If the patient is released after it is determined that he is not in danger, he and his chaperones may not desecrate Shabbat to return home. If necessary – for example, if the patient needs rest – he may be transported home by a non-Jewish driver. However, the chaperone may not ride along unless the patient needs help en route (see below, 28:2).
Similarly, if a woman is rushed to the hospital to give birth and then released after an examination reveals that she is not yet ready to give birth, she may not desecrate Shabbat to return home. In a time of need, if she is still considered sick – for example, if she needs to lie down – she may be driven home by a non-Jew, but her chaperone may not ride along.
A Jewish ambulance driver from an outlying community, which needs an ambulance for emergencies, may return to his community after transporting a patient to the hospital. However, he may not drive home the patient or his chaperone, as transporting them entails transgressing Torah prohibitions, since their added weight causes the engine to burn more fuel. Even if the prohibition were merely rabbinic, it would still be forbidden for them to ride home with a Jewish driver.[9]
If a Jewish ambulance driver in a city drives to treat a patient, he may not drive back to the EMT station afterwards on Shabbat. Since ambulances contain two-way radios, the driver can be contacted at his present location if he is needed for another emergency. However, if there is a real need to drive back – for example, if he expects that he will need an additional medic or more medical equipment for his next trip, or if resting at the station will enable him to treat people more effectively later – he may return to the station.
If an ambulance was summoned to treat someone in grave danger, but before the ambulance arrives another way to rush him to the hospital was found, someone must call and cancel the request for an ambulance, as it may be needed for a patient elsewhere while it continues to a destination where it is no longer needed. Additionally, there is a concern that medical personnel will not take things seriously when they are alerted on Shabbat in the future, thinking that their help might no longer be necessary but that no one has notified them because they do not want to make a phone call on Shabbat.
If a Jewish driver is transporting a woman in labor to the hospital, and during the drive she says that her contractions have stopped (to the point that, if she were at home, she would not consider going to the hospital), he may not continue driving. He must stop and park in a safe place until Shabbat is over (R. Shlomo Zalman Auerbach). If the ambulance must be returned to the station for reasons of piku’aĥ nefesh, the driver returns to the station, and the woman and her chaperone may remain in the ambulance and return with him.
A Jewish doctor who is summoned to treat a gravely ill patient may drive to the patient without ascertaining the details, since even the possibility of saving a life overrides Shabbat. Nevertheless, it is preferable that he call to clarify the patient’s state, since it is possible that the clarification will lead the doctor to decide that the trip is unnecessary, and it is preferable to minimize the Shabbat desecration. Even when it is clear that the patient is gravely ill and requires the doctor, the phone conversation is still useful. First, it is possible that the doctor will be able to give specific instructions for how to care for the patient until he arrives. Additionally, it may become clear to the doctor that he needs to bring additional equipment with him.[10]
[9]. As explained in the next section and in n. 12, the Sages’ permissive ruling that “the end is permitted because of the beginning” applies primarily to doctors, nurses, and emergency medical volunteers, who often need to travel on Shabbat. If we would not make it easy for them to return home, there is a real concern that in the future they will avoid setting out in the first place. In contrast, the Sages were not lenient for the patients themselves and their chaperones because there is no concern that they will hesitate to come in the future. After all, a person will always be concerned about his own health. Moreover, the incidents are infrequent and would not regularly disrupt the patient’s Shabbat rest. However, in a time of need a patient may return home with a non-Jewish driver because one may instruct a non-Jew to perform melakhot that are prohibited by Torah law on behalf of a sick person, even if there is no danger to life (SA 328:17; MB ad loc. 47; below, 28:2). However, there are no grounds for leniency for a chaperone, as his added weight would cause the engine to burn more fuel (Nishmat Avraham 278:4 and n. 47; 330:9). But if the patient requires a chaperone on the trip back, the chaperone may travel with the patient and the non-Jewish driver.
[10]. The Talmud states in Eruvin 32b that it is preferable for a learned person to transgress a minor prohibition in order to save an unlearned person from unknowingly transgressing a severe prohibition. This is the ruling of SA 306:14 and MB ad loc. 56, which state that one should desecrate Shabbat to save a Jew from apostasy. Based on this, when an ambulance was summoned but an alternative arrangement was made after the request was issued, one should call and cancel the request. Compared to driving on Shabbat, which involves multiple violations of Mav’ir, making a phone call is a less severe transgression. However, R. Shlomo Zalman Auerbach opposes this approach, presenting a strong argument: there is no transgression involved in traveling to save lives, so calling to cancel does not minimize Shabbat desecration (cited in Ha-tzava Ka-halakha 32:1, n. 3). Torat Ha-yoledet ch. 21 n. 2 makes the same point in the name of R. Yosef Shalom Elyashiv. Nevertheless, R. Chaim Pinchas Scheinberg comments there that even those who are undertaking lifesaving work should minimize Shabbat desecration, as MB states in 328:35. It would seem, though, that someone must cancel the request for an ambulance for a different reason: to potentially save another life. There may be someone elsewhere who is gravely ill, and the ambulance will not be available to help him if it is making this unnecessary trip. In addition, a false alarm is likely to cause the emergency medical workers to hesitate in the future, especially if they know that on Shabbat people will not call to cancel the request for a doctor or an ambulance.
If a Jewish ambulance driver is in the process of driving a woman in labor to the hospital and her contractions stop, he may not continue traveling (R. Shlomo Zalman Auerbach, Minĥat Shlomo 1:91:21; Nishmat Avraham 330:25 and n. 7). However, if he is from an outlying community and must return there with the ambulance, he need not stop to drop off the passengers before he returns to the station. Doing so would require additional violations of Mav’ir with respect to the lights and the engine. Since the passengers are already in the vehicle, they may return with him.
