[The laws of] Shabbos are suspended¹ as to the attitude we take in permitting the transgression of Shabbos to save a life, whether it is דְחוּיָה or הוּתְּרָה. Shulchan Aruch Harav 328: 13 and this author maintain that it is דְחוּיָה and, therefore, if a method can possibly be found to minimize the transgression, such as doing the melachah with a שִׁינוּי, i.e. in an unusual manner, then that is preferable (see Sho’el U’maishiv 41, 42). Tzemach Tzedek (o.c. 38), Tashbatz (III: 37), Magein Avraham (328: 17) etc. hold הוּתְּרָה and there is no need to seek ways of minimizing the transgression. Chelkas Yoav (o.c. 14) writes that where a definite danger exists it is הוּתְּרָה, but where there is doubt as to whether the situation is life-threatening, it is דְחוּיָה. [See also Kovetz Shiurim, Kesubos paragraph 13; Biur Halacha 278: 1] where there is a life-threatening situation, as are all mitzvos in the Torah. Therefore, one who is dangerously ill and he is an observant person, though he occasionally transgresses a law because of temptation,² and even for a day-old child,³ 44; B’hag; Tur 617; see also Rosh, Maseches Yoma 8: 13; Peri Megadim 328: 1; Biur Halacha 330] it is a mitzvah to violate the Shabbos to save him. [Even] if the patient refuses, we force him to accept help. It is a grave sin to carry piety to the point of idiocy, and refuse treatment because it would violate a law. About such a person is it said:⁴ "Only of the blood of your lives will I demand an account." One who is quick to desecrate the Shabbos for the sake of a critically ill person, deserves praise. Even if a non-Jew is present, [every] effort should be made that a Jew do [what is necessary].⁵. Rosh, Shulchan Aruch (328: 12), Taz (ibid.) and Mishnah Berurah rule that a Jew is preferable. Rema and Shulchan Aruch Harav prefer that it be done by a non-Jew if one is available. The author agrees with the former. Any person that desecrates Shabbos for the sake of a critically ill person, even if it was found later to be unnecessary, will be rewarded. For example, if the doctor said: "This patient requires one dried fig [for cure]" and ten people ran and plucked one fig each and brought it, they all will be well rewarded by Hashem, blessed be His Name, even if the patient was cured [as a result of] the first [fig]. Similarly, in any life-threatening situation, even when the threat to life is uncertain,⁶ it is a mitzvah to desecrate Shabbos for him, and to do any and all d'oraisa prohibitions for him, because there is not a thing that stands in the way of a life-threatening situation. The Torah was given only for the purpose of [bringing] life, as it is said: "That man shall do them and live through them," and [the Sages] inferred: "Live through them but not to die on account of them." This holds true except for the laws concerning idolatry, illicit sexual relations and murder, where one must die rather than transgress.⁷

footnotes: ¹ דְחוּיָה = suspended. More literally the word דְחוּיָה means “pushed aside,” as opposed to הוּתְּרָה —“made permissible.” There is great controversy among the poskim ² Either due to lack of self-control or to inconveniences. This is as opposed to one who transgresses spitefully, who, having done so twice, may not be saved if desecrating the Shabbos is necessary. ³ Desecrating the Shabbos is permitted to save an unborn fetus. [Ritva, Maseches Niddah ⁴ Genesis 9: 5. ⁵ This is a matter of controversy among the poskim ⁶ V. paragraph 3. ⁷ V. Yoreh Dei’ah 157.

Any person⁸ 328: 27, 29] who asserts: "I recognize that this person is critically ill," and no experienced doctor is present who denies it; he may be relied on, and the Shabbos may be violated for him.⁹] Even if he does not say it with certainty but says that it seems to him that Shabbos should be violated for him, we accept his opinion and violate Shabbos for him, because [of the precept]: "Where there is a possible threat to life we are required to rule leniently." If one doctor's opinion is that he is critical, and requires a certain cure, and another doctor maintains that he does not require it, or if the patient says that he does not require it, we accept the opinion of the doctor who says that he requires it.¹⁰ If the patient says that he needs a particular cure, but the doctor says that he does not, we accept [what] the patient [says].¹¹, see Biur Halachah 328: 9. But, if the doctor says that this cure is harmful for him, we accept [what] the doctor [says].¹² 328: 6.

footnotes: ⁸ Who is himself a Sabbath observer and is familiar with that illness. [Mishnah Berurah ⁹ In this case, since it is not an expert opinion, a non-Jew is preferable (see note 5). This is true only where this will not cause any delay. [Mishnah Berurah ¹⁰ However, where one doctor is a greater authority, he is relied upon. ¹¹ Radvaz ¹² See Machatzis Hashekel

If a skilled physician,¹³ 328] even a non-Jew, or someone who is knowledgeable says that, although at present the patient is not in danger, nevertheless, if a particular treatment is not done the condition may deteriorate and become critical, even if the patient says that it is unnecessary, we accept the doctor's opinion and violate the Shabbos. If the doctor says that if a particular treatment is not done [the patient] will certainly die, and if done he will possibly live; here, too, the Shabbos may be violated.

footnotes: ¹³ Licensed physicians are generally considered skilled. [Birkei Yosef

Any internal injury [or wound] that begins at the lips inward, including the teeth, where the wound resulted from a blow or a blister or anything similar, the Shabbos may be violated for his sake without a [medical] evaluation.¹⁴ 328: 4] Even if no one knowledgeable is present and the patient says nothing, you may do for him anything that is usually done during the weekdays.¹⁵ even treatments whose denial poses no danger are also permitted. [Magid Mishneh; Magein Avraham 328: 4] Others permit this only by a non-Jew. [Shulchan Aruch Harav] Mishnah Berurah (328: 14) rules according to the stricter view where a melacha d’oraisa is involved. However, when it is obvious regarding that illness, that it is possible to wait, and violating the Shabbos is unnecessary, you may not violate it. Pain is not considered a "wound." If you have a toothache and are suffering a great deal of pain to the point that you feel ill all over, you may ask a non-Jew to extract it.¹⁶ 328: 10.

footnotes: ¹⁴ The Shabbos may be violated by calling a doctor for someone who is experiencing a great deal of pain internally whose cause is unknown. [Biur Halacha ¹⁵ See note 1. According to some poskim ¹⁶ See Mishnah Berurah

[For] a wound on the back of the hand or the back of the foot, as well as any wound that was caused by anything made of metal,¹⁷ 328: 26] or for an anal blister,¹⁸ as well as for one who swallowed a leech, or was bitten by a rabid dog,¹⁹ or any snake,²⁰ even if it is doubtful if it is poisonous, as well as for someone who has a high fever, the Shabbos may be violated for him. However, for an ordinary fever²¹ we violate the Shabbos for a patient with 102° temperature. When the patient has 101° temperature, Shabbos is violated only when the patient requests it. [Shabbos] is not violated, but should be attended by a non-Jew.

footnotes: ¹⁷ If the wound is deep. [Aruch Hashulchan ¹⁸ Not including common hemmorhoids. ¹⁹ Or any rabid animal. ²⁰ Or scorpion. ²¹ Of course the condition of the patient such as age, cause of illness, etc. must be taken into account according to the opinion of doctors. According to Igros Moshe

One who is polycythemic (high blood pressure) should be bled immediately.²² A fire may be made to warm one who was bled and feels chilled, even in mid-summer.

footnotes: ²² Today, current medical practice is followed.

One who has pain in both eyes,²³ is based on Shulchan Aruch 328: 9. Kaf Hachaim interprets the Shulchan Aruch’s statement as referring to pain even in one eye. or there is pus in one of them, or if his eyes are watering or bleeding,²⁴ is not permitted. [Shulchan Aruch 328: 9] or any other symptom dangerous to the eye, the Shabbos may be violated for him.

footnotes: ²³ This halachah ²⁴ Violating Shabbos is permitted where these conditions appear at the onset of the problem. Where the illness is improving and these conditions are residual and normal, a melachah d’oraisa

A patient who is critically ill and requires meat and [only] forbidden meat is available, you may slaughter [an animal] for him rather than give him forbidden meat, because we are concerned that, possibly, upon discovering that he was fed forbidden meat, he will be nauseated by it. However, in circumstances where there is no concern that he will be nauseated by it, for instance, where he is a minor, or is mentally incapacitated, he should be fed forbidden meat, and you may not slaughter an animal for him on Shabbos.

Food that was cooked on Shabbos for the sake of a patient, is forbidden to a well person on Shabbos.²⁵ (318: 14) permits food cooked by a non-Jew for a critically-ill person to be eaten even by a totally healthy person. But, after Shabbos it is permitted immediately even for a well person, if the cooking was done by a Jew.

footnotes: ²⁵ See Chapter 38: 9. However, the Mishnah Berurah

If one is being forced to transgress even a serious sin for the moment,²⁶ 328: 31] the Shabbos should not be violated in order to save him from committing the transgression. But, if he is being forced to convert and to leave the fold of the Jewish people, even if he is a minor, it is obligatory to exert all effort to save him, even if it is necessary to violate Shabbos by [transgressing] a d'oraisa prohibition,²⁷, as does the Mishnah Berurah. Chayei Adam (68: 13), however, allows violating only d’rabanan prohibitions. just as it is obligatory to violate Shabbos for someone who is critically ill; for it is written:²⁸ "The people of Yisrael shall keep the Shabbos." The Torah tells us: Violate one Shabbos for his sake so that he may keep many Shabbosos. Even where it is doubtful whether the intervention will succeed or not, nevertheless it is obligatory to violate Shabbos and attempt to do whatever is possible, just as we violate [Shabbos] for a possible life-threatening situation. However, one who is faithless and wants to convert, Shabbos must not be violated for him [by doing] a d'oraisa prohibition, because since he is at fault, we do not say to anyone: "Sin for the benefit of your friend." Nevertheless, when it involves a d'rabanan prohibition, such as walking beyond the techum, or to ride a horse, or to ride on a wagon, as well as handling money; according to some poskim it is permissible to violate Shabbos to save him.²⁹ 306: 56. Magein Avraham (254) disagrees.

footnotes: ²⁶ Even idolatry. Where there is a possibility that he may be willing to die rather than transgress, it is obligatory to violate Shabbos to save him. [Mishnah Berurah ²⁷ Concerning a minor, the author accepts the ruling of Eliyahu Rabba ²⁸ Exodus 31: 16. ²⁹ Eliyahu Rabba, Peri Megadim, Mishnah Berurah