When Saving a Life Overrides Religious Commandments

The Torah says (Leviticus 18:5): "You shall observe My statutes and My laws, which a person shall do and live by them- I am the Lord." The Sages explain (Yoma 85b): "Live by them- and not die by them." Al the commandments of the Torah were given so that we may live by them. If performing a mitzvah puts a person's life in danger, then the Torah instructs us not to fulfill that mitzvah.

If someone is dangerously ill on Shabbat and caring for them requires desecrating Shabbat, we must do so without hesitation. As the Sages taught: "Saving a life overrides Shabbat."

Maimonides (Rambam) writes (Hilchot Shabbat 2:3): "One must not delay in desecrating Shabbat for someone whose life is in danger, as it says: '...and live by them'- not die by them. You learn from here that the laws of the Torah are not vengeance, but mercy, kindness, and peace."

The Jerusalem Talmud says: "One who asks (whether to desecrate Shabbat for danger) is like a shedder of blood, and the one asked is blameworthy." That is, if a person delays by asking a rabbi whether or not to break Shabbat when someone is in danger, they may cause the patient to die- and the rabbi is at fault if he failed to teach that this is allowed without asking.

This teaches us the critical importance of acting quickly to save a life. As the Sages also taught (Bava Batra 11a): "Anyone who saves a single life from Israel is as if they saved an entire world."

If a dangerously ill patient refuses care to avoid desecrating Shabbat, they are considered a "pious fool," a shedder of blood, and responsible for their own death. We are obligated to compel them to accept treatment to save their life. (Chazon Ovadia, Shabbat III, p. 229)

Following Medical Advice

A patient must follow medical instructions, even if this means eating on Yom Kippur or consuming non-kosher food such as pork, because this is what G-d commands. The Rashbatz wrote: "A sick person should not worry about violating Shabbat, because the same G-d who commands us to keep Shabbat also commanded us to break it when a life is in danger. One who desecrates Shabbat to save a life is doing a great mitzvah. Better to desecrate one Shabbat so the person may live to keep many more."

Harmful Staring

If looking at someone causes them embarrassment, it is considered a form of harm, and the observer is committing a transgression (see Ramban on Bava Batra 59b). This is especially relevant when an ambulance arrives for a woman in labor or a patient. Onlookers often gather which causes discomfort and shame, particularly when the person is exposed or struggling. The presence of a crowd delays care and violates dignity. It is a mitzvah to disperse these onlookers, including children.

Relying on Miracles

A sick person must seek medical care and not rely on miracles. At the same time, they should trust in G-d, who is the true healer, and view the doctor as His messenger- not as a source of healing on their own. As it says (Jeremiah 17:5): "Cursed is the man who trusts in people...Blessed is the one who trusts in G-d."

A Midrash (Shmuel, ch. 4) tells a story of Rabbi Yishmael and Rabbi Akiva. A sick person asks for a cure, and they advise him. A bystander protests: "G-d made him sick- how can you intervene?" They ask him, "What is your profession?" He says, "I am a farmer." They reply: "G-d made the earth- how do you dare plant in it?" He responds: "If I don’t weed and tend it, it yields nothing." They explain: just as a field must be maintained to grow, so must the human body be treated. Medicine is like fertilizer, and doctors are like farmers.

Similarly, the Talmud (Avodah Zarah 55a) says that illnesses are dispatched with conditions: on a certain day, at a certain hour, through a specific person and medication. Illness is sworn not to leave except by certain means. The Rashba writes that relying on miracles is forbidden. Even if G-d sends healing, one must pursue it naturally and follow the doctor’s instructions.

The Rambam says that if a patient refuses treatment and expects a miracle, they may die needlessly, similar to someone who enters fire and is burned. The book "Chovot HaLevavot" adds that such behavior can make one liable for their own death. "Shevet Yehuda" writes: both patient and family must seek the best doctors and treatments. Anyone who neglects this and claims "G-d will heal" is foolish and held accountable.

Chazal say (Sanhedrin 17b): "One should not live in a city without a doctor."

The Torah allows us to break severe prohibitions on Shabbat and Yom Kippur to preserve life. The Chida also rules that a patient must follow natural treatments, trust in G-d to heal through doctors, and not rely solely on miracles. (Chazon Ovadia, Shabbat III, p. 230)

"Do According to What They Teach You"

If the Sages determined that a certain condition is life-threatening, we must follow their ruling even if one hundred doctors claim it’s not. For example: a woman within 72 hours after giving birth is considered dangerously ill. Even if many doctors say she can fast on Yom Kippur without harm, she must still eat, because halachah says she is at risk.

The Rambam writes that even if medical experts say differently, we follow the words of the Sages: "Do not stray from what they teach you, right or left." The Radbaz adds that we don’t determine Torah law based on contemporary medicine alone. The responsa "Da’at Kohen" explains that even if modern cases appear safe, we cannot ignore the potential risk defined by the Sages.

That said, after consulting with a doctor, there are situations where a rabbi should also be consulted- especially when the doctor may not fully understand halachic concerns or may be too lenient in matters such as early induction, fasting, or pregnancy termination.

The Doctor’s Duty to Heal

There is a mitzvah for the doctor to treat any patient who comes to them. As the Torah says (Exodus 21:19): "He shall surely heal him", which the Sages interpreted to mean that permission was given to the doctor to heal.

Even though illness comes from G-d, doctors are permitted, and commanded, to heal. This is not seen as interfering with divine will, but rather as fulfilling it. A doctor who refuses to treat a patient and sends them elsewhere is like someone who sheds blood, because not all doctors are equally effective.

Doctor in Mourning

A doctor in the seven-day mourning period (shivah) who is asked to treat a patient- even one who is not in immediate danger- should treat them. This is both allowed and a mitzvah, even if there are other doctors available, and the doctor may accept payment.

Receiving Payment on Shabbat

A doctor who treats a patient on Shabbat may receive payment for it, since it is considered payment for a mitzvah and not a prohibited Shabbat wage.

Avoiding Unnecessary Shabbat Violation

A pregnant woman who begins to feel early contractions before Shabbat should, if it’s very easy, go to the hospital or stay nearby to avoid travel on Shabbat. However, if doing so would cause her distress or ruin her Shabbat, she may remain at home without concern. She is not required to rent a hotel room near the hospital.

Bright Lighting for Patients

If lighting is needed on Shabbat to care for a dangerously ill person, and there is a choice between a dim light or a bright one, one may turn on the brighter light. It is considered a single act, and there is no added violation by using the stronger light.

Kidney Donation

If a kidney patient is in danger and needs a transplant, a family member or friend may donate a kidney, and it is a great mitzvah to do so. As long as expert doctors determine that the donor faces no significant danger, this act can save a life and "Whoever saves a life is as if they saved an entire world."

Corneal Transplant

Someone who is losing their eyesight and can be healed by receiving a cornea from a deceased person may undergo the procedure. If affordable, it’s preferable to do it abroad, where the donor is more likely to be non-Jewish and the doctors more experienced. If not, it is permitted in Israel, even if the majority of donors are Jewish.

Disconnecting Life Support

Even for a terminally ill patient with no hope of recovery, doctors are required to continue providing care. Disconnecting life support to hasten death is considered murder. Family members must ensure the patient is nourished and properly treated.

The Talmud (Shabbat 151b) says: "Closing the eyes of a dying person while the soul departs is like spilling blood." Just as touching a flickering candle puts it out, so too interfering with the dying process is forbidden. Unplugging machines is no different and is bloodshed.

"Better Dead than Alive"?

If a patient is in great pain, the doctors have given up hope, and the patient says they would prefer to die, one may privately pray: "Master of the world, please have mercy- if it is Your will, heal and restore this person. But if a decree has already been made, please ease their suffering and do what is best in Your eyes".