Rabbi Yehuda Finchas
Rabbi, I went to Rabbi Goldberg’s shiur, and he mentioned that whenever possible, pikuach nefesh (saving a life) on Shabbat should be done with a shinui (a modification of the usual practice) or by a non-Jew. If so, why are Hatzalah members Jewish? Is this correct for Sephardim as well?
The Principle of Pikuach Nefesh
Pikuach nefesh is a fundamental principle in Judaism, emphasizing the sanctity of human life. It means the “safeguarding of life” and underscores the importance of protecting life above all else, even at the expense of overriding all other mitzvot, with the sole exception of the three cardinal sins of murder, idolatry, and adultery.
Practically, this means that when someone’s life is in danger, it is not only permissible but obligatory to violate halacha if necessary to save their life. For example, if a person suddenly falls ill on Shabbat, we are obligated to provide lifesaving medical treatment, call an ambulance, or drive to the hospital, even though these actions would otherwise be forbidden.
Shulchan Aruch and the Rema: A Difference of Opinion
The Shulchan Aruch and the Rema disagree on whether it is ideal to perform pikuach nefesh actions with either a shinui or through a non-Jew, as long as it does not cause a delay in treatment. The Shulchan Aruch (O.C. 328:12) rules that when desecrating Shabbat for a choleh she-yesh bo sakana (a person whose life is in danger), one should try to have a Jewish adult perform the action, rather than a non-Jew. The Rema adds that if it is possible to do so without delay with a shinui, it should be done that way. If a non-Jew can perform the action without causing a delay, then a non-Jew should do it. However, if there is concern that the non-Jew might delay, it is better not to have a non-Jew perform the action.
In contrast, when it comes to a yoledet (a woman in labor), the Shulchan Aruch and the Rema agree that a shinui should be employed whenever possible. I will explain why in more detail in the next edition.
Sephardic Practice: Hacham Ovadia and Hacham Benzion
Hacham Ovadia, zt”l, (Hazon Ovadya, Shabbat Vol. 3, p. 281) follows the Shulchan Aruch position and rules that a Jewish adult should perform pikuach nefesh, as there is concern that if you seek a non-Jew, you might not find one in time, thereby endangering the patient. Hacham Benzion Abba Shaul (Ohr Lezion 2:36:2) reasons that, since pikuach nefesh is such a great mitzvah of saving lives, one should rush to the opportunity to save a person’s life, rather than searching for someone else to do so.
Hutra vs. Dechuya: The Underlying Debate
Hacham Ovadia (Yabia Omer, Vol. 10, O.C. 30) explains the difference of opinion between the Shulchan Aruch and the Rema. This difference depends on whether pikuach nefesh on Shabbat is hutra or dechuya. Hutra means the act does not constitute chilul Shabbat at all, it is as if Shabbat is a “weekday” in this regard. Dechuya, on the other hand, means that pikuach nefesh overrides or takes precedence over Shabbat.
Another ramification of this debate is whether one should perform pikuach nefesh with a shinui, even if a shinui would not endanger the patient. If Shabbat is considered dechuya, a shinui should be performed to reduce the severity of the prohibition. However, if Shabbat is hutra, it can be done in a regular fashion.
Conclusion
To answer the original question, there is a difference between Sephardi and Ashkenazi minhag regarding pikuach nefesh on Shabbat. According to Sephardi practice, pikuach nefesh is performed in a regular fashion and there is no requirement to use a shinui or to involve a non-Jew. Ashkenazi practice aims to minimize chilul Shabbat whenever possible. This is done by either asking a non-Jew to perform the lifesaving action or performing it with a shinui. However, this is only applicable when there is no risk of delay or danger to the patient.
This distinction also explains why Hatzalah members are usually Jewish. Every call for assistance is potentially life-threatening, and every second is critical. In such cases, the priority is immediate and decisive action, without unnecessary complications or delays. When someone’s life is at risk and time is critical, immediate intervention is necessary. Even to pause and confirm with a rabbi whether one is opting for the correct course of action could result in a delay that may be fatal (S.A. O.C. 328:2). Those who perform it with urgency and diligence are praiseworthy (Yoma 84b).
Rabbi Yehuda Finchas is a recognized expert, lecturer, and author on Medical Halacha. He is the head of the Torat Habayit Medical Halacha Institute. His latest book is “Brain Death in Halacha and the Tower of Babel Syndrome.” To contact Rabbi Finchas, please email rabbi@torathabayit.com.