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27 – Sick People and Saving Lives

01. The Principles of Piku’aĥ Nefesh (Saving a Life)

Saving a life overrides Shabbat, as the Torah states: “Keep My decrees and laws, which a person shall do and live by; I am the Lord” (Vayikra 18:5). The Sages expound: “‘live by’ – and not die by” (Yoma 85b); the mitzvot of the Torah were given so that people may live by them, not die to fulfill them.[1]

We desecrate Shabbat to attempt a rescue, even if the chances of its success are slim. Thus, we desecrate Shabbat to bring someone medication, even if it works in only a small percentage of cases, and even if it is an experimental drug that might not be effective. However, we do not desecrate Shabbat to acquire a drug if there is no substantive reason to think that it might help (MA 328:1; Rema, YD 155:3; Orĥot Shabbat 20:7).

In a case of uncertainty, we still desecrate Shabbat. For example, if a building collapses, and we do not know whether anyone was inside, and even if someone was inside, we do not know whether he is still alive, we clear away the rubble on Shabbat despite the uncertainty (SA 329:2-5). The act of clearing rubble (“mefakĥin et ha-gal”) lends its name to the general category of piku’aĥ nefesh, which overrides Shabbat.

Even if a rescue attempt fails, God rewards all who made an effort. Similarly, if several people drove to different places to obtain a certain medicine that someone needed, they all receive divine reward, even though some of them traveled for naught (Menaĥot 64a; SA 328:15).

Even though one may desecrate Shabbat to save a sick person, one who knows that he will need to care for a dangerously sick person on Shabbat should prepare as much as possible beforehand to minimize the melakhot he will perform on Shabbat, since one must prepare for Shabbat before Shabbat (MB 344:11). If it is uncertain whether one will need to care for a sick person on Shabbat, it is good for him to prepare before Shabbat, though it is not obligatory (MB 330:1). For instance, if one sometimes is called upon to care for the wounded, he should preferably prepare adhesive and cloth bandages before Shabbat so that he will not have to cut them on Shabbat.

It is good for a woman who is due to give birth to prepare her hospital bag before Shabbat. If the expectant couple is planning to drive to the hospital in their car, they should preferably remove unnecessary items from the car before Shabbat. However, the expectant mother does not need to spend the Shabbatot near her due date close to the hospital, as that is an excessive burden that one is not required to undertake on Friday. If she has to travel to the hospital on Shabbat, she may do so, since saving a life overrides Shabbat (SSK 32:34 and 36:6-7).

[1]. Saving a life overrides all mitzvot, with the exception of the three cardinal sins: idolatry, murder, and sexual transgressions. Concerning these three, the rule is “One should be killed and not transgress” (San. 74a; MT, Laws of Torah Principles 5:1-2). The punishment that the Torah prescribes for Shabbat desecration is stoning, the most severe punishment in the Torah and the same punishment specified for idol worship. Nevertheless, when it comes to lifesaving activities, performing melakha on Shabbat is not considered a transgression. In contrast, the three cardinal sins are considered transgressions no matter how dire the situation. This is because if one transgresses one of them, his life loses all meaning, and he brings death and destruction to the world.

02. Determining Danger

Any illness that doctors normally consider dangerous or that regular people would make haste to save a patient suffering from it is deemed dangerous halakhically, even if only a small minority of people die because of it, and therefore justifies desecrating Shabbat. Thus, one may drive a woman in labor to the hospital, even though in a clear majority of cases she can safely give birth at home (Magid Mishneh 2:11). However, one may not desecrate Shabbat on account of illnesses and risks that are generally not considered dangerous (Shevet Mi-Yehuda 1:19:2; SSK ch. 32 nn. 2 and 23).

The Sages defined certain conditions as dangerous. These include internal injuries (severe pains or wounds or internal bleeding); injuries on the back of the hand and foot (that is, infections and dangerous cuts); very high fevers; scorpion or snake bites; and eye afflictions (SA 328:3-9). The Sages determined all of these cases based on experience, and today’s doctors agree in principle, though they use different terminology to describe the conditions. This is not the place to expand on the definition of a life-threatening condition, but there is a general principle: If those present think that the ill or injured party might be in mortal danger, they immediately do whatever is necessary to help him. If they need to call a doctor, they should do so; if they need to drive him to the hospital, they should do so.

When the people nearby do not know whether the patient might be in danger, they should ask a doctor, nurse, or medic in the vicinity, or they should call a doctor. If the doctor thinks that the patient might be in mortal danger, even if the patient claims that his condition is not dangerous, they must heed the doctor (SA 328:10 and 618:1, 5).

If the patient maintains that he is in danger, then even if the doctor thinks he is not, we must desecrate Shabbat and take him to the hospital to be examined. This is because “The heart knows its own bitterness” (Mishlei 14:10), meaning that sometimes only the patient can assess his own condition. Similarly, if a sick person demands a certain medicine or treatment that, based on his experience, could save his life, we heed him (SA 618:1). We only rely on the patient’s intuition on condition that it makes some sense. However, if his illness is known and he demands a treatment that the doctors believe is ineffective, we heed the doctors (BHL 328:10, s.v. “ve-rofe”). Similarly, if the sick person is known to be hypochondriac or excessively fearful and a medically knowledgeable person is certain that he is not in any danger, we do not desecrate Shabbat on his account.

If, in an effort to be pious, one asks a rabbi whether to desecrate Shabbat in order to help someone in mortal danger, he is a killer, for while he is asking, the patient’s situation may deteriorate, and the Torah commands us: “Do not stand idly by the blood of your neighbor” (Vayikra 19:16). Furthermore, the rabbi whose students ask such questions is reprehensible, as he should have taught them that saving a life overrides Shabbat (y. Yoma 8:5; MB 328:6).

03. For Whom Do We Desecrate Shabbat?

The Sages offered a rationale for desecrating Shabbat to save someone’s life: “Desecrate one Shabbat so that he will observe many Shabbatot” (Yoma 85b). However, in practice, even when it is clear that the person being saved will not observe Shabbat, one is commanded to desecrate Shabbat to save him because the Torah strives to increase life. Therefore, we desecrate Shabbat to save a mentally impaired person (shoteh), who is exempt from observing the mitzvot. Similarly, we desecrate Shabbat for someone who is unconscious and about to die, in order to prolong his life for a short while (BHL 329:4, s.v. “ela”).

We desecrate Shabbat in order to save an unborn fetus, even if forty days have not yet passed since conception (Behag; Ritva; BHL 330:7, end of s.v. “o”). Similarly, we desecrate Shabbat to save a premature baby. Although in the past it was forbidden to desecrate Shabbat to save a baby born in the eighth month, whose nails and hair had not yet grown in, as it was certain that it would not survive, nowadays, with the improvement of medicine and the invention of the incubator, whenever doctors assess that the baby has a chance of long-term survival, we desecrate Shabbat to save him. (See SA 330:7-8; SSK 36:12 and n. 26.)

Technically, a Jew may not desecrate Shabbat to save a non-Jew, since one may only desecrate Shabbat for the sake of someone who is himself commanded to keep Shabbat. However, in practice, this rule only applies when another non-Jew is present to save his fellow non-Jew. If no other non-Jew is present, one must treat the non-Jew, even if this requires desecrating Shabbat. Since we want non-Jews to save Jews, we must save them as well. Thus, saving a non-Jew’s life is included in the category of piku’aĥ nefesh.[2]

[2]. The basis of this permissive ruling, namely, that it ultimately prevents danger to Jews, is articulated in Ĥatam Sofer, YD 131 and Divrei Ĥayim, OĤ 2:25. Similar rulings appear in Igrot Moshe, OĤ 4:79; R. Shlomo Zalman Auerbach, cited in SSK ch. 40 n. 47; Tzitz Eliezer 8:15:6 and 9:17:1; and Yabi’a Omer 8:38. Additionally, according to Ramban (Hasagot Le-sefer Ha-mitzvot, Hosafot Le-mitzvot Aseh 15), we desecrate Shabbat to save a ger toshav (a “resident alien,” a non-Jew who has accepted the seven Noaĥide laws before a beit din). This is also the opinion of Rashbatz. Others maintain that even if a non-Jew did not accept the Noahide laws before a beit din, if he observes these laws in practice, he is considered a ger toshav (Maharatz Ĥayot; R. Meir Dan Plotzky). This is also the opinion of R. Naĥum Rabinovitch in Melumdei Milĥama, p. 143. Many others maintain that we do not desecrate Shabbat for a ger toshav, and that this category does not even exist nowadays. However, according to all opinions, in practice we desecrate Shabbat to save the life of any person, as explained above. In a hospital that operates in accordance with halakha, it is preferable to have non-Jewish doctors and nurses on duty during Shabbat. If non-Jewish patients arrive, the non-Jewish medical staff can care for them. If a Jewish doctor has the most expertise on an illness afflicting a non-Jewish patient, and during the week such a case would normally be referred to him, the Jewish doctor treats the non-Jewish patient, even if this will involve performing melakhot that under normal circumstances are prohibited by Torah law.

04. Using a Non-Jew or Child to Minimize Shabbat Desecration

As we have seen (above, 25:1), a Jew who performs melakha on Shabbat violates Torah law, whereas a Jew who asks a non-Jew to perform melakha for him violates rabbinic law. Similarly, a minor who performs melakha on Shabbat only transgresses rabbinically (above, 24:1). Consequently, it would seem, at first glance, that when it is necessary to do melakha in order to save a sick person, it is preferable to ask a non-Jew or a child to do it, thereby minimizing Shabbat desecration. However, the Sages stated: “These things should not be done by non-Jews or children, but rather by adult Jews” (Yoma 84b; SA 328:12). This means that even if a non-Jew or a child is present, one should not ask him to do the melakha. Only an adult Jew should do it. Rishonim offer two possible explanations for this rule. First, it is possible that a non-Jew or a child will hesitate and not act aggressively enough to help the sick person (Tosafot). Second, even when it is clear that they will act aggressively enough, we are concerned that those present might incorrectly conclude that an adult Jew may not desecrate Shabbat in order to help someone who is dangerously ill. Then, if faced with a similar situation sometime in the future, they might delay helping in order to look for a non-Jew or a child. In the meantime, the sick person might die (Ran).

Therefore, the Rishonim write that if many people are available to help the sick person, it is a mitzva for the most respected person present to do so, thus making it clear to everyone that saving a life overrides Shabbat and that there is no need to seek ways to minimize the melakha (Ri’az; Tashbetz; MB 328:34).

If the situation is less pressured, and it is easy to find a non-Jew or a child to do the necessary melakhot, and doing so will not cause any delay, then even though le-khatĥila an adult Jew may do whatever melakha is necessary to save a life, it is optimal greater enhancement to minimize Shabbat desecration by having a non-Jew or a child perform the melakhot (SSK 38:2). However, if there is even the slightest, tiniest shadow of a doubt that using a non-Jew or a child will delay the provision of lifesaving treatment, either now or in the future, it is better for an adult Jew to do the melakha.[3]

[3]. According to Rashba and Ran, Shabbat is superseded (deĥuya) by danger to life; in contrast, according to Maharam of Rothenburg, danger to life effectively suspends Shabbat and causes all melakha to become completely permitted (hutra). It would seem that according to those who feel that Shabbat is simply superseded, Shabbat desecration should be minimized whenever possible. Those melakhot that are necessary should be done using a shinui or by a non-Jew or minor. In contrast, according to those who maintain that Shabbat is suspended, everything may be done in the normal way and all is permitted le-khatĥila. In truth, there is little practical difference between these approaches, since even according to those who maintain that Shabbat is merely superseded, it is still preferable for a Jew to engage in lifesaving activity rather than a non-Jew (SAH 328:13), as stated in Yoma 84b. Rishonim there explain that if one asks a non-Jew to help, he might not act aggressively enough (Tosafot), or Jews who witness this might hesitate and not act aggressively enough in future cases (Ran). Therefore, even though Rema writes in 328:12 that it is preferable to use a non-Jew, a minor, or a shinui, almost all Aĥaronim follow SA’s opinion that it is preferable for a Jew to be the one to desecrate Shabbat to save a life (Taz; Eliya Rabba; Tosefet Shabbat; MB ad loc. 37; SSK 32:6). Nevertheless, when there is no concern about hesitation, either in the present or in the future, it is preferable to minimize Shabbat desecration and ask a non-Jew to do the melakha. After all, when Shabbat 128b discusses the case of a woman in labor who is not in a state of panic, it states that one should use a shinui if possible, in order to minimize Shabbat desecration. SSK 38:2 states this as well. The order of preference is: a non-Jew, a minor, a Jew using a shinui, and two Jews working together.

05. Using a Shinui to Minimize Shabbat Desecration

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.

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).

07. Choosing a Hospital and Doctor

When one must drive a gravely ill person or a woman in labor to the hospital, he should drive to the nearest hospital, in order to avoid additional Shabbat desecration. Even if there are better hospitals available, for routine matters, like births and treatment of injuries and common diseases, there is no significant difference between hospitals, so one drives to the closest one. Even if the patient or woman in labor prefers a more distant hospital because it is cheaper, has nicer rooms, or is more conveniently located for relatives who will wish to visit, since these are not medical considerations, one may not drive farther on Shabbat for any of these reasons. Similarly, if a woman is away from home for Shabbat and goes into labor, she should go to a local hospital.

When a case is more complicated and there is a medical reason to prefer a more distant hospital, one may drive there on Shabbat. For example, if the more distant hospital specializes in the treatment of the patient’s illness, or if the illness is complex, and the more distant hospital is already familiar with the patient and will therefore be able to provide the appropriate treatment more quickly, one may drive the patient there. So too, if a woman’s pregnancy is considered high-risk, and the distant hospital has a protocol in place for her needs, one may drive her there on Shabbat. Everything should be done in accordance with accepted medical recommendations. The more complicated and difficult the case, the farther one may travel to ensure the best care. Thus, if there is only a slight medical advantage, one may travel only slightly farther to gain that advantage. After all, during the week, sick people and women in labor are not advised to travel long distances to the best hospitals for every minor medical issue. So too on Shabbat, they may not travel farther to reach the best hospitals, since accepted medical recommendations do not demand it.

If a woman in labor claims that she will receive better medical care at a more distant hospital, even if her claim has no realistic basis, one may drive a bit farther in order to ease her mind, but not a lot farther. Even when one may extend the drive for a medical reason, it must remain within reason.

In general, it is preferable to go to a hospital that operates in accordance with halakha. On Shabbat, one may travel slightly farther in order to reach such a hospital. This way there will be less Shabbat desecration in the hospital, and the patient will feel more comfortable. However, one should not travel much farther for this purpose.[7]

[7]. If the more distant hospital has a medical approach that is more compatible with the patient’s or pregnant woman’s outlook (for example, a preference for natural childbirth over Caesarean sections), one may travel farther to get there. However, since this is not a clear advantage, and in most cases this difference in outlook does not come into play, one should not travel much farther to reach the preferred hospital for this reason.According to R. Eliezer Waldenberg, if there is no medical reason to prefer a more distant doctor, but the patient believes that the distant doctor is better, one must listen to the patient and call the preferred doctor, even when it involves additional Shabbat desecration (Tzitz Eliezer 13:55-56). As the Yerushalmi states: “A person does not merit to be healed by just anyone” (y. Nedarim 4:2). He also infers this from AZ 55a, which speaks of suffering resulting from the treatment of a particular doctor. Therefore, one must listen to a patient who demands a specific doctor. SSK 32:38 states similarly, as does R. Yitzĥak Zilberstein (Torat Ha-yoledet 7:2), who adds that if a woman in labor feels that the standard of medical care is better in the more distant hospital, one may travel there. He cites R. Scheinberg (n. 4) as saying that under normal circumstances, one should rely on the nearest hospital since we do not allow additional Shabbat desecration in order to put the patient’s mind at rest unless it is a situation where the Sages tell us that if we do not ease his mind, he will be in danger.

In my opinion, if there is no substantive medical reason to prefer the more distant hospital, but nevertheless the patient feels that the distant hospital is medically superior, one may travel a little farther, but not much farther. The reason for this is that for a dangerously sick person, we do everything on Shabbat that we would do during the week (Rambam; SA 328:3). However, going beyond this is overly indulgent. During the week, medical opinion is that it is proper to travel a little farther to ease the mind of a gravely ill person or a woman in labor, but that there is no need to travel much farther. A possible support for this position appears in another area of Shabbat law: during the course of a circumcision, one may cut away bits of skin that do not invalidate the circumcision, even though cutting them off on Shabbat would otherwise be prohibited by Torah law (Shabbat 133b; SA 331:2). This is because once circumcision overrides Shabbat, everything that is part of the circumcision process overrides it as well (Rashi). Thus, arguably, once one may travel on Shabbat, one may extend the trip a little to get to the hospital that the patient thinks is medically superior. However, to extend the trip greatly would mean that the patient would no longer view the extra travel as an addition to the basic trip but rather a separate trip – which may be undertaken only if it may save a life. In contrast, if the patient concedes that the more distant hospital is not medically superior, but he just has a better feeling about it, the trip should not be extended at all. See Torat Ha-yoledet ch. 7, end of n. 4. We should add that in the case of a complex illness, there can sometimes be a medical advantage if the patient is personally acquainted with a member of the medical staff.

  1. Zilberstein points out that one should not increase travel time in order to reach a hospital just because it has higher kashrut standards. However, if the more distant hospital will make a point of minimizing Shabbat desecration, it may be that it is preferable to travel to it, because of the principle (Menaĥot 63b, 72a) that it is better to transgress one melakha many times than several melakhot a few times each (Torat Ha-yoledet 7:3-4). We should add that it also may be that the sick person has more confidence in the medical staff at the religious hospital, in which case one may travel a little farther to reach it.

If a woman in labor tells an ambulance driver that she prefers the more distant hospital because she feels that it is medically superior, but the real reason for her preference is so that her family will be able to visit her, the resulting Shabbat desecration is her responsibility, since the driver has no way to know that she is lying. From his perspective, this may be a case of saving a life, on account of which one desecrates Shabbat.

08. Accompanying a Sick Person or Woman in Labor to the Hospital

A patient who is rushed to the hospital generally needs a chaperone, to offer support and to ensure that he is given proper care by the medical staff. Unfortunately, due to heavy volume of patients at a hospital, patients who are alone are sometimes overlooked. Therefore, if a family finds out that a relative has been hospitalized with a serious injury or illness and is alone in the hospital, one of the family members must travel there, even on Shabbat.

Similarly, a woman in labor must be accompanied to the hospital. Even if she does not request, someone – her husband, mother, or doula – should travel with her. If the woman in labor or the patient arrives at the hospital without a chaperone, it is permitted to call someone to travel to the hospital. Even though caring for a woman in labor is straightforward and familiar, there is still a concern that she will panic and endanger herself. Therefore, one may desecrate Shabbat on her behalf and do whatever he may do for a dangerously sick person (SA 330:1; MB ad loc. 3; BHL s.v. “u-madlikin”).

Recently, some women request the presence of both their husbands and their mothers at the hospital. Some also ask their doulas to attend. Since this is not a lifesaving medical necessity, only one chaperone may travel along – her husband, her mother, or her doula. Only in an unusual circumstance, such as when a woman becomes hysterical and insists that both her husband and her mother must accompany her, may they both do so. Similarly, if she experiences anxiety and demands that they call her doula, the doula may be called. Nevertheless, one may not plan for more than one person to accompany her on Shabbat.

Others disagree and maintain that one should do whatever the woman in labor wants, even if she is not hysterical. If she wants her husband, mother, and doula to come with her, they all travel along, to put her mind at ease. According to this approach, one may even make a detour in order to pick them up or call them to request that they make their own way to the hospital. However, this would seem to be excessive, and it does not legitimize driving on Shabbat. The widespread custom is that one person accompanies a woman in labor. However, if the drive is long and the husband is driving, the mother or doula may come along as well, since sometimes another person is needed to help the woman during the drive.

If the woman in labor has small children at home, one must prearrange for neighbors to care for the children in the event that the parents must travel on Shabbat. However, if they live in a remote location, or if the neighbors are bad or untrustworthy people, with whom it dangerous to leave children, and leaving the children home alone would also be dangerous, the children may travel with the parents to the hospital. One may also make a slight detour in order to drop them off with a family that can take care of them.[8]

[8]. One may violate Torah prohibitions in order to accompany a sick person or a woman in labor, just as one may light a fire for a woman in labor even when it is not truly necessary (SA 330:1; MB ad loc. 3; BHL s.v. “u-madlikin”). This is even more relevant today, when the generally accepted wisdom is that the patient needs someone to accompany him in the hospital in order to ensure that he receives proper care (Nishmat Avraham, OĤ 278:4 with n. 29, and 330:6 citing R. Yehoshua Neuwirth; R. Yoel Katan in Assia 9). If a non-Jew is available to drive the children to family or friends, one may ask him to do so, even if the neighbors can watch the children in a pinch. If it is not necessary to take a detour or make an extra trip to pick up the mother or the doula, even if the woman in labor is not completely hysterical, if she demands that they travel with her even on Shabbat, they may be picked up in a pinch. However, one may not plan for them to travel with her, because in fact there is no need for more than one person to escort her.

A woman in labor who wants to rely on the lenient opinion and have two people accompany her must be honest with herself regarding how much she truly needs the extra person. She should imagine that, for example, she went into labor on a Shabbat that her mother or doula happened to be hosting large numbers of guests for a son’s aufruf, when traveling to the hospital would mean deserting her guests until after Shabbat and missing her son being called up to the Torah. If, under such circumstances, the woman in labor would still demand that her mother or doula accompany her in addition to her husband, and they would still agree to go, this indicates that they really do consider their role in her childbirth potentially lifesaving, and they may accompany her according to the lenient opinion. However, if under such circumstances the woman in labor would forego their presence, it indicates that she does not consider their role to be life-saving. Accordingly, even on a regular Shabbat, she should suffice with one chaperone. The ambulance driver does not count as a chaperone, as he will not stay in the hospital with the patient or woman in labor (see Igrot Moshe, OĤ 1:132; Or Le-Tziyon 2:36:23; BHL 330:1, s.v. “u-madlikin”; Yalkut Yosef 330:9). It is proper not to rely on the lenient opinion at all, because adding another chaperone has no lifesaving value; the merit of keeping Shabbat is more effective.

09. Driving Home on Shabbat

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.

10. Doctors and Nurses Driving to Work and Back Home on Shabbat

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.[11]

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.[12]

[11]. 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).

[12]. 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).

11. Scheduling Surgeries and Circumcisions on the Days Preceding Shabbat

Sometimes, one may need to schedule a surgical procedure that will then require follow-up care involving the performance of various melakhot. Similarly, some procedures, such as the extraction of a wisdom tooth, cause pain for several days, which may impair one’s ability to enjoy Shabbat. If the surgery is not urgent, it is proper le-khatĥila to schedule it for the first three days of the week. However, if the best surgeon is only available during the second half of the week, the operation may be scheduled for then, even if it is possible to get an appointment at the beginning of the week with a less expert surgeon (see above, 2:10-11).

If a woman is due to give birth and her doctors decide that labor should be induced, it may be done on Friday, even though it is reasonable to assume that this will cause her to give birth on Shabbat (SSK 32:33 and the notes).

If an operation is urgent, it should not be postponed, even if it is possible to postpone it until the beginning of the week. This is because sometimes problems arise, and the surgery may be delayed beyond the time that is medically desirable.

If a baby boy was sick and his circumcision was delayed, poskim disagree whether the circumcision may be held on a Thursday or Friday. Some argue that since it has already been postponed beyond the Torah-mandated eighth day, the baby should not be circumcised on Thursday or Friday, because in the days following the circumcision he might require care that would involve Shabbat desecration. This is the custom in many Sephardic communities (Tashbetz 1:21; Rav Pe’alim, YD 4:28; Yabi’a Omer, YD 5:23). Others maintain that the likelihood of needing to desecrate Shabbat following the circumcision is not high, and since there is a mitzva to perform the circumcision as soon as possible, one should do so even on Thursday or Friday (Shakh, YD 266:18; MA 331:9). This is the widespread custom among Ashkenazic and Yemenite Jews, as well as some Sephardim.

12. Fighting Wars on Shabbat

It is a mitzva to wage a defensive war against Israel’s enemies. This mitzva is even greater than the mitzva of saving human life, as one is not required to risk his own life in order to save the life of another, or even multiple lives. In contrast, it is a mitzva – incumbent upon every individual – to risk one’s life to save the Jewish people from their enemies (Mishpat Kohen §143; Tzitz Eliezer 13:100; see Peninei Halakha: Collected Essays II 11:3).

Therefore, if enemies attack Israel, it is a mitzva to wage war against them even if this will endanger lives and require Shabbat desecration. Indeed, Rambam rules: “There is a mitzva incumbent upon all capable Jews to come to the aid of their brothers who are under siege, and to save them from non-Jews on Shabbat; they may not delay until after Shabbat…” (MT 2:23). Similarly, if it is known that enemies or terrorists are planning to attack Jews, it is a mitzva to attack them in order to deter them. If there is a strategic objective served by attacking them on Shabbat, we attack on Shabbat (Heikhal Yitzĥak, OĤ 37:3; Amud Ha-yemini §16; see Rema 329:6).

Furthermore, it is also a mitzva to wage war to prevent future danger, even though doing so will put lives at risk and require Shabbat desecration. This is in accordance with the statement of the Sages that if enemies come to pillage border towns, even if they are taking only straw and hay, “we attack them with weapons and desecrate Shabbat on their account” (Eruvin 45a). We do this because if our enemies know that they can steal without repercussions, they will ultimately end up attacking people. This is also the ruling of Shulĥan Arukh (329:6). Accordingly, it is a mitzva to perform ongoing security operations on Shabbat, to protect our borders from our enemies. Nowadays, the entire country of Israel has the status of border towns with respect to preventing terror attacks (R. Shlomo Goren). Therefore, throughout Israel, it is a mitzva to perform ongoing security operations on Shabbat, to protect life and property.

If Jews who do not observe Shabbat go on a hike on Shabbat in an area where it is necessary to travel with an armed escort, and there is no way to prevent them from hiking in the first place, it is a mitzva for soldiers to protect them, even if this entails Shabbat desecration. Even though it is the hikers’ Shabbat desecration that creates the need for security, nevertheless, since they are in fact in a dangerous place, they must be protected from the enemy (R. Goren, Meshiv Milĥama 1:7 and 2:110; see Ha-tzava Ka-halakha ch. 21). However, soldiers may not help them desecrate Shabbat. Thus, soldiers may not open checkpoints for them so that they can pass through, give them travel permits, or board their bus to enable them to set out. Only after the group is already underway may soldiers provide security for them.

Bodies of fallen soldiers may be retrieved from the battlefield on Shabbat to ensure that they do not fall into enemy hands. Even though technically one may not desecrate Shabbat in order to save corpses, since abandoning bodies harms the morale of soldiers, and since Israeli society is willing to free terrorists in order to retrieve bodies captured by the enemy, retrieving them from the battlefield prevents danger to life. After the bodies are recovered, one may not desecrate Shabbat any further to care for the bodies (Meshiv Milĥama vol. 1, p. 61 and 2:117; Ha-tzava Ka-halakha ch. 20).

The war to conquer the Eretz Yisrael is considered a milĥemet mitzva (obligatory war). Accordingly, when there is a tactical advantage, one may initiate an attack even on Shabbat, as our ancestors did in the days of Yehoshua when they conquered Yeriĥo on Shabbat (y. Shabbat 1:8; Tur, OĤ 249:1).[13]

[13]. A milĥemet reshut (discretionary war) should not be started on Shabbat, nor on the last three days of the week. However, if a war continues until Shabbat, even if it seems as if it will not hurt the war effort to stop fighting on Shabbat, we do not stop. As the Torah states: “You may cut [trees] down for constructing siege works against the city that is waging war on you, until it has been reduced” (Devarim 20:20). The Sages tell us: “We do not begin a siege against a non-Jewish town in the last three days of the week; but if it was begun, we do not stop. Shammai used to say that ‘until it has been reduced’ means even on Shabbat.” A milĥemet reshut is a war that is meant to extend the boundaries of Israel and increase its power. Such a war is undertaken only by a Jewish king and with the consent of the Sanhedrin (MT, Laws of Kings 5:1-2). It should be noted that in the past, when all monarchies would launch discretionary wars, the monarchy of Israel had to initiate such wars as well, in order to solidify its position. Had it not done so, it would have endangered its long-term survival.In contrast, a war undertaken to conquer Eretz Yisrael is a milĥemet mitzva, as Ramban writes (Hasagot Le-sefer Ha-mitzvot, Hosafot Le-mitzvot Aseh 4). A great many authorities agree with him (see Li-netivot Yisrael vol. 1 ch. 23: “Le-mitzvot Ha-aretz”). At first glance, it seems Rambam believes that conquering Eretz Yisrael is not included in the definition of milĥemet mitzva. However, he too concedes that if an enemy attacks, it is a mitzva to mount a defensive war, both because of the mitzva to settle the land (Devar Yehoshua, OĤ 2:48), and because of the danger to life (Melumdei Milĥama §1). See Ha-tzava Ka-halakha, pp. 7-10.

In Meshiv Milĥama 1:2, R. Goren analyzes the Gemara’s dictum, “‘until it has been reduced’ means even on Shabbat.” He extrapolates that permission to violate Shabbat for war is even more sweeping than permission to violate Shabbat to save a life. Specifically, a milĥemet mitzva completely suspends (hutra) Shabbat, whereas saving a life only supersedes (doĥeh) Shabbat. When Rambam limits starting a siege to the beginning of the week, he is referring to local battles, but an all-out war has no Shabbat limitations. It is as if Shabbat has been canceled entirely. However, many view the legitimacy of fighting on Shabbat as an expanded form of saving a life, since the soldiers are engaged in saving many lives. Others, based on MT 30:13, maintain that even for a milĥemet mitzva, we do not begin a siege at the end of the week. This is the opinion of Radbaz 4:77. Tur, OĤ 249, states that it is a milĥemet reshut that we do not start in the days preceding Shabbat, but we may start a milĥemet mitzva even on Shabbat itself. The entire disagreement is limited to a case in which there is no tactical advantage to beginning the war on Shabbat; but if starting the war on Shabbat is likely to save lives, then all agree that we may start the war on Shabbat. See Ha-tzava Ka-halakha 25:13, pp. 250-251.

13. A Commanding Officer’s Authority During Wartime and Normal Times

During a war, one must do everything possible for the sake of victory, on Shabbat as well. One may not delay matters by referring questions to rabbis, nor should he bother commanding officers by asking them what is or is not necessary. Rather, anything required must be done as quickly as possible.

In contrast, in normal times, when routine and ongoing security operations and intelligence-gathering are being carried out, Shabbat desecration should be minimized. Only activities meant to prevent life-threatening situations should be undertaken. When possible, it is preferable to use a shinui or another method that renders these actions prohibited on the rabbinic level only. To that end, the military rabbinate of the Israel Defense Forces (IDF) must establish special Shabbat procedures that enable each soldier to carry out his security operations while minimizing Shabbat desecration. Normally, one may not conduct training exercises on Shabbat. Only when forces are on high alert and there is a security need may soldiers be trained for an upcoming operation in which they will participate.[14]

When things function properly, one may rely on a commanding officer’s familiarity with both security needs and halakha, in accordance with the directives of the military rabbinate. Then, if he gives an order that entails Shabbat desecration, the implication is that it is necessary for security needs and must be obeyed. However, when there is reason to distrust the officer – whether because he does not take the rabbinate’s directives seriously, because the rabbinate is not fulfilling its responsibilities, or because the order is illogical – the soldier must clarify with his commanding officer whether the action requested is necessary for security. If, despite what the officer says, it is clear to the soldier that the order involves Shabbat desecration that is not necessary to maintain security, he may not obey the order, as one may not desecrate Shabbat except to save a life. If the soldier is uncertain, he must follow the order, because even the possibility of saving a life overrides Shabbat. However, after Shabbat he must clarify with the army rabbinate, and if necessary with his own rabbis, whether the order was legitimate or not. If it was not, he must file a complaint against his commanding officer and object to his actions, using all avenues available to him.

The primary way to determine if the purpose of an army operation is connected to piku’aĥ nefesh is to see how the army actually relates to the operation. If all week long it is taken seriously and viewed as indispensable to security, and it is carried out even if it involves missing rest time or canceling an entertainment program, then it may be done on Shabbat. However, if all week long it is not taken seriously, and the operation is sometimes canceled for the sake of convenience, then there is no license to desecrate Shabbat in order to do it.[15]

[14]. See the previous note. In an all-out war, R. Goren maintains that Shabbat is suspended. Even according to those who disagree and argue that Shabbat is only superseded, we must avoid doing anything that might prolong the war. As we saw above in sections 4-5, a shinui should not be used if it may delay victory, either now or in the future. In contrast, in normal times, when one can wait patiently to undertake an activity, he should minimize Shabbat desecration as much as possible. For example, one should begin with the least severe prohibition, similar to how a sick person should eat on Yom Kippur (SA 619:7-8). Rema YD 155:3 and Bi’ur Ha-Gra ad loc. 24 extend this principle to medical treatments in general. See above in 18:2, where we discuss when writing is necessary on Shabbat and how to minimize the prohibitions involved. See also Ha-tzava Ka-halakha 16:26 with n. 51, and 17:8.

[15]. It is difficult to define what level of danger justifies desecration of Shabbat, since there are endless dangers. Even routine life is full of danger – on the roads, while going for a walk, and even while climbing a ladder at home. Even the flu can become life-threatening on rare occasions. Nevertheless, we do not hospitalize everyone who contracts the flu. The rule is that if something is generally considered dangerous, and people take serious, directed action to avoid it, it is considered a danger for which one desecrates Shabbat. This is the position of R. Isser Yehuda Unterman in Shevet Mi-Yehuda 1:19:2, as quoted in SSK ch. 32 n. 2. R. Shlomo Zalman Auerbach and R. Eliezer Waldenberg (Tzitz Eliezer 9:17:8:22) agree with this position. Thus we can generally establish the halakha based on how people relate to the danger all week. See Ha-tzava Ka-halakha 16:8, 13, 14, 16-19.

14. Common Army Questions

Soldiers who are patrolling in a vehicle on Shabbat may not deviate from the established route in order to eat in a more convenient outpost or to meet up with friends, because driving is permitted to them only for the sake of security. However, if there is no specific patrol route, the soldiers may plan the route to suit their convenience. If they have a half-hour break to eat and rest, they may plan for that break to be at a place of their convenience. If they are expected to patrol inside settlements to make the army presence felt and to deter terrorists, they may park near a synagogue or somewhere convenient for eating.[16]

Soldiers who know that they will be commencing a military operation on Shabbat must spend Shabbat on their base, since if they travel home before Shabbat, they would have to desecrate Shabbat to return to the base (see MB 344:11). Even if the commanding officer is married and will greatly upset his family members by remaining on base, if the operation will definitely take place on Shabbat, he may not go home, since that would force him to travel back on Shabbat. However, if there is a chance that the operation will be canceled, he may go home for Shabbat. As long as it is not certain that the operation will be executed on Shabbat, he may try to preserve his and his family’s oneg Shabbat. The officer should be sure to explain to his family that since it is uncertain whether or not he will be called, he may remain at home. This way they will not belittle Shabbat observance. If he finds out on Shabbat that the operation is taking place, he may drive to the base. If it can be arranged for a non-Jew to drive him to the base on Shabbat, then even if he is certain that the operation will take place on Shabbat, he may go home for Shabbat and then have the non-Jew drive him to the base. After the operation, if a non-Jew is available to drive him home, he may travel with him. If no non-Jewish driver is available, he may not return home.[17]

If soldiers are summoned to deal with an incident, but before they arrive it becomes clear that they are not needed, they should be called and told not to come, in order to minimize Shabbat desecration. An additional justification for this is that if it later becomes clear to soldiers that they were not informed of the cancelation because people did not want to use the phone on Shabbat, there is a concern that if they are summoned again on Shabbat, they will hesitate to come (see above, n. 10).

If an observant soldier is assigned guard duty or patrol duty on Shabbat, it is good if he swaps his Shabbat assignment with a non-observant soldier’s weekday assignment as long as the non-observant soldier is willing and there is no concern that switching the assignments will cause the guard duty to be taken lightly. Thus, the observant soldier will be able to pray and enjoy Shabbat, and the non-observant soldier will accrue merit for enabling this. Additionally, while the non-observant soldier is guarding, he is doing a mitzva and not desecrating Shabbat. Nevertheless, the observant soldier need not initiate such a swap, because defending the country is a mitzva, and there is no need to seek ways to get out of it on Shabbat (see Ha-tzava Ka-halakha ch. 27).

[16]. The Talmud states in Yoma 84b that one may engage in actions that are aimed at saving lives even when the actions serve a secondary purpose as well. For example, one may use a net to retrieve a child who fell into a river, even if some fish will be caught as well. Similarly, one may build steps to rescue a child from a pit, even if these steps will be useful later on as well. This is the ruling of SA 328:13. All this is on condition that no additional melakha is done to achieve the secondary purpose. Rishonim disagree about whether one may intend to achieve the secondary purpose; this is discussed in SHT ad loc. 17. However, in the case of patrolling soldiers, even if they intend to eat at a convenient place, it would seem that all would permit this. After all, there is a slight tactical advantage in doing so, as they will be more refreshed as a result. See Ha-tzava Ka-halakha 17:6, pp. 172-3.

[17]. See section 10 and n. 11 above regarding a doctor who has a shift on Shabbat. It emerges from there that when it is certain that a military operation will begin on Shabbat, the officers and soldiers must spend Shabbat on the base. According to R. Shlomo Zalman Auerbach, they may spend Shabbat at home and then drive to the base on Shabbat, but the accepted ruling is to be stringent. Even if one could be lenient on a one-time basis, one may not rely on this leniency regularly (see section 2 and n. 7 above). Furthermore, R. Shlomo Zalman Auerbach himself did not rule this way in practice. He only said that one is not obligated to object if someone else is lenient (Ha-tzava Ka-halakha 26:19 and n. 41). Therefore, in practice, an officer who knows that he will need to lead an operation on Shabbat should remain on base. However, if there is a chance that the operation will be canceled, it would seem that a career officer may spend Shabbat at home. If he is called up, then he travels to the base. We must take into account that if we are too stringent and demand that he remains on base, the pressure from his family to leave the army will increase. Even though we do not use this reasoning to allow him to return home after an operation if Torah prohibitions are involved (as explained above in n. 12), nevertheless, before the operation, when there is some doubt about whether it will be carried out, he may be lenient. See further above, 2:10-11. If a non-Jewish driver is available, the officer may travel both ways with him just as doctors and nurses do, as explained above in section 10 and n. 12.

15. What Must One Give Up to Minimize Shabbat Desecration?

One need not forgo his Shabbat rest or anything else that is dear to him in order to minimize the Shabbat desecration of another person who is involved in lifesaving activities. In addition, there is a concern that if one is forced to forgo something dear to him, he will hesitate to do what is needed to remove a hazard. For example, if one sees fallen electrical wires that are exposed and deadly, he could theoretically stand there for all of Shabbat in order to warn passersby not to touch the wires. Nevertheless, if this is difficult for him – e.g., if Shabbat will not be over for hours – he may alert the electric company, which will send repairmen to fix the wires on Shabbat (R. Shlomo Zalman Auerbach, cited in SSK 41:21; Tzitz Eliezer 8:15:11:7).

If a gravely ill person’s home is so cold that it endangers his life, a neighbor whose home is heated need not be asked to inconvenience himself by taking in the sick person. Rather, the heat may be turned on in the sick person’s home, as saving a life overrides Shabbat. Even if the neighbor is asked to take in the sick person, he is not required to do so (based on the ruling of R. Shlomo Zalman Auerbach in SSK ch. 32 n. 174; he derives this from the rule that one need not forgo his property and may confront a burglar even if the results may be lethal).

Similarly, a soldier on guard duty need not volunteer to do an extra shift in order to prevent his replacement from traveling on Shabbat. Since one may travel on Shabbat in order to perform guard duty, the first guard does not have to forfeit his rest in order to prevent this travel.

If soldiers need to travel in tanks for a security mission but will destroy the eruv if they take the shortest possible route, they should take a longer route, unless all of the eruv’s beneficiaries agree to let it be destroyed. This is because the eruv’s beneficiaries do not have to forfeit their benefit just so that the tank driver can minimize driving on Shabbat. Similarly, one who is driving a patient to the hospital should not barrel through private or public gardens, even when that is the shortest route to the hospital. Rather, the driver must go around, because neither the individual nor the community is obligated to forfeit its gardens so that someone involved in life-saving travel can minimize his Shabbat desecration (R. Shlomo Zalman Auerbach, as cited in Ha-tzava Ka-halakha 26:4-7; see there for the dissenting opinion as well).

16. Police Activity on Shabbat

All agree that police officers must desecrate Shabbat to save lives. Thus, if a suspicious object is found, or if dangerous people are seen engaging in suspicious activities, one must call the police. If a serious fight breaks out that could turn lethal, one must call the police. If robbers break into a home and might harm the residents, one must call the police. However, according to some poskim, in a situation where there is no danger to life, a police officer may not perform melakhot that are prohibited by Torah law. For example, if thieves robbed a home and left, since there is no longer any danger to human life, one may not call the police. Even if the thieves are still in the home, but the residents are not home, since there is no danger to life, one may not call the police. Similarly, if one witnesses thieves breaking into a closed store or bank, one may not call the police. In addition, a police officer may not write up reports about a theft, fingerprint an apprehended thief, or transport a thief to the police station on Shabbat (SSK 41:24-25; Yalkut Yosef 329:20-27).

However, several leading rabbinic authorities maintain that one may call the police in order to prevent theft or property damage, and a police officer may respond by driving to the scene of the crime, because if property damage or theft is not dealt with on Shabbat, the crime rate will skyrocket, and ultimately people’s lives will be endangered. Within this opinion, there is debate about whether police officers may drive back to the station after an incident and whether they may perform regular patrols on Shabbat. Some are inclined to permit this when the drivers are not Jewish (Heikhal Yitzĥak, OĤ 32; Yaskil Avdi, OĤ 5:44; Tzitz Eliezer 4:4).

Our master and teacher R. Shaul Yisraeli (Amud Ha-yemini §17) allows Jewish police officers to drive on patrol, to drive back to the station after an incident, and to transport suspects. He argues that if we go easy on criminals or make it difficult for the police to do their jobs on Shabbat, police officers might quit or become hesitant in doing their jobs, and the crime rate will rise to the point that lives are endangered. Therefore, we may do whatever is necessary to prevent criminal activity on Shabbat. Furthermore, as we have seen, the Sages allow those involved with saving lives to return home, even though they will be carrying their weapons through a public domain. If we do not let them return, they might hesitate to go out to help people in the future (above, section 10).

Another factor supports this approach. As we have seen, the Sages stated that if a gravely ill person needs someone to take care of him, then even if a non-Jew is available, it is preferable for a Jew to undertake whatever melakhot are necessary to help him. If a non-Jew is asked to take care of him, it may happen that if someone is dangerously ill in the future and no non-Jew is available, people will be hesitant to desecrate Shabbat in order to help him (above, section 4). The same logic applies regarding police activity. If we restrict the ability of the police to catch thieves and prevent crime on Shabbat, ultimately this will lead to loss of life. We should add that nowadays some criminal activity in Israel is connected with terrorist activity. Therefore, the struggle against thieves is, to a large extent, also a struggle against terrorists, and thus directly involves saving lives.

According to all opinions, one may not call the police on Shabbat in order to fill out reports that are strictly financial, such as for the purpose of making an insurance claim or the like. Additionally, one may not call the police on Friday night to complain about noisy neighbors.

The police force should commission rabbis to review the entire array of police operations and determine, together with the police chiefs, what is vital and must be done on Shabbat and what is not. Similarly, they should establish special Shabbat protocols to minimize Shabbat desecration; for example, the officers can use a shinui whenever possible. They should also establish a procedure ensuring that if a non-Jewish police officer is on duty, he will be the one to drive and to write reports. All Jewish police officers should also be provided with a Shabbat pen, so that their writing will only be rabbinically prohibited (above, 18:2; see Harĥavot).

17. Mobile Phones and Weapons Necessary for Health and Security

In an area enclosed by an eruv, emergency medical professionals and volunteers who always carry beepers or cell phones may carry these devices on Shabbat. Similarly, one who always carries a pistol or rifle may carry it on Shabbat. Muktzeh is not an issue, because many maintain that a pistol is a kli she-melakhto le-heter, since its purpose is defense and deterrence. Similarly, since a two-way radio is designed to help save lives, it is also a kli she-melakhto le-heter. A cell phone is used primarily for calls that are unrelated to saving lives, so it is a kli she-melakhto le-isur. Nevertheless, one may carry such an object to use it le-tzorekh gufo, and therefore it may be carried to save lives.

However, in an area without an eruv, one should not carry these items. When there are life-saving reasons for people to remain close to weapons and communication devices in case of emergency, they may carry these items to places where one normally goes on Shabbat, such as to prayers and celebrations. If we do not allow this, no one will volunteer to undertake security and rescue efforts. In general, this consideration is used to permit rabbinic transgressions. Only under very pressing circumstances is it permitted for one to transgress Torah prohibitions (see above, n. 12). Therefore, one should carry the two-way radio with a shinui (for example, under one’s shirt), which makes the transgression rabbinic. However, one should carry the gun normally, because it would be dangerous to carry it with a shinui. Additionally, some maintain that for security personnel, a weapon is not considered something that is carried, but an article of clothing that is worn.[18]

However, one may not carry a gun or a two-way radio on Shabbat for the sake of a leisurely stroll to a place with no eruv. Thus, one should not take a walk outside the eruv in an area where he must be armed for security reasons, as this will require people to carry weapons needlessly.

If a soldier wants to leave his base in order to participate in prayer services taking place in a nearby community, and he will need to pass through an area with no eruv to get there, after he leaves the base he should rest his gun and two-way radio on a mekom petur. He should then carry the items from there to the community. He should do this on his way back as well, as explained above in 21:7.

Regarding putting out a dangerous fire, see 16:6-7 above. Regarding alarm systems, see 17:15 above.

[18]. R. Goren writes that a gun is a kli she-melakhto le-heter, because it is meant to save lives (Meshiv Milĥama 2:61). This is also the opinion of R. Shlomo Zalman Auerbach, who maintains that guns, beepers, and hand-held computers (containing medical information that a doctor needs) are not muktzeh (Shulĥan Shlomo 2:308:16; Nishmat Avraham 301:19 and n. 6). A mobile phone, which is used primarily for everyday purposes, is a kli she-melakhto le-isur (above, 23:8). However, one may carry it to use it le-tzorekh gufo, like calling for help if necessary.According to the Sages in the Mishna (Shabbat 63a), a sword and a bow are not considered ornamental, but rather they are considered shameful, because in the prophesied future, “no one will study war” (Yeshayahu 2:4). Therefore one may not bear them on Shabbat. R. Eliezer disagrees, saying they are considered ornamental, and one may go out carrying them on Shabbat. SA 301:7 rules in accordance with the Sages. However, AHS 301:7 makes the innovative claim that soldiers may go with weapons on their bodies because the weapon is part of their clothing. R. Goren writes that one may rely upon this rationale if there is a great need to do so (Meshiv Milĥama 2:61). Therefore, when there is a need for some people to have weapons close at hand, but people will hesitate to volunteer to bear weapons unless we permit them to attend the synagogue and celebrations, it is preferable that they bear weapons in their belt as they n

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