Halacha – Pikuach Nefesh


Pikuach Nefesh is a fundamental principle in Judaism that highlights the value and sanctity of human life. It means the “safeguarding of life” and emphasizes the importance of preserving and protecting human life above all else, at the expense of overriding all other mitzvot with the sole exception of the three cardinal sins of murder, idolatry, and adultery (Sanhedrin 74a).

Practically, this means that when someone’s life is in danger, it is not only permissible but obligatory to violate the halacha if necessary to save their life. For example, if a person suddenly takes ill on Shabbat, we are obligated to provide any lifesaving medical treatment, call the ambulance service, or drive to the hospital, even though these actions would otherwise be forbidden. When it comes to pikuach nefesh, we don’t need to be 100 percent certain that somebody’s life is in danger or that our possible treatment will definitely help. Even when in doubt, so long as our concern is real and our life-saving intentions pure, if necessary, we may violate halacha to try to save a life (Yoma 83a). If a person has a life-threatening illness and the only cure involves some violation of hamets, he must avail himself of this option, because just like all other mitzvot, saving a life takes priority over the prohibition of hamets

Judaism teaches that every human life is precious and invaluable and that it is our duty to preserve and protect human life. The mishnah declares, “Whoever saves a single life is considered as if they saved an entire world” (Sanhedrin 4:5). As Rambam reasons, this mitzvah intends to foster “compassion, loving-kindness, and peace in the world” (Mishneh Torah, Shabbat, 2:3). 

This is what Hacham Ovadia, zt”l, (Yechaveh Daat 1:61) writes regarding a seriously ill person, who is instructed by his physician not to fast on Yom Kippur: “If there is concern of possible danger to his life by fasting, one must listen to the doctor and eat on Yom Kippur, because pikuach nefesh overrides the mitzvah of fasting on Yom Kippur. If the sick person is stringent and fasts, has he not acted in a pious manner, on the contrary, he will be punished for this.”  


VeNishmartem Meod LenafshotechemGuarding One’s Soul 

The Torah furthermore instructs us, “Guard yourself and exceedingly safeguard your soul” (Devarim4:9). The Talmud interprets this to mean that we are obligated to protect ourselves and others from potentially dangerous situations (Brachot 32b). Included in this mitzvah is the obligation to preserve our health with many halachot to help ensure our safety and wellbeing. Even though the Torah refers to our nefesh, our spiritual self, the Talmud extends this to our body and physical health as well. There is no contradiction between the two, and the message is clear and profound. We do not safeguard, protect, and care for our bodies merely as an end in itself, and certainly not as a vehicle for a self-glorification or idolization. Rather, we protect and embrace the physical self as it houses our soul. We maintain our physical health as a means of protecting, sustaining, and nurturing our souls.

Rabbi Moshe Rivkes concludes his commentary,Beer haGolah, on the Shulḥan Arukh, with an eternal message written over four hundred years ago but still relevant today: The reason why the Torah insisted a person protect his soul and his wellbeing is because Hashem created the world out of kindness, with the purpose of doing good to those He created. He wanted them to be able to recognize His greatness, perform His mitzvot and fulfill His Torah. However, anyone who places themself in danger acts as though he despises the Will of Hashem and in serving Him and there is no greater act of heresy and disrespect than that. 

With Hashem’s assistance, I will be writing a series of practical medical halacha columns elaborating on the mitzvot of Pikuach Nefesh, safeguarding one’s soul and one’s health. 

Rabbi Yehuda Finchas is a worldwide expert and writer on medical halacha, and his latest book is entitled “Brain Death in Halacha and the Tower of Babel Syndrome.” To contact Rabbi Finchas, email rabbi@torathabayit.com.