavitcher Rebbe (Hapardes, Tishrei 5739), who both rule (based on the aforementioned sources) that one should avoid undergoing elective surgery during the three days before Shabbat. The Rif’s reason applies in this situation, since people generally experience considerable pain for at least several days following surgery. The Ba’al Hama’or’s concern also arises, as post-operative care frequently requires acts that violate Shabbat.
Rav Yehoshua Neuwirth (Shemirat Shabbat Kehilchatah 32:33) rules that one should attempt to schedule elective surgery on Sunday, Monday, or Tuesday provided that it is possible. However, he cites Rav Shlomo Zalman Auerbach (note 97) as ruling that if a more qualified surgeon is available during the second half of the week, then one may undergo the surgery on those days.
Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 12:43) adopts a different approach. In general, he believes that Halachah permits non-emergency surgery only if failure to perform it will eventually endanger the patient.11Rav Waldenberg (Teshuvot Tzitz Eliezer 11:41) prohibits cosmetic surgery unless it provides tangible health benefits, but not everyone shares his opinion. See Teshuvot Igrot Moshe (Choshen Mishpat 2:66), Teshuvot Minchat Yitzchak (6:105:2), Teshuvot Chelkat Yaakov (3:11), and Rav J. David Bleich’s Judaism and Healing (pp. 126-128). One wonders whether Rav Moshe and the Lubavitcher Rebbe would have prohibited surgery during the end of the week if they permitted only those surgical procedures that protect a patient from eventual danger. One similarly wonders how Rav Waldenberg would have ruled regarding elective surgery during the latter half of the week if he believed that one could undergo surgery even when it does not eliminate any dangers to one’s health. Therefore, he argues that elective surgery can be defined as an action done for the sake of a mitzvah, since any elective surgery that serves only a frivolous purpose is forbidden. Moreover, Rav Waldenberg asserts that it is nearly impossible for a hospital to arrange for elective surgeries to take place only on Sundays, Mondays, and Tuesdays. Such a policy could lead to the lack of availability of hospital beds, as one cannot accurately predict the number of arrivals in an emergency room. Indeed, he notes that Shaarei Zedek Hospital in Jerusalem (which functions according to Halachah) allows surgery on Thursday and Friday even if it can be safely postponed until the following Sunday or Monday.12Interestingly, see Kovetz Teshuvot (43), where Rav Yosef Shalom Eliashiv rules that a woman is not obligated to go out of her way to be near a hospital for Shabbat during her ninth month of pregnancy (despite concern that she might go into labor and need to violate Shabbat), although he adds that doing so would be praiseworthy.
Conclusion
Generally speaking, one may not deliberately create a situation that will necessitate desecrating Shabbat in order to save a life. One may do so, however, for the sake of a mitzvah, so practical cases must be presented to a competent rabbi in order to determine whether they contain an element that might constitute a mitzvah for these purposes.
Part IV: Returning from an Emergency
In this chapter, we examine whether medical personnel may return home on Shabbat following their involvement in a life-saving mission. We open with the Talmudic background and then proceed to outline the three primary views regarding this issue, as presented by Rav Tzvi Pesach Frank, Rav Moshe Feinstein, and Rav Shlomo Zalman Auerbach.
Talmudic Background
One who goes [2000 amot] outside one’s city [on Shabbat] for a permitted reason1Ordinarily, one may not walk more than 2000 amot beyond the city limits (techum). A midwife going to deliver a baby would be an example of a halachically valid reason (Rashi s.v. Mi). Someone who walks beyond the techum without such a reason is required to remain within four amot (six to eight feet) of where he is located (Eruvin 41b). and is then informed that the issue has already been resolved may now go 2000 amot (3000-4000 feet) [like the techum2The techum (“boundary”) refers to a 2000 amah radius around a city’s limits (1 amah=1.5 to 2 feet). A dispute exists regarding whether the Rabbis decreed that one may not walk beyond the techum on Shabbat, or the prohibition to leave the techum is Biblical. Some Rishonim maintain a middle view, believing that one may not walk beyond 12 mil (24,000 amot) on Shabbat on a Biblical level, and the Rabbis reduced the permitted distance to from 12 mil to 2000 amot. For a summary and analysis of the opinions, see Ritva (Eruvin 17b s.v. Rabbi Yonatan). In practice, the Mishnah Berurah (407:7 and Biur Halachah s.v. L’man) concludes that the prohibition to leave the techum is completely rabbinic, even beyond 12 mil. For a brief overview of the laws of techumin, see Rav Pinchas Kehati’s introduction to Eruvin. These laws are discussed at great length by the Shulchan Aruch and its commentaries in Orach Chaim 396-416. of local residents]. All3The Yerushalmi and most editions of the Mishnah read, “For all who go to rescue,” thus rendering the continuation of this passage as a concluding phrase of the previous sentence. We have, however, presented the Mishnah’s text as it appears in the Babylonian Gemara, with the word “all” beginning a new sentence. who go to rescue [Jews from their enemies4We have added these words based on the Gemara’s interpretation on the following page (45a). on Shabbat] may return to their place [of origin].
Tosafot (s.v. Kol) note that the Rabbis sometimes permit the completion of an action on account of its beginning. For example, the Gemara (Beitzah 11b) delineates three cases in which the Rabbis permit the completion of an activity on Yom Tov (a Biblical festival), despite the fact that only its beginning serves a purpose on Yom Tov. The Rabbis decided that the early stages of these tasks meet important communal needs and forbidding their completion would inhibit people from ever beginning them.5For example, it is rabbinically prohibited to place a bandage on a wound in certain circumstances on Shabbat (see Eruvin 102b and Rashi s.v. Aval). Nonetheless, a Kohein who removes a bandage in order that it not be a barrier (chatzitzah), which would prevent him from working in the Beit Hamikdash (Temple), may return the bandage to his hand after he has completed his service. The Rabbis permitted returning the bandage lest forcing him to remain the rest of Shabbat without his bandage might prompt him to avoid removing it initially. Work in the Beit Hamikdash with the bandage covering his hand would be prohibited (see Rashi, Beitzah 11b s.v. Bemikdash). We thus permit a Kohein to do a prohibited act (putting on the bandage) after he has completed working in the Beit Hamikdash in order to ensure that he will begin his work properly, rather than hesitating to remove his bandage. Similarly, Tosafot imply, if those who go to save others’ lives are forbidden to return home, they may hesitate to undertake the mission altogether, thus endangering lives. The Nishmat Avraham (Orach Chaim 329:7) cites the Magen Avraham (497:18), in a related context, as restricting the application of this Gemara to rabbinic enactments.6This reading of the Magen Avraham is not conclusive. He addresses the general concept of activities that are permitted because of their beginning, but he does not address the issue of life-saving missions. However, the Chatam Sofer (Orach Chaim 203) and Rav Yaakov Emden (Sh’eilat Yaavetz 1:132 s.v. Udekashya) believe that the Rabbis may even permit the completion of a Biblical prohibition when they deem it necessary so as not to discourage people from performing certain mitzvot on Shabbat.7See B’ikvei Hatzon (p. 52), where Rav Hershel Schachter suggests that this consideration does not apply to paid medical personnel. Since they receive financial compensation for their work, no concern exists that they will not do their job without being permitted to return home on Shabbat. Rav Schachter cites other examples of people who may not return home from life-saving missions because they did not undertake the missions purely for the mitzvah of piku’ach nefesh.
The Gemara (Eruvin 45a) questions how the above passage from the Mishnah could permit returning from a life-saving mission all the way to one’s place of origin. After all, the Mishnah indicates elsewhere (Rosh Hashanah 23b) that both a midwife who comes to aid an expectant mother and someone who comes to rescue people from an invading army or a disaster may walk 2000 amot from the town of their immediate destination.8The Mishnah records that at first, those witnesses who had come to beit din from beyond the techum to testify about seeing the new moon were permitted to stay only within the immediate area of the beit din (see Tosafot, Rosh Hashanah 23b s.v. Lo). However, Rabban Gamliel I (referred to as Rabban Gamliel Hazakein in order to distinguish him from his grandson, Rabban Gamliel II of Yavneh) issued a decree permitting the witnesses to walk 2000 amot in any direction - just like residents of the beit din’s location. The Mishnah in Eruvin, by contrast, permits returning from saving a life without restricting the number of amot that one may travel after resolving the emergency. Hence, it appears to contradict the Mishnah in Rosh Hashanah’s limitaton of 2000 amot from the city limits.
The Gemara offers two resolutions to this contradiction. Rav (cited by Rav Yehudah) explains that the Mishnah in Eruvin does not intend to permit returning all the way home. Rather, it is specifically addressing “all who go to rescue” in battle,9The entire topic of waging war on Shabbat generated vigorous debate between the Maccabees (who fought even on Shabbat) and other groups of Jews during the Second Temple Period. Rav Yitzchak Herzog (Pesakim Uktavim, Orach Chaim 1:53) and Rav Shlomo Goren (Torat Hashabbat Vehamo’eid pp. 49-55 and Machanayim 20:6-13) analyze sources from that period that indicate that some Jews at the time erroneously believed that one may not defend oneself from enemy soldiers on Shabbat. and it states that they may return, assuming that we know from Rosh Hashanah that soldiers may return only 2000 amot. The Mishnah in Eruvin repeated the soldiers’ permission to return in order to teach a different point: the soldiers may return (within 2000 amot) while carrying their weapons. Ordinarily, one may not carry in a public domain on Shabbat,10A community often may convert its public areas into a private domain by constructing an eruv. We offer technical definitions for public and private domain and discuss the laws of constructing an eruv in our first volume (pp. 165-199). but the Rabbis decreed that soldiers should return from battle with their weapons in light of a tragic incident. The Gemara recounts that when war was waged on Shabbat, the soldiers used to place their arms in the house nearest to the town wall after the hostilities ceased, in order to avoid carrying the weapons unnecessarily on Shabbat. One time, however, the enemy realized this practice (and the resultant vulnerability of the soldiers), so enemy troops attacked the soldiers as soon as they had all dropped off their weapons. The Jewish soldiers scampered into the house to retrieve their weapons, and more Jews killed one another in the resulting confusion than died in the actual battle. Therefore, the Rabbis decreed that soldiers may return 2000 amot with their weapons.
Rav Nachman bar Yitzchak, however, resolves the apparent contradiction between Mishnayot differently. He claims that the Mishnah in Rosh Hashanah addresses victorious battles, when Jewish soldiers have no need to return beyond 2000 cubits. The Mishnah in Eruvin, according to Rav Nachman bar Yitzchak, is speaking of a time where the Jews regrettably lose a battle and thus fear remaining outside their homes. In such situations, they may return home even beyond the 2000 amot with their arms.11Although the Gemara specifically mentions a case where Jews lost a battle, the Rambam (Hilchot Shabbat 27:17) appears to extrapolate from it that Jews may return all the way home in any situation where non-Jewish enemies pose a threat to Jews who remain within the techum of the emergency. The Rosh (Eruvin 4:5) cites the Maharam of Rothenburg as accepting the opinions of both Rav and Rav Nachman bar Yitzchak. A Jewish soldier may thus return all the way home only if he is scared that the enemy might attack him should he stay within 2000 amot of the battlefield. When the Jews are stronger and this concern does not exist, he may go only 2000 amot from the battle site, in accordance with Rav Nachman bar Yitzchak’s opinion. When the Jew is returning, he may carry his weapons in accordance with the view of Rav.12It is not entirely clear if he is permitted to carry his weapons during a time that the Jews are stronger and he is going only 2000 amot (see Teshuvot Minchat Shlomo, 1:8, p. 57), but a soldier may certainly carry his weapons in times of danger when he is traveling all the way home (see Shulchan Aruch, Orach Chaim 407:3).
The Rambam (Hilchot Shabbat 27:17) also writes that those who go to save endangered Jews may return with their weapons to their places of origin only if they fear that they may be attacked. He adds that other people who travel to save lives on Shabbat (such as going to save somebody from drowning) may similarly return all the way back to their homes (even outside of 2000 amot) if they fear attack. The Shulchan Aruch in Orach Chaim 407:3 appears to codify this ruling.
There is a problem, however, with the rulings of the Rambam and Shulchan Aruch. Earlier (Hilchot Shabbat 2:23), the Rambam writes that “Jews who go to war on Shabbat to aid their brethren are permitted to return to their place of origin carrying their weapons, so as not to cause danger in the future [by their hesitating to leave their homes again on Shabbat].” This passage does not limit the permission to return all the way home to cases where the Jews fear attack if they stay put. Similarly, the Shulchan Aruch (Orach Chaim 329:9) elsewhere asserts, “Those who go on a life-saving mission are permitted to return with their weapons to their place of origin,” without limiting this rule to situations in which security is unstable.13The Shulchan Aruch appears to apply this leniency to anyone who goes to save a life, even in a context other than war, as is apparent from the juxtaposition to his previous sentence (329:8).
Twentieth Century Authorities
This seeming contradiction in both the Rambam and Shulchan Aruch has aroused much debate among poskim regarding how to rule in situations that commonly arise in modern times. It should be emphasized that one cannot simply sidestep the difficulty in their rulings by acting in accordance with the strictest possible interpretation. Rav Shlomo Zalman Auerbach (Teshuvot Minchat Shlomo 1:8 p. 58) writes that it is not proper to be more stringent than the letter of the law in these matters, as this behavior may pressure others to act excessively stringently and result in tragedies similar to the disaster in the battle recorded by the Gemara. We will now examine the approaches of three major authorities to practical cases.
I. Rav Tzvi Pesach Frank - The Strict Approach
Rav Tzvi Pesach Frank (Teshuvot Har Tzvi, Orach Chaim 2:10) presents the most strict approach to this topic. A physician who resided in Pardes Hannah and made an emergency trip on Shabbat to Hadera asked Rav Frank if he were allowed to drive home and turn off his car’s engine on Shabbat.
Rav Frank ruled that the doctor may not drive home on Shabbat. In fact, he even forbade the doctor to turn off his engine at the site of the emergency (a rabbinic prohibition - kibui she’einah tzerichah legufah). Rav Frank ruled that the Rabbis permitted the rescuer to do only certain specific activities on Shabbat, but not to engage in all rabbinically prohibited activities. Thus, while the physician could walk within Hadera’s techum (Shabbat boundary), no other restricted activity was permissible. Considering that Arabs have lived on the outskirts of Hadera since well before Rav Frank wrote his responsum (in 1950), an Arab could have transported the doctor back to Pardes Chanah on a donkey or horse and buggy, about a half-hour trip.14Binyamin Taub, a cousin of mine who lived in Hadera from 1935 until his death in 2003, informed me of these facts. Rav Frank does not, however, suggest asking an Arab to transport the doctor home, apparently because he does not even permit asking non-Jews to perform prohibited activities on Shabbat in order to return the doctor home.
Rav Frank does not address the contradictory statements of both the Shulchan Aruch and Rambam. Presumably he accepts the places where they rule strictly (that one may return all the way home only in cases of danger from enemies) as authoritative and believes that they serve to qualify the sources that do not spell out any restrictions on the rescuer’s ability to return home.
II. Rav Moshe Feinstein - The Lenient Approach
Members of Hatzoloh (New York’s Jewish volunteer ambulance corps) asked Rav Moshe Feinstein if they could drive home after completing a rescue mission on Shabbat (Teshuvot Igrot Moshe, Orach Chaim 4:80). Rav Moshe presented an original interpretation of the Gemara, Tosafot, and Rambam mentioned above and concluded that one may even violate Biblical prohibitions, such as driving, when returning from a rescue mission.15Driving a car repeatedly violates the Biblical prohibition of hav’arah (kindling a fire; Shemot 35:3), as every push of the accelerator feeds more fuel to the engine.
Rav Moshe focuses on the aforementioned comments of Tosafot, who imply that the Mishnah permits rescuers to return from their missions on Shabbat in order to ensure that they will not hesitate to undertake future rescue missions on Shabbat. Rav Moshe explains that had it not been permitted for the rescuers to return home, they would have been reluctant to undertake the mission. In order to avoid future tragedies, where someone might die because nobody came to save him, the Rabbis permit rescuers to return home from their missions. Although we have already noted that the Gemara interprets the word “rescue” in the Mishnah as referring specifically to soldiers, Rav Moshe writes that the Mishnah’s reasoning (as indicated by Tosafot) applies to midwives and other rescue personnel, too. This interpretation is quite innovative, as the Mishnah states that the midwife and rescuer may walk within the local Shabbat boundary of the area in which the rescue took place.16See Rashba, Beitzah 11b s.v. Biplugta (quoted in Rav Moshe’s responsum), who appears to support what Rav Moshe suggests to be Tosafot’s opinion. See Rav Yitzchak Isaac Liebes’s essay in Halachah Urefu’ah (3:73-85) for further analysis of the Rashba’s comments.
Rav Moshe also offers a unique resolution to the seemingly contradictory statements of the Rambam (and, by extension, the Shulchan Aruch). At first, the Rambam (Hilchot Shabbat 2:23) writes that rescuers are permitted to return home with their weapons, while he later limits this permission to cases in which the rescuers fear for their safety in the place where they have arrived (Hilchot Shabbat 27:17). Rav Moshe suggests that the first source addresses a short-term rescue mission, when the rescuers expect to act for a relatively short period of time (such as ambulance squad members on a rescue call). It sounds from the Rambam’s description of the battle that non-Jews suddenly came and threatened a city. Rav Moshe claims that the Rambam means that the hostilities suddenly flared up, so the soldiers thought that they could quickly repel the enemy and return home the same Shabbat. The Rambam’s later ruling, however, addresses a long-term task, such as a war. In this regard, the Rambam uses the vaguer phrase, “saving Jewish lives from non-Jews," which Rav Moshe interprets as meaning a general war. People in such situations may not return all the way home from their victory on Shabbat because they did not specifically expect their mission to end on Shabbat. Short-term rescuers, however, may return home on Shabbat because they do not expect to be away for an extended period of time, so they might hesitate to embark on another mission if it will separate them from their families for the entire Shabbat or festival.17Rav J. David Bleich (Contemporary Halakhic Problems 4:135) asserts that Rav Moshe is the sole authority to permit Biblical prohibitions in such a situation (see, however, Techumin 3:46, based on Teshuvot Heichal Yitzchak, O.C. 32, and Techumin 23:91). Rav Bleich (4:137) is particularly critical of Rav Moshe’s explanation of the Rambam, as he feels that Rav Moshe’s approach does not fit into the Gemara’s cases. Nonetheless, Rav Bleich does offer his own justification for Hatzoloh’s practice of returning home on Shabbat (see pp. 143-144, and see Teshuvot Minchat Shlomo 1:8, p. 59, where Rav Shlomo Zalman finds this justification difficult).
Based on his interpretation, Rav Moshe rules that Hatzoloh members may drive home from rescue missions, and I have heard that many Hatzoloh divisions follow his ruling in practice.18Rav Moshe does not clarify whether his ruling applies only to volunteers, or even to paid rescue workers. Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 21:59) assumes that Rav Moshe does not distinguish between volunteers and professionals. Also see note 7 above. It should be noted that there are other considerations that might permit the Hatzoloh workers to drive home on Shabbat and Yom Tov, as we shall later cite from Rav Yehoshua Neuwirth.
III. Rav Shlomo Zalman Auerbach - A Middle Approach
Rav Shlomo Zalman Auerbach (Teshuvot Minchat Shlomo 1:8) presents a detailed critique of Rav Moshe’s responsum.19Rav Shlomo Zalman writes that he received permission from Rav Moshe to publish this critique. This is a beautiful example of the Gemara’s statement that great Torah scholars should act pleasantly towards each other when debating Halachah (see Sanhedrin 24a). Rav Shlomo Zalman writes that the Talmud, Rambam, and Shulchan Aruch clearly indicate that a rescuer may return home with his weapons for only one reason - actual fears for his safety in the place where he performed the rescue. Thus, a physician may drive home only when he made an emergency call to a dangerous place. Rav Shlomo Zalman remarks, however, that if the physician has treated a patient in the safety of a hospital on Shabbat, why should he not remain in a comfortable office for the duration of Shabbat?!
Moreover, Rav Shlomo Zalman asserts that the Gemara never raises the concern that someone will refuse to save lives due to his desire to spend Shabbat and Yom Tov with his family.20In a later responsum (Tinyana 60:18), Rav Shlomo Zalman indicates that his primary objection to Rav Moshe’s view lies in the absence of an explicit source in the Talmud and Rishonim that permits a doctor to violate a Biblical prohibition when returning from an emergency call. He therefore rejects Rav Moshe’s interpretation of the Rambam and prefers the traditional explanation that the second passage in the Rambam qualifies the first. Accordingly, Rav Shlomo Zalman fundamentally adopts Rav Tzvi Pesach Frank’s approach, that the lone dispensation given the physician after a rescue mission is to walk within the techum of the place where he has arrived. Rav Shlomo Zalman writes, however, that since the Chatam Sofer (Choshen Mishpat 194), permits a doctor to ask a non-Jew to transport him home after a rescue mission, this may be done.21Riding in a car without driving does not appear to violate any prohibition per se (besides amirah l’nochri); see Teshuvot Har Tzvi (Y.D. 233) and Teshuvot Igrot Moshe (O.C. 1:132). Also see Contemporary Halakhic Problems (1:137-138), where Rav Bleich quotes a professor of physics, “Frequency of acceleration is by no means solely a function of the weight of the automobile.” Rav Shlomo Zalman cautions, though, that the Chatam Sofer’s ruling is itself based on an unconventional interpretation, so it may not be extended to permit doctors to themselves violate Biblical prohibitions in order to return home on Shabbat.22Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 11:39) also acknowledges that some of the Chatam Sofer’s responsa do seem to support Rav Moshe’s view, but he argues that most authorities do not accept this view, and he adds a possible alternative way to interpret the Chatam Sofer’s words.
Other Authorities
Rav Yehoshua Neuwirth (Shemirat Shabbat Kehilchatah 40:66-69) rules in accordance with Rav Shlomo Zalman. However, he permits the physician to ride in a taxi driven by a non-Jew only within the techum of the emergency situation. Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 8:15:7:12) also accepts Rav Shlomo Zalman’s ruling provided that serious concern exists that the doctor will otherwise stop saving people on Shabbat.23Also see Teshuvot Tzitz Eliezer 21:59, where Rav Waldenberg reiterates that he disagrees with Rav Moshe but adds that one should not castigate doctors who follow Rav Moshe’s view, and 22:95, where he writes to a doctor who was occasionally summoned more than once on the same Shabbat that it is completely permissible for him to ask a non-Jew to drive him home in his own car, so that, if necessary, he can return to the hospital quickly.
Rav Neuwirth adds a critical provision for many practical situations. He rules that an ambulance driver may return to his place of origin if the area he serves does not have another ambulance to meet the emergency needs of its residents. Similarly, it seems that a doctor may drive home if “reasonable chance” exists that he will be summoned to another emergency during that Shabbat or Yom Tov and will not be able to respond appropriately without his car. However, Rav Yitzchak Isaac Liebes (Halachah Urefu’ah 3:73) notes that this leniency applies only when the ambulance driver or doctor will not be able to respond to a call quickly from his current location. On the other hand, if the ambulance brought a patient to a nearby hospital and could simply go from the hospital to any future emergency in the area, then the driver may not return it to its original station.24Regarding Rav Moshe’s ruling that Hatzoloh members may return home on Shabbat even if their ambulance is not needed for additional emergencies on Shabbat, simply so they will not hesitate to undertake future rescue missions, Rav Liebes concludes his essay by questioning whether any classical sources permit violating Biblical prohibitions for this reason, and thus writes that the matter requires further study (tzarich iyun).
Rav Moshe Shternbuch (Teshuvot Vehanhagot 3:105) appears to fundamentally accept Rav Moshe Feinstein’s view (also see Techumin 23:91). Although he does not explain any of the sources in the manner that Rav Moshe suggested, Rav Shternbuch distinguishes between individuals who occasionally encounter a life-threatening situation and Hatzoloh members, who are constantly responsible for treating a large public. Ordinary citizens may not violate Biblical prohibitions on Shabbat in order to return from life-saving missions, as the aforementioned Gemara indicates,25Rav Shternbuch notes that Tosafot (Pesachim 46b s.v. Rabah) describe life-threatening emergencies as a rare occurrence. Thus, the traditional sources about returning from an emergency likely assume the same reality, which remains true for private citizens, but not for Hatzoloh members. and we do not worry that sometime in the future they will hesitate to embark on another mission. The possibility, however, that medical personnel will not respond to future emergencies on Shabbat itself constitutes piku’ach nefesh, as someone in their society always needs medical attention. In practice, Rav Shternbuch urges Hatzoloh to use reliable non-Jewish medics or Jewish medics who do not mind remaining at their destination until the end of Shabbat (also see Teshuvot Sheivet Halevi 6:26). If neither of these options exists, though, then he essentially permits using Jews who will return home on Shabbat, although he adds that Halachic authorities familiar with each community should rule regarding its ambulance corps.
Conclusion
We have outlined the basic views regarding the important question of whether medical personnel may drive home from an emergency on Shabbat. Rav Moshe Feinstein permits Hatzoloh drivers to drive home on Shabbat, Rav Shlomo Zalman Auerbach permits a doctor to summon a non-Jewish taxi driver to take him home, while Rav Tzvi Pesach Frank does not even permit a doctor to ask a non-Jew to drive him home.
We have presented only the basic considerations concerning this issue; many other variables must be considered in practical cases. Thus, competent Halachic guidance must always be sought by medical professionals who face this problem.
Avinu Malkeinu Shelach Refuah Shleimah Lecholei Amecha!
May God heal His nation’s sick!