Halachaהלכה

Pikuach Nefesh and Forbidden Materials in Medical Life-Saving

Jewish law addresses whether life-saving medical procedures using ordinarily forbidden substances—such as non-kosher animal organs in transplantation—are permissible under the principle of pikuach nefesh. Sources from Tanakh through the Acharonim establish that preserving life overrides virtually all Torah prohibitions, including dietary laws, when a person faces mortal danger.

וְחַי בָּהֶם וְלֹא שֶׁיָּמוּת בָּהֶם

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Source 1 · Tanach
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Torah: Prohibition of the Pig

Leviticus 11:7-8

The foundational Torah prohibition — the pig is declared non-kosher because it does not chew its cud, and its flesh may not be eaten. This is the source-text for all discussions of pig-derived matter and its status.

וְאֶת־הַ֠חֲזִ֠יר כִּֽי־מַפְרִ֨יס פַּרְסָ֜ה ה֗וּא וְשֹׁסַ֥ע שֶׁ֙סַע֙ פַּרְסָ֔ה וְה֖וּא גֵּרָ֣ה לֹֽא־יִגָּ֑ר טָמֵ֥א ה֖וּא לָכֶֽם׃ מִבְּשָׂרָם֙ לֹ֣א תֹאכֵ֔לוּ וּבְנִבְלָתָ֖ם לֹ֣א תִגָּ֑עוּ טְמֵאִ֥ים הֵ֖ם לָכֶֽם׃

and the swine—although it has true hoofs, with the hoofs cleft through, it does not chew the cud: it is impure for you. You shall not eat of their flesh or touch their carcasses; they are impure for you.

Source 2 · Chazal
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Talmud Yoma: Pikuach Nefesh Overrides Nearly Everything

Yoma 85a

The Talmud establishes that saving a life (pikuach nefesh) overrides virtually all Torah prohibitions, deriving this from 'v'chai bahem' — one shall live by the commandments, not die by them. This is the foundational sugya for permitting otherwise-forbidden acts to preserve life.

וּכְבָר הָיָה רַבִּי יִשְׁמָעֵאל וְרַבִּי עֲקִיבָא וְרַבִּי אֶלְעָזָר בֶּן עֲזַרְיָה מְהַלְּכִין בַּדֶּרֶךְ, וְלֵוִי הַסַּדָּר וְרַבִּי יִשְׁמָעֵאל בְּנוֹ שֶׁל רַבִּי אֶלְעָזָר בֶּן עֲזַרְיָה מְהַלְּכִין אַחֲרֵיהֶן. נִשְׁאֲלָה שְׁאֵלָה זוֹ בִּפְנֵיהֶם: מִנַּיִין לְפִקּוּחַ נֶפֶשׁ שֶׁדּוֹחֶה אֶת הַשַּׁבָּת? נַעֲנָה רַבִּי יִשְׁמָעֵאל וְאָמַר: ״אִם בַּמַּחְתֶּרֶת יִמָּצֵא הַגַּנָּב״ — וּמָה זֶה, שֶׁסָּפֵק עַל מָמוֹן בָּא סָפֵק עַל נְפָשׁוֹת בָּא, וּשְׁפִיכוּת דָּמִים מְטַמֵּא אֶת הָאָרֶץ, וְגוֹרֵם לַשְּׁכִינָה שֶׁתִּסְתַּלֵּק מִיִּשְׂרָאֵל, נִיתָּן לְהַצִּילוֹ בְּנַפְשׁוֹ — קַל וָחוֹמֶר לְפִקּוּחַ נֶפֶשׁ שֶׁדּוֹחֶה אֶת הַשַּׁבָּת.

§ The Gemara relates: It once happened that Rabbi Yishmael, and Rabbi Akiva, and Rabbi Elazar ben Azarya were walking on the road, and Levi HaSadar and Rabbi Yishmael, son of Rabbi Elazar ben Azarya, were walking respectfully behind them, since they were younger and did not walk alongside their teachers. This question was asked before them: From where is it derived that saving a life overrides Shabbat? Rabbi Yishmael answered and said that it is stated: “If a thief be found breaking in and be struck so that he dies, there shall be no blood-guiltiness for him” (Exodus 22:1). Now, if this is true for the thief, where there is uncertainty whether he comes to take money or to take lives, and it is known that bloodshed renders the land impure, since it is stated about a murderer: “And you shall not defile the land” (Numbers 35:34), and it causes the Divine Presence to depart from the Jewish people, as the verse continues: “In the midst of which I dwell, for I the Lord dwell in the midst of the children of Israel” (Numbers 35:34), and even so the home owner is permitted to save himself at the cost of the thief’s life, then a fortiori saving a life overrides Shabbat.

Source 3 · Chazal
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Talmud Sanhedrin: The Three Exceptions to Pikuach Nefesh

Sanhedrin 74a

The Talmud rules that one must die rather than violate only three cardinal sins — idolatry, sexual immorality, and murder. All other prohibitions, including eating forbidden foods, are waived when life is at stake, establishing a clear hierarchy.

אָמַר רַבִּי יוֹחָנָן מִשּׁוּם רַבִּי שִׁמְעוֹן בֶּן יְהוֹצָדָק: נִימְנוּ וְגָמְרוּ בַּעֲלִיַּת בֵּית נַתְּזָה בְּלוֹד, כׇּל עֲבֵירוֹת שֶׁבַּתּוֹרָה אִם אוֹמְרִין לָאָדָם ״עֲבוֹר וְאַל תֵּהָרֵג״ – יַעֲבוֹר וְאַל יֵהָרֵג, חוּץ מֵעֲבוֹדָה זָרָה וְגִילּוּי עֲרָיוֹת וּשְׁפִיכוּת דָּמִים.

§ The Gemara now considers which prohibitions are permitted in times of mortal danger. Rabbi Yoḥanan says in the name of Rabbi Shimon ben Yehotzadak: The Sages who discussed this issue counted the votes of those assembled and concluded in the upper story of the house of Nitza in the city of Lod: With regard to all other transgressions in the Torah, if a person is told: Transgress this prohibition and you will not be killed, he may transgress that prohibition and not be killed, because the preserving of his own life overrides all of the Torah’s prohibitions. This is the halakha concerning all prohibitions except for those of idol worship, forbidden sexual relations, and bloodshed. Concerning those prohibitions, one must allow himself to be killed rather than transgress them.

Source 4 · Rishonim
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Rambam: Forbidden Foods and Pikuach Nefesh

Mishneh Torah, Forbidden Foods 14:17

The Rambam rules explicitly that when one's life is in danger, all food prohibitions are suspended, including non-kosher animals. A sick person in mortal danger is fed whatever is necessary to preserve life, even things ordinarily forbidden by Torah law.

כֵּיצַד. הָיוּ לְפָנֵינוּ טֶבֶל וּנְבֵלָה מַאֲכִילִין אוֹתוֹ נְבֵלָה תְּחִלָּה שֶׁהַטֶּבֶל בְּמִיתָה. נְבֵלָה וּסְפִיחֵי שְׁבִיעִית מַאֲכִילִין אוֹתוֹ סְפִיחֵי שְׁבִיעִית שֶׁאֲסוּרִין מִדִּבְרֵי סוֹפְרִים כְּמוֹ שֶׁיִּתְבָּאֵר בְּהִלְכוֹת שְׁמִטָּה.

What is implied? If there is tevel and a nevelah, we feed him the nevelah first. {The rationale is] that [partaking of] tevel is punishable by death [at the hand of heaven]. If [the choice is between] a nevelah and produce that grows on its own during the Sabbatical year, we feed him the produce, for it is forbidden [only] by Rabbinic decree, as will be explained in Hilchot Shemitah.

Source 5 · Rishonim
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Rambam: Yesodei HaTorah — Giving One's Life vs. Transgressing

Mishneh Torah, Foundations of the Torah 5:1-6

Rambam systematically discusses when one must submit to death rather than transgress, and when one must transgress to live. He frames pikuach nefesh as a positive Torah obligation, not merely a permission — one who endangers themselves to avoid transgression is culpable.

כָּל בֵּית יִשְׂרָאֵל מְצֻוִּין עַל קִדּוּשׁ הַשֵּׁם הַגָּדוֹל הַזֶּה שֶׁנֶּאֱמַר (ויקרא כב לב) "וְנִקְדַּשְׁתִּי בְּתוֹךְ בְּנֵי יִשְׂרָאֵל". וּמֻזְהָרִין שֶׁלֹּא לְחַלְּלוֹ שֶׁנֶּאֱמַר (ויקרא כב לב) "וְלֹא תְחַלְּלוּ אֶת שֵׁם קָדְשִׁי". כֵּיצַד. כְּשֶׁיַּעֲמֹד עוֹבֵד כּוֹכָבִים וְיֶאֱנֹס אֶת יִשְׂרָאֵל לַעֲבֹר עַל אַחַת מִכָּל מִצְוֹת הָאֲמוּרוֹת בַּתּוֹרָה אוֹ יַהַרְגֶּנּוּ יַעֲבֹר וְאַל יֵהָרֵג שֶׁנֶּאֱמַר בַּמִּצְוֹת (ויקרא יח ה) "אֲשֶׁר יַעֲשֶׂה אוֹתָם הָאָדָם וָחַי בָּהֶם". וָחַי בָּהֶם וְלֹא שֶׁיָּמוּת בָּהֶם. וְאִם מֵת וְלֹא עָבַר הֲרֵי זֶה מִתְחַיֵּב בְּנַפְשׁוֹ: כָּעִנְיָן שֶׁאָמְרוּ בָּאֳנָסִין כָּךְ אָמְרוּ בָּחֳלָאִים. כֵּיצַד. מִי שֶׁחָלָה וְנָטָה לָמוּת וְאָמְרוּ הָרוֹפְאִים שֶׁרְפוּאָתוֹ בְּדָבָר פְּלוֹנִי מֵאִסּוּרִין שֶׁבַּתּוֹרָה עוֹשִׂין. וּמִתְרַפְּאִין בְּכָל אִסּוּרִין שֶׁבַּתּוֹרָה בִּמְקוֹם סַכָּנָה חוּץ מֵעֲבוֹדַת כּוֹכָבִים וְגִלּוּי עֲרָיוֹת וּשְׁפִיכַת דָּמִים שֶׁאֲפִלּוּ בִּמְקוֹם סַכָּנָה אֵין מִתְרַפְּאִין בָּהֶן. וְאִם עָבַר וְנִתְרַפֵּא עוֹנְשִׁין אוֹתוֹ בֵּית דִּין עֹנֶשׁ הָרָאוּי לוֹ:

The entire house of Israel are commanded regarding the sanctification of [God's] great name, as [Leviticus 22:32] states: "And I shall be sanctified amidst the children of Israel." Also, they are warned against desecrating [His holy name], as [the above verse] states: "And they shall not desecrate My holy name." What is implied? Should a gentile arise and force a Jew to violate one of the Torah's commandments at the pain of death, he should violate the commandment rather than be killed, because [Leviticus 18:5] states concerning the mitzvot: "which a man will perform and live by them." [They were given so that] one may live by them and not die because of them. If a person dies rather than transgress, he is held accountable for his life. Just as these principles apply regarding being forced [to transgress], they also apply regarding sicknesses. What is implied? When a person becomes sick and is in danger of dying, if the physicians say that his cure involves transgressing a given Torah prohibition, [the physicians' advice] should be followed. When there is a danger [to life], one may use any of the Torah prohibitions as a remedy, with the exception of the worship of false gods, forbidden sexual relations, and murder. Even when there is a danger [to life], one may not use them as a remedy. If one transgresses and uses them as a remedy, the court may impose the appropriate punishment upon him.

Source 6 · Rishonim
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Rambam: Obligation to Save One's Own Life

Mishneh Torah, Murderer and the Preservation of Life 1:14

Rambam derives from 'venishmartem me'od l'nafshoteichem' a positive obligation to guard one's physical health and life. This transforms pikuach nefesh from a passive permission into an active duty, directly obligating a patient to accept life-saving procedures including those involving forbidden materials.

אוֹ לִסְטִים בָּאִים עָלָיו.

Whenever a person can save another person's life, but he fails to do so, he transgresses a negative commandment, as Leviticus 19:16 states: "Do not stand idly by while your brother's blood is at stake." Similarly, this commandment applies when a person sees a colleague drowning at sea or being attacked by robbers or a wild animal, and he can save him himself or can hire others to save him.

Source 7 · Acharonim
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Noda BiYehudah: Autopsy and Benefit from the Dead for Medical Purposes

Noda BiYehudah II, Yoreh Deah 210

The Noda BiYehudah's landmark responsum on performing autopsies to save future lives discusses the principle of whether benefit derived from forbidden matter in a life-saving context is permitted. His analysis of 'lifnenu' (before us) vs. future patients is foundational to later discussions of xenotransplantation-type scenarios.

את כל אלה כתבתי לפי דבריכם שאתם קורים זה פיקוח והצלת נפש. אבל אני תמה הלא אם זה יקרא אפילו ספק הצלת נפשות א"כ למה לכם כל הפלפול והלא זה הוא דין ערוך ומפורש שאפילו ספק דוחה שבת החמורה ומשנה מפורשת ביומא דף פ"ג וכל ספק נפשות דוחה שבת ושם דף פ"ד ע"ב ולא ספק שבת זו אלא אפילו ספק שבת אחרת ע"ש. ואמנם כ"ז ביש ספק סכנת נפשות לפנינו כגון חולה או נפילת גל, וכן במס' חולין שם גבי רוצח הפיקוח נפש לפנינו וכן אפילו לענין ממון שם במס' ב"ב ההיזק לפנינו אבל בנדון דידן אין כאן שום חולה הצריך לזה רק שרוצים ללמוד חכמה זו אולי יזדמן חולה שיהיה צריך לזה ודאי דלא דחינן משום חששא קלה זו שום איסור תורה או אפילו איסור דרבנן שאם אתה קורא לחששא זו ספק נפשות א"כ יהיה כל מלאכת הרפואות שחיקת ובישול סמנים והכנת כלי איזמל להקזה מותר בשבת שמא יזדמן היום או בלילה חולה שיהיה צורך לזה ולחלק בין חששא לזמן קרוב לחששא לזמן רחוק קשה לחלק. וחלילה להתיר דבר זה ואפילו רופאי האומות אינן עושים נסיון בחכמת הניתוח ע"י שום מת כי אם בהרוגים ע"פ משפט או במי שהסכים בעצמו בחייו לכך ואם אנו ח"ו מקילים בדבר זה א"כ ינתחו כל המתים כדי ללמוד סידור אברים הפנימים ומהותן כדי שידעו לעשות רפואות להחיים. ולכן האריכות בזה הוא ללא צורך ואין בזה שום צד להתיר. ולדעתי שגגה יצאה מלפני כבוד מעלתו שמיהר להשיב להקל.

I have written all of this in accordance with your words, for you call this saving lives. But I am puzzled. If this is considered even a questionable case of saving lives, why must you engage in all of these mental gymnastics? It is clear and explicit that even an uncertainty supersedes the severity of Shabbat, and there is an explicit mishna on Yoma 83 that the possibility of saving a life supersedes Shabbat. And there on 84b it states that not only an uncertainty concerning the present Shabbat, but even an uncertainty concerning a different Shabbat [supersedes]. However, this all applies when there is a present case of uncertainty concerning a risk to life—such as a sick person or collapsed building. Similarly, in the case in Hullin regarding a murderer, the risk to life is present. So too in the monetary case in Bava Batra, the potential damage is present. But in our case, there is no ill person who needs this. Rather, they want to study this discipline in case they encounter a sick person who requires it. We certainly do not supersede any Torah prohibition or even a rabbinic prohibition due to such a slight concern. For if you call this concern “an uncertainty pertaining to a life,” then any task related to healing—grinding and cooking medicine or preparing a scalpel for bloodletting—will be permitted on Shabbat, perhaps they will encounter a sick person who requires it that night or the next day. It is also difficult to distinguish between concern for the need arising in the near future and concern for the need arising in the distant future. Heaven forfend that such a thing should be permitted. Even gentile physicians do not gain surgical experience with just any corpse, but only with those put to death by the law or with those who themselves consented to it while living. If we, God forbid, are lax in this matter, they will operate on every corpse to learn anatomy and physiology, so that they may know how to cure the living. Therefore, this is all unnecessarily lengthy, and there is no lenient approach whatsoever. In my opinion, your Excellency was mistaken in rushing to respond leniently.

Source 8 · Acharonim
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Tomer Devorah: Imitating Divine Compassion — Life Above All

Tomer Devorah 1:1

Rav Moshe Cordovero teaches that the highest divine attribute is compassion — 'mi-El kamocha' — forgiving and bearing sin. He emphasizes that true Godliness consists in sustaining and saving life at all costs, providing a kabbalistic-ethical framework for why preserving life transcends the particularity of any single prohibition.

יָשׁוּב יְרַחֲמֵנוּ. תִּתֵּן אֱמֶת. אִם כֵּן רָאוּי שֶׁתִּמְצָאֶנָּה בוֹ י"ג מִדּוֹת אֵלּוּ.

Therefore it is fitting that he should [make his actions] resemble the actions of the Crown (Keter), which are the thirteen highest traits of mercy. And they are hinted to in the secret of the verses (Michah 7:18-20), "Who is a power like You; He will again have mercy on us; You shall give truth." If so, it is fitting that these thirteen traits [also] be found in man.

Source 9 · Hasidic
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Kedushat Levi: Holiness Inheres in the Soul, Not the Body's Consumption

Kedushat Levi, Leviticus, Kedoshim

The Kedushat Levi teaches that the essence of Jewish holiness (kedushah) is anchored in the soul and its relationship with God, not in the physical material the body contains. This Chassidic insight suggests that a pig heart sustaining a Jewish life does not contaminate the soul's essential sanctity.

ונראה לפרש בעזרת השם הענין הוא כך, אם תהיה טוב אז מאי"ן באת כו', במדריגה טובה. ואם חס ושלום להיפך אזי יהיה מאין באת מטפה סרוחה. כי ידוע שיש שני מיני מדריגות של יראת השם יתברך. האחד, הוא יראת העונש חס ושלום. והב', היא יראת הרוממות היא יראה האמיתית והוא מדריגת צדיקים מחמת שהצדיק מסתכל תמיד באי"ן הנעלם והחכמה מאין תמצא ומעלה תמיד על מחשבתו שהבורא ברוך הוא וברוך שמו אין סוף ואין תכלית ולית מחשבה תפיסה ביה כלל ומעלה תמיד על מחשבתו איך שכל המלאכים ושרפים חיות ואופני הקודש עד אין שיעור ומספר וכל העולמות עד אין מספר כולם מתבהלים ומתפחדים מאימתו ואיך בריה שפלה כו'. והנה כשבא צדיק ליראה זו ומתמיד בה הוא דבוק ברוחניות ומשבר כל התאות הגשמיות הוא חלק אביו ואמו שנתנו בו ומדבק בנ"ר ונשמה חלק הבורא ברוך הוא וברוך שמו כמאמר חכמינו ז"ל (קידושין ל:) שלשה שותפים באדם, עד שמהפך חומר לצורה ומסתכל תמיד באי"ן הנעלם. וזה היה מדריגת משה רבינו עליו השלום שהיה עניו מכל האדם, רוצה לומר שהיה תמיד דבוק באי"ן הנעלם וממילא היה בעיניו כאין והיה עניו מכל אדם. וזאת היראה היא עיקרית מכל המצות, כי כל המצות הם להזדככות החומר רמ"ח מצות עשה כנגד רמ"ח איברים ושס"ה מצות לא תעשה כנגד שס"ה גידין, בכדי שיבא לידי יראה זו ולדבק את עצמו במדת אין. והנה מי שזוכה ליראה זו כיון שהזדכך חמרו ובטל ממנו חלק אביו ואמו ונעשה מחומרו צורה ודבק בהשם יתברך בוודאי הוא אינו בא מטפה סרוחה ואין הולך למקום כו'. גם ידוע שהצדיק נקרא בן להקדוש ברוך הוא כמאמר (משלי י, א) בן חכם ישמח אב וכו', והחכמה הוא היראה כידוע. וכשבא בן אצל אביו למשפט בודאי אין לו לירא כלל, כי בוודאי יצא זכאי בדין. מה שאין כן מדריגה השניה שהוא יראת העונש ואין לו יראת הרוממות הנ"ל הוא מדובק מחלק אביו ואמו אזי הוא בא מטפה סרוחה והולך למקום כו' והוא במדריגת עבד והעבד כשבא למשפט אינו יודע אם יצא זכאי: וזהו כוונת עקביא בן מהללאל שמדבר מב' מדריגות הנ"ל. מדריגה הא', דע מאין באת, פירוש שיסתכל האדם תמיד באי"ן הנעלם איך הוא מחיה ומהוה כל העולמות כולם בכל רגע ממש מאין ליש ובלתי חיותו הכל אפס וזו גם כן ולאן אתה הולך, כלומר שכל עשיית המצות כדי שתקרב עצמך למדת האי"ן. מה שאין כן חס ושלום אם לא תעשה רצונו של מקום ותדבק עצמך בגשמיות אזי מאין באת מטפה סרוחה ולאן אתה הולך כו' ולפני מי אתה עתיד כו' לפני מלך מלכי המלכים הקדוש ברוך הוא, כיון שהוא במדריגת עבד משפטו לפני המלך דייקא ואינו יודע אם יצא זכאי. וזו כוונת הפסוק קדושים תהיו כי קדוש אני איש אמו ואביו תיראו, היינו שצריך אדם לירא שלא ידביק עצמו בחלק אביו ואמו שהוא הגשמיות ולקדש את עצמו ולבקש ולדבק בחלק הבורא יתברך שמו ויהיה מובדל מהגשמיות. וזו כי קדוש אני ה':

We hope to justify Akavyah’s using the language the ‎‎Mishnah recorded. Akavyah posits that a person in ‎evaluating himself, taking stock of himself, is tempted to look at a ‎list of his achievements first. If that person is a good person, ‎Akavyah reminds him that seeing that he is “descended” from an ‎evil smelling drop of semen he does not really have anything to ‎boast about. If he is a morally weak or inferior person, he is ‎reminded of his superior ancestors as his origin, something which ‎should make him ashamed for not living up to his forefathers’ ‎standards. Akavya was aware that there are two levels of “fear of ‎the Lord.” The lower level is called “fear of punishment,” whereas ‎the higher level is called ‎יראת הרוממות‎ “the awe of the ‎overwhelming superiority of the Creator.” He therefore addresses ‎both categories of individuals, assuming that each category finds ‎it difficult on occasion to resist the evil urge so that he may ‎commit a transgression. True ‎יראת השם‎ is only this latter category ‎of “awe and reverence of the Lord.” This is the level of ‎יראת שמים‎ ‎of the righteous, seeing that the ‎צדיק‎ always focuses on the ‎concept of the ‎אין סוף‎, “G’d as personification of infinity.” In Job ‎‎18,12 we have been taught that ‎חכמה ‏‎, “true wisdom,” is only ‎found in the realm described as ‎מאין‎, same letters as ‎אין‎ in ‎אין סוף‎. ‎The tzaddik always keeps reflecting on the fantastic ‎concept of the infinity of the Creator and how He is in charge of ‎millions of different categories of holy angels and a universe the ‎extent of which boggles the imagination. He thinks of how all ‎these angels are in constant awe of Him so that through his ‎preoccupation with such thoughts he does not fall victim to the ‎urge to taste the physical pleasures offered by the region into ‎which we have been placed by our fate. These physical urges, ‎after all, have become part of him only by genetic transmission ‎from his father and mother, whereas his divine soul, G’d’s ‎contribution to every human being as an integral part of Him, is ‎supplied by Him Who, most certainly is not subject to such urges. ‎It was Moses’ ability to concentrate on that “third” of his ‎ancestry, i.e. the ‎אין סוף‎, that resulted in his being described as ‎איש האלוקים‎, a “godly man.” (Deuteronomy 33,1) He had attained this ‎status by becoming what the Torah called: “the most humble ‎man on earth.” (Numbers 12,3) It follows from the Torah’s ‎definition of his personality that he had concentrated on the ‎closest possible connection with what was concealed from him, ‎‎(as well as from any living human being) i.e. G’d’s essence, so that ‎he considered himself as ‎אין‎, as if non-existent, immaterial.‎ Anyone who has the good fortune to have refined his ‎personality to such an extent can hardly have considered himself ‎as having originated from a putrid drop of sperm, in the words of ‎Akavya, neither would he have considered himself as proceeding ‎to a destination described by Akavya as ‎עפר רמה ותולעה‎, “dust, ‎decay and vermin.” It is also known that the tzaddik is ‎referred to as ‎בן‎, “son” by G’d, and when a son comes to his ‎father, even in order to be judged, he does not approach his ‎father with fear as he is sure that his father will find him ‎innocent of the accusations which resulted in his having to stand ‎trial. Such self-confidence by a son is not automatic if the son had ‎all his life been obeying his father only because he had feared ‎being punished if any wrongdoing of his would be discovered. The ‎fact that this type of son had not looked up to his father as ‎someone deserving of the utmost respect regardless of his power ‎to mete out punishment, had prevented a close bond being ‎established between father and son. Hence the son’s real anxiety ‎when appearing before his father as an accused. The son whose ‎obedience was based on fear of punishment is far more closely ‎tied to his physical father and mother, so that when reminded ‎that his origin in this world goes back to a putrid drop of semen ‎this is likely to remind him of his insignificance, and will restrain ‎him from committing transgressions, most of which are due to ‎his arrogance vis a vis his peers. He is not in a relationship ‎of son to his Creator, but rather in the relationship of servant to ‎master. When a servant is summoned to appear in court to ‎answer some accusation, he is not supremely confident of his ‎acquittal, -assuming that he is innocent,- but is greatly worried ‎about the outcome of the trial. This is what Akavya had in mind ‎when he addressed his saying, while not to sinners, but to two ‎different categories of Jews both of whom observe the ‎commandments but for different reasons. When he spoke of ‎concerning yourself with “where you are headed,” he meant that ‎when you worry to constantly become closer to your Creator as ‎you serve Him because of your ‎יראת הרוממות‎, he meant that this ‎by itself would ensure that he would not lapse into sin. When ‎addressing the person serving G’d from fear of punishment, ‎however, he reminded that person that failure to consider that ‎his destination might become only dust, decay and vermin, ‎without the prospect of a hereafter, this might act as a deterrent ‎to being lured into sin. In light of the foregoing, we conclude that ‎the reason why the verse ‎איש אמו ואביו תיראו‎, which on the face of ‎it appears to repeat the fifth commandment to “honour your ‎father and mother,” with a minor variation, is inserted by the ‎Torah at this point to warn us not to attach oneself to the merely ‎physical parts of mother and father, but to seek closer association ‎with the Divine Father, one’s spiritual origin. Of this part of ‎man’s origin only can it be said: ‎כי קדוש אני‎, “for I am holy.”‎

Source 10 · Modern
Verified

Mishnah Berurah: The Obligation to Save Life

Mishnah Berurah 328:1

The Chofetz Chaim rules that pikuach nefesh is an obligation incumbent on everyone, and that delay or hesitation in performing a life-saving act out of piety is itself sinful. This reinforces that a patient receiving a pig heart transplant is not only permitted but obligated to accept it.

(א) מיחוש בעלמא והוא מתחזק וכו' - דאם כאיב ליה טובא וחלה כל גופו עי"ז או שנפל למשכב אף שאין בו סכנה מותר לעשות בשבילו רפואה שאין בה מלאכה וכההיא דסימן שכ"ז ס"א וכה"ג וע"י א"י מותר לעשות אפילו מלאכה גמורה וכדלקמן בסי"ז וסל"ז ע"ש: