05. Using a Shinui to Minimize Shabbat Desecration

https://ph.yhb.org.il/en/01-27-05/

When dealing with saving lives on Shabbat, a serious dilemma arises. On the one hand, it would seem to be preferable to use a shinui when doing whatever melakhot are necessary. After all, when a melakha is done in the normal way, one violates Torah law, while when it is done with a shinui, one transgresses only rabbinically (above 9:3). On the other hand, when it comes to saving a life on Shabbat, the Sages proclaimed that “One who acts quickly is to be praised” (Yoma 84b; SA 328:2). If so, it would seem preferable to refrain from placing constraints upon one who is attempting to save a life. Rather, he should act as he would on a weekday, as efforts such as minimizing Shabbat desecration or attempting to do the melakhot with a shinui are likely to slow him down. This is especially true if he thinks it is necessary to consult with a rabbi about how to act when a person’s life is in danger.

In practice, the basic principle is that rescue efforts must be undertaken in the best and fastest way possible. If trying to do melakhot with a shinui is likely to delay treatment, it is preferable to do them in the normal fashion, without any shinui. This is because according to halakha, the rescuer may do melakhot in the normal way, since saving a life overrides Shabbat. Nevertheless, when it is clear that a shinui will not hamper the rescue in any way, it is preferable le-khatĥila to make use of a shinui. Therefore, it is advisable for doctors, nurses, and emergency medical workers to learn how to minimize Shabbat desecration while saving a person’s life.

There is a similar dilemma regarding treatments normally administered to a gravely ill patient during the week, some of which are not necessary to prevent his death. Since the caregivers do not know which treatments are truly necessary and which are not, they must treat the patient just as they would treat him during the week. However, one who understands medicine and knows for certain that a specific melakha is not necessary to save the patient, or that the treatment can be postponed until after Shabbat, he should avoid doing the melakha on Shabbat (SA 328:4). Palliative treatments are administered on Shabbat even when it is clear that they do not treat the disease, because when the patient’s pain is reduced, he will have more strength to overcome his illness.[4]


[4]. At first glance, according to those who maintain that Shabbat is suspended (hutra) by danger to life, all treatments normally administered to the patient are permitted, and there is no need to use a shinui or to minimize prohibitions. Indeed, this is implied in SA 328:4: “We do everything for him [on Shabbat] that we do for him during the week.” However, BHL, s.v. “kol” states that since the vast majority of Rishonim maintain that Shabbat is merely superseded (deĥuya) by danger to life, one should not do melakhot that are prohibited by Torah law unless they are necessary to save a life. Additionally, Rema writes in 328:12 that when possible, it is proper to employ a shinui when doing a melakha. Nevertheless, it seems that in practice there is almost no disagreement. Even according to MB, we must do anything that effectively minimizes the patient’s pain or strengthens him, because this can indirectly affect his ability to heal (SSK 32:22, 57). On the other hand, when it is possible to do the melakha with a shinui without causing any delay or hesitation, it is preferable to do so, as in the case of a woman in labor (SA 330:1). This is also the opinion of Ben Ish Ĥai, Year 2, Tetzaveh 15. Indeed, although some maintain that a woman in labor is an exceptional case, and that for any other sick person one should not do anything differently from what would be done during the week (Or Le-Tziyon 2:36:2-3; Halikhot Olam vol. 4, Tetzaveh 1:4), it nevertheless seems, as I wrote in the main text, that when there is no concern that using a shinui will delay treatment, it is preferable to use a shinui and minimize Shabbat desecration. This can be seen in Menaĥot 64a and SA 328:16, which state (in the context of cutting figs for the needs of a gravely ill person) that one should minimize Shabbat desecration. At the same time, in order to make sure that people will not hesitate to take care of sick people, the basic instruction is that on Shabbat we do for the sick person “everything that we do for him during the week” (SA 328:4). Anyone who acts accordingly, even if he could have incorporated a shinui, has acted properly, as saving a life overrides Shabbat. In my humble opinion, it seems that all poskim would agree with this delineation. Even if those who maintain that Shabbat is suspended would say that it is unnecessary to use a shinui, one should le-khatĥila follow the majority opinion, that Shabbat is superseded, when possible (see Harĥavot). Hospital administrators should examine their Shabbat procedures, including the arrangements for operations, tests, changing sheets, and food preparation, in order to minimize transgressing as much as possible without harming the standard of care. It is also proper to use non-Jews for Shabbat shifts whenever possible.
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