This is the central Talmudic discussion of pikuach nefesh overriding Shabbat. The Talmud records debates among Tannaim and Amoraim citing various prooftexts, including 'you shall live by them,' 'desecrate one Shabbat so that he may observe many Shabbatot,' and Rabbi Shimon ben Menasya's ruling. It concludes that violating Shabbat to save a life is not merely permitted but obligatory, and that the most learned person should perform the act (not a non-Jew or minor).
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. נַעֲנָה רַבִּי עֲקִיבָא וְאָמַר: ״וְכִי יָזִיד אִישׁ עַל רֵעֵהוּ וְגוֹ׳ מֵעִם מִזְבְּחִי תִּקָּחֶנּוּ לָמוּת״. ״מֵעִם מִזְבְּחִי״ — וְלֹא מֵעַל מִזְבְּחִי. וְאָמַר רַבָּה בַּר בַּר חָנָה אָמַר רַבִּי יוֹחָנָן: לֹא שָׁנוּ אֶלָּא לְהָמִית, אֲבָל לְהַחֲיוֹת — אֲפִילּוּ מֵעַל מִזְבְּחִי. וּמָה זֶה, שֶׁסָּפֵק יֵשׁ מַמָּשׁ בִּדְבָרָיו סָפֵק אֵין מַמָּשׁ בִּדְבָרָיו, וַעֲבוֹדָה דּוֹחָה שַׁבָּת — קַל וָחוֹמֶר לְפִקּוּחַ נֶפֶשׁ שֶׁדּוֹחֶה אֶת הַשַּׁבָּת. נַעֲנָה רַבִּי אֶלְעָזָר וְאָמַר: וּמָה מִילָה שֶׁהִיא אֶחָד מִמָּאתַיִם וְאַרְבָּעִים וּשְׁמוֹנָה אֵיבָרִים שֶׁבָּאָדָם דּוֹחָה אֶת הַשַּׁבָּת — קַל וָחוֹמֶר לְכׇל גּוּפוֹ שֶׁדּוֹחֶה אֶת הַשַּׁבָּת. רַבִּי יוֹסֵי בְּרַבִּי יְהוּדָה אוֹמֵר: ״אֶת שַׁבְּתוֹתַי תִּשְׁמוֹרוּ״, יָכוֹל לַכֹּל — תַּלְמוּד לוֹמַר: ״אַךְ״ חָלַק. רַבִּי יוֹנָתָן בֶּן יוֹסֵף אוֹמֵר: ״כִּי קוֹדֶשׁ הִיא לָכֶם״, הִיא מְסוּרָה בְּיֶדְכֶם וְלֹא אַתֶּם מְסוּרִים בְּיָדָהּ. רַבִּי שִׁמְעוֹן בֶּן מְנַסְיָא אוֹמֵר: ״וְשָׁמְרוּ בְנֵי יִשְׂרָאֵל אֶת הַשַּׁבָּת״, אָמְרָה תּוֹרָה: חַלֵּל עָלָיו שַׁבָּת אַחַת כְּדֵי שֶׁיִּשְׁמוֹר שַׁבָּתוֹת הַרְבֵּה. אָמַר רַב יְהוּדָה אָמַר שְׁמוּאֵל: אִי הֲוַאי הָתָם, הֲוָה אָמֵינָא דִּידִי עֲדִיפָא מִדִּידְהוּ: ״וְחַי בָּהֶם״ — וְלֹא שֶׁיָּמוּת בָּהֶם. אָמַר רָבָא: לְכוּלְּהוּ אִית לְהוּ פִּירְכָא, בַּר מִדִּשְׁמוּאֵל דְּלֵית לֵיהּ פִּירְכָא. דְּרַבִּי יִשְׁמָעֵאל — דִּילְמָא כִּדְרָבָא. דְּאָמַר רָבָא: מַאי טַעְמָא דְּמַחְתֶּרֶת? חֲזָקָה, אֵין אָדָם מַעֲמִיד עַצְמוֹ עַל מָמוֹנוֹ. וְהַאי מִידָּע יָדַע דְּקָאֵי לְאַפֵּיהּ, וְאָמַר אִי קָאֵי לְאַפַּאי — קָטֵילְנָא לֵיהּ, וְהַתּוֹרָה אָמְרָה: בָּא לְהׇרְגְּךָ — הַשְׁכֵּם לְהׇרְגוֹ. וְאַשְׁכְּחַן וַדַּאי, סָפֵק מְנָלַן? וְכוּלְּהוּ אַשְׁכְּחַן וַדַּאי, סָפֵק מְנָא לַן? וְדִשְׁמוּאֵל, וַדַּאי לֵית לֵיהּ פִּירְכָא. אָמַר רָבִינָא וְאִיתֵּימָא רַב נַחְמָן בַּר יִצְחָק: טָבָא חֲדָא פִּלְפַּלְתָּא חֲרִיפָא מִמְּלָא צַנָּא דְקָרֵי.
§ 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. Rabbi Akiva answered and said that it is stated: “And if a man comes purposefully upon his neighbor to slay him with guile, you shall take him from My altar, that he may die” (Exodus 21:14). The phrase “take him from My altar” implies that if the murderer is a priest and comes to perform the service, one does not wait for him to do so but takes him to his execution immediately. But one should not take him from on top of My altar. If he already began the service and is in the midst of it, one does not take him down from the altar immediately but instead allows him to finish his service. And Rabba bar bar Ḥana said that Rabbi Yoḥanan said: They taught only that a priest is not removed from the altar in order to execute him for murder, but to preserve a life, e.g., if the priest can testify to the innocence of one who is sentenced to death, one removes him even from on top of My altar, even while he is sacrificing an offering. Just as this priest, about whom there is uncertainty whether there is substance to his words of testimony or whether there is no substance to his words, is taken from the Temple service in order to save a life, and Temple service overrides Shabbat, so too, a fortiori, saving a life overrides Shabbat. Rabbi Elazar ben Azarya answered and said: Just as the mitzva of circumcision, which rectifies only one of the 248 limbs of the body, overrides Shabbat, so too, a fortiori, saving one’s whole body, which is entirely involved in mitzvot, overrides Shabbat. Other tanna’im debated this same issue. Rabbi Yosei, son of Rabbi Yehuda, says that it is stated: “But keep my Shabbatot” (Exodus 31:13). One might have thought that this applies to everyone in all circumstances; therefore, the verse states “but,” a term that restricts and qualifies. It implies that there are circumstances where one must keep Shabbat and circumstances where one must desecrate it, i.e., to save a life. Rabbi Yonatan ben Yosef says that it is stated: “For it is sacred to you” (Exodus 31:14). This implies that Shabbat is given into your hands, and you are not given to it to die on account of Shabbat. Rabbi Shimon ben Menasya said: It is stated: “And the children of Israel shall keep Shabbat, to observe Shabbat” (Exodus 31:16). The Torah said: Desecrate one Shabbat on his behalf so he will observe many Shabbatot. Rav Yehuda said that Shmuel said: If I would have been there among those Sages who debated this question, I would have said that my proof is preferable to theirs, as it states: “You shall keep My statutes and My ordinances, which a person shall do and live by them” (Leviticus 18:5), and not that he should die by them. In all circumstances, one must take care not to die as a result of fulfilling the mitzvot. Rava commented on this: All of these arguments have refutations except for that of Shmuel, which has no refutation. The Gemara explains Rava’s claim: The proof brought by Rabbi Yishmael from the thief who breaks in could perhaps be refuted based on the principle of Rava, as Rava said: What is the reason for the halakha about the thief who breaks in? There is a presumption that while a person is being robbed he does not restrain himself with respect to his money. And this thief knows that the homeowner will rise to oppose him and said to himself from the start: If he rises against me, I will kill him. And the Torah states: If a person comes to kill you, rise to kill him first. We found a source for saving a life that is in certain danger, but from where do we derive that even in a case where there is uncertainty as to whether a life is in danger one may desecrate Shabbat? Consequently, Rabbi Yishmael’s argument is refuted. And for all the other arguments as well, we have found proofs for saving a life from certain danger. But for cases of uncertainty, from where do we derive this? For this reason, all the arguments are refuted. However, the proof that Shmuel brought from the verse: “And live by them,” which teaches that one should not even put a life in possible danger to observe mitzvot, there is certainly no refutation. Ravina said, and some say it was Rav Naḥman bar Yitzḥak who said with regard to this superior proof of Shmuel: One spicy pepper is better than a whole basket of squash, since its flavor is more powerful than all the others.