06. Traveling to the Hospital

When rushing a patient to the hospital, one drives normally, as he would during the week. He should not try to drive with a shinui, as this may cause delay or be dangerous. One may travel to the hospital in a private vehicle or call an ambulance. All items necessary for the patient or woman in labor – vital medications, medical documents, and proper identification – may be carried from the house to the car, even in an area without an eruv. Even items that are not vital to saving lives but are important to the patient or his chaperone – including changes of clothing, food, and books – may be taken to the hospital. If there is no eruv, such items should be carried with a shinui. In addition, the person carrying them should walk directly from the house to the car without stopping, so that the act of carrying will qualify as a shvut di-shvut, which is permitted in a case of great necessity. Muktzeh items may not be brought, but if they were packed in the hospital bag together with necessary items, one may bring the bag. Muktzeh items that will be greatly needed after Shabbat – such as money and a cellphone – may be placed in the bag on Shabbat using a shinui and brought to the hospital along with the bag.[5]

After arriving at the hospital and parking in a place that does not interfere with the arrival of other vehicles, it is, at first glance, forbidden to turn off the car. After all, thus far all travel was for the patient’s sake; in contrast, one turns off the car for the sake of the car itself – to lock it and to make sure that the batteries do not die. Therefore, when possible, one should ask a non-Jew to turn off the car’s motor and headlights and then to lock the car.

If no non-Jew is available, or if searching for one is likely to delay attending to the patient, one may turn off the car and headlights with a shinui, so that the prohibition is only rabbinic. For example, he may grasp the key or press the button that operates the headlights with the back of his fingers. He should also lock the car with a shinui, for example, by pushing the remote control with the back of his fingers. Then, even though the headlights will go on as a result, it will have been done with a shinui. The reason all this is permitted is that the Sages allowed one to take such steps at the end of a rescue effort to ensure that people are willing to do what needs to be done at the beginning. After all, if a driver knows that he will not be able to turn off and lock his car upon arrival at the hospital, the next time he might avoid taking the patient to the hospital altogether. Therefore, the Sages permitted transgressing any rabbinic prohibitions to make it easier for those individuals helping to save lives.[6]


[5]. Many maintain that one may carry vital items if one simply walks from the house to the car without stopping (as our streets are considered a karmelit according to many, and if he walks without stopping there is no Torah prohibition according to most poskim; see 21 n. 3). Under pressing circumstances, if one cannot figure out how to incorporate a shinui, one may rely upon these authorities. However, le-khatĥila it is proper to carry items with a shinui, thus meeting the requirements of all the poskim.
Many halakha books have lengthy discussions about how to drive with a shinui. However, concerning oneself with this is likely to make it more difficult to save lives, and sometimes could even endanger the driver and passenger. Therefore, the rule is that one should drive without a shinui. Only one who knows how to incorporate a shinui without endangering anyone’s life should do so. Nishmat Avraham (278:4, n. 37) presents this approach in the name of R. Shlomo Zalman Auerbach. Regarding muktzeh items, see Harĥavot. A soldier who is called up on Shabbat may take his tefilin with him, because under pressing circumstances we rely on those who maintain that tefilin are not muktzeh (above, 23:8).
[6]. See SSK 40:72, nn. 146, 153; Nishmat Avraham 278:4, nn. 24, 28; Yalkut Yosef 330:8. Whenever a shinui is used to perform Kibui, it is a shvut di-shvut, and is permitted in order to prevent loss (above, 9:11). However, when one uses a shinui and the headlights are turned on, there is only one shvut involved. Nevertheless, it is permitted because the Sages allowed desecrating Shabbat at the end of a rescue effort in order to ensure that there is no hesitation at the beginning. Perhaps there is another possible reason for leniency: the act of locking the car, which causes the headlights to turn on, might be merely rabbinic, as it is a psik reisha de-lo niĥa lei (since one is not interested in activating the headlights).
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