If a doctor has a shift on Shabbat morning and lives too far away from the hospital to reach it on foot, he must drive to the hospital before Shabbat so he will not have to desecrate Shabbat. Be-di’avad, if he did not drive to the hospital beforehand, he may drive there on Shabbat, since saving a life overrides Shabbat. Nevertheless, if he knows before Shabbat that he will have a shift on Shabbat, he must arrange to spend Shabbat in the hospital or nearby (Igrot Moshe, OĤ 1:131).
The best solution for doctors and nurses in such a situation is to hire a non-Jewish driver to drive them from their homes to the hospital. This way, these doctors and nurses can enjoy Shabbat in their homes, and then when they need to go to the hospital, they can get there with the help of a non-Jew. Even though the Sages prohibited benefiting from melakha performed by a non-Jew on Shabbat (above, 25:1), they permitted this for the sake of a sick person.
Doctors and nurses who finish their shifts on Shabbat morning may return home with the help of a non-Jewish driver. The Sages ruled that those involved with saving lives on Shabbat may transgress rabbinic prohibitions in order to return home, so that they will not be tempted in the future to refuse to go in the first place. If they are forced to stay in the hospital until after Shabbat, it will be very upsetting for them and their families, and we are concerned that as a result they will quit their jobs or avoid working shifts on Shabbat.
. In a place where using a non-Jewish driver is not possible, R. Shlomo Zalman Auerbach says (in opposition to Igrot Moshe) that a doctor may stay at home until he needs to go to the hospital for his shift. When the time comes for him to leave, since it is for a lifesaving endeavor, he may drive to the hospital. Even though it is true as a rule that one should prepare before Shabbat to obviate the need for Shabbat desecration, there is no need to take the very difficult step of spending all of Shabbat away from home, thus harming both his oneg Shabbat and his family time. However, R. Shlomo Zalman Auerbach emphasizes that one should be lenient in this case only if the hospital administration makes serious efforts to prevent unnecessary Shabbat desecration. Therefore, in his opinion, one should not in fact be lenient in this situation nowadays, as it is possible to arrange for a non-Jewish driver. With a non-Jewish driver, one may also be lenient and travel farther than twelve mil, which some say is the teĥum by Torah law (SSK ch. 32 n. 106; ch. 40 n. 71; see the end of the next note).
. The Mishna in Eruvin 44b states that those who set out on a rescue mission outside of the teĥum may travel 2,000 amot in any direction, the same as anyone else at their destination. Tosafot (s.v. “kol”) comment that this is an example of the rationale of “the end is permitted because of the beginning,” where certain actions at the end of an undertaking are permitted in order to ensure that people will be willing to do what needs to be done at the beginning. For instance, if we do not allow the rescuers 2,000 amot of movement, they will hesitate to undertake the rescue mission in the first place. Similarly in RH 23b, the Talmud states that a midwife who traveled beyond the teĥum on Shabbat may then travel 2,000 amot as well. This is the ruling of SA 329:9 and §407. See below, 30:11. Most poskim limit this rationale to rabbinic transgressions (MA 497:18; Tzitz Eliezer 11:39), and they do not always permit these either (Har Tzvi, OĤ 2:10; Minĥat Shlomo 1:8). However, Minĥat Shlomo, Mahadura Tinyana 60:11 permits returning with the help of a non-Jewish driver if it is within twelve mil. Some maintain that when necessary, this principle overrides even Torah prohibitions, to ensure that people will not hesitate before setting out on future lifesaving trips (see Ĥatam Sofer, OĤ 203; Igrot Moshe, OĤ 4:80; Amud Ha-yemini §17). See Ha-tzava Ka-halakha 24 n. 18; Orĥot Shabbat 20:59-61 and Essay 5 at the end of the work; SSK 40:81, 83; Nishmat Avraham 278:4 and n. 47.
In practice, since it is possible to arrange for a non-Jewish driver to take doctors and nurses back to their homes, under no circumstances should one be lenient and drive home on Shabbat with a Jewish driver. If no non-Jewish driver is available, there is no concern that in the future they will hesitate to go to the hospital in the first place because of this one instance. With a non-Jewish driver, one may be lenient and drive even beyond twelve mil, since according to most Rishonim even this distance is only a rabbinic prohibition (Rosh and Rashba; see below 30:1). In addition, when people are inside a vehicle, the road is a karmelit and the Jewish passenger is not actively doing anything, so there is a strong case to say that even those who are stringent regarding twelve mil would not maintain that any Torah prohibition is involved (see Assia 7, pp. 241-249).