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.
gAfter 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.tmize 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would say that it is unnecessary to use a shinui, one should le-khatĥila follow the majority opinion, that Shabbat is superseded, when possible (see Harĥavot).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.
. See SSK 40:72, nn. 146, 153; Nishmat Avraham 278:4, nn. 24, 28; Yalkut Yosef 330:8. Whenever a shinui is used to turn off a car, 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).