Halachaהלכה

Pikuach Nefesh: When Saving Life Overrides Shabbat

These sources establish the halakhic principle that preserving human life overrides the prohibition of working on Shabbat. Drawing from biblical verses, Talmudic discussions, and Mishnaic rulings, the sources show that violating Shabbat to save a life is not merely permitted but obligatory, and should be performed by the most learned members of the community.

דְחוּיָה הִיא שַׁבָּת אֵצֶל סַכָּנַת נְפָשׁוֹת

12 sources · verified

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Source 1 · Tanach
Verified

Exodus — "You Shall Keep My Sabbaths"

Exodus 31:13-14

God commands Israel to keep the Sabbath as a sign, stating that it is holy to them. The Talmud derives from the phrase 'to you' (לכם) that Shabbat is given for you — you are not to die on its account — establishing the scriptural basis for pikuach nefesh overriding Shabbat.

וּשְׁמַרְתֶּם֙ אֶת־הַשַּׁבָּ֔ת כִּ֛י קֹ֥דֶשׁ הִ֖וא לָכֶ֑ם מְחַֽלְלֶ֙יהָ֙ מ֣וֹת יוּמָ֔ת כִּ֗י כׇּל־הָעֹשֶׂ֥ה בָהּ֙ מְלָאכָ֔ה וְנִכְרְתָ֛ה הַנֶּ֥פֶשׁ הַהִ֖וא מִקֶּ֥רֶב עַמֶּֽיהָ׃

You shall keep the sabbath, for it is holy for you. One who profanes it shall be put to death: whoever does work on it, that person shall be cut off from among kin.

Source 2 · Tanach
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Leviticus — "You Shall Live by Them"

Leviticus 18:5

The verse commands to live by the Torah's laws, not to die by them (וָחַי בָּהֶם, וְלֹא שֶׁיָּמוּת בָּהֶם). This is the primary biblical prooftext invoked throughout the Talmud to permit — and require — violating Shabbat and other commandments to preserve human life.

וּשְׁמַרְתֶּ֤ם אֶת־חֻקֹּתַי֙ וְאֶת־מִשְׁפָּטַ֔י אֲשֶׁ֨ר יַעֲשֶׂ֥ה אֹתָ֛ם הָאָדָ֖ם וָחַ֣י בָּהֶ֑ם אֲנִ֖י יְהֹוָֽה׃ {ס}

You shall keep My laws and My rules, by the pursuit of which humans shall live: I am GOD.

Source 3 · Chazal
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Mishnah Yoma — Saving Life on Yom Kippur

Mishnah Yoma 8:6

The Mishnah rules that one in danger of death is fed on Yom Kippur on the advice of experts; if no expert is present, the person feeds himself. This extends the principle of pikuach nefesh to the most solemn fast day and implicitly applies the same logic to Shabbat.

וְעוֹד אָמַר רַבִּי מַתְיָא בֶן חָרָשׁ, הַחוֹשֵׁשׁ בִּגְרוֹנוֹ, מַטִּילִין לוֹ סַם בְּתוֹךְ פִּיו בְּשַׁבָּת, מִפְּנֵי שֶׁהוּא סְפֵק נְפָשׁוֹת, וְכָל סְפֵק נְפָשׁוֹת דּוֹחֶה אֶת הַשַּׁבָּת:

And a case of uncertainty concerning a life-threatening situation overrides Shabbat.

Source 4 · Chazal
Verified

Talmud Yoma — The Core Sugya on Pikuach Nefesh

Yoma 85a-85b

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.

Source 5 · Chazal
Verified

Talmud Sanhedrin — Yehareg V'Al Ya'avor

Sanhedrin 74a

Establishes the principle that one must violate all commandments to save one's life except for the three cardinal sins (murder, sexual immorality, idolatry). This contextualizes pikuach nefesh: Shabbat, not being one of the three, must be violated to preserve life.

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. וַעֲבוֹדָה זָרָה לָא? וְהָא תַּנְיָא: אָמַר רַבִּי יִשְׁמָעֵאל, מִנַּיִן שֶׁאִם אָמְרוּ לוֹ לָאָדָם ״עֲבוֹד עֲבוֹדָה זָרָה וְאַל תֵּהָרֵג״, מִנַּיִן שֶׁיַּעֲבוֹד וְאַל יֵהָרֵג? תַּלְמוּד לוֹמַר ״וָחַי בָּהֶם״ – וְלֹא שֶׁיָּמוּת בָּהֶם.

§ 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. The Gemara asks: And should one not transgress the prohibition of idol worship to save his life? But isn’t it taught in a baraita: Rabbi Yishmael said: From where is it derived that if a person is told: Worship idols and you will not be killed, from where is it derived that he should worship the idol and not be killed? The verse states: “You shall keep My statutes and My judgments, which a person shall do, and he shall live by them” (Leviticus 18:5), thereby teaching that the mitzvot were given to provide life, but they were not given so that one will die due to their observance.

Source 6 · Rishonim
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Rambam — The Wise Man Performs the Violation Himself

Mishneh Torah, Sabbath 2:3

Rambam explicitly rules that the desecration of Shabbat for pikuach nefesh should be performed by gedolei Yisrael (the greatest Torah scholars), not delegated to non-Jews or minors, in order to teach that saving life is a Torah obligation and not a prohibition.

כְּשֶׁעוֹשִׂים דְּבָרִים הָאֵלּוּ אֵין עוֹשִׂין אוֹתָן לֹא עַל יְדֵי נָכְרִים וְלֹא עַל יְדֵי קְטַנִּים וְלֹא עַל יְדֵי עֲבָדִים וְלֹא עַל יְדֵי נָשִׁים כְּדֵי שֶׁלֹּא תְּהֵא שַׁבָּת קַלָּה בְּעֵינֵיהֶם. אֶלָּא עַל יְדֵי גְּדוֹלֵי יִשְׂרָאֵל וְחַכְמֵיהֶם. וְאָסוּר לְהִתְמַהְמֵהַּ בְּחִלּוּל שַׁבָּת לְחוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה שֶׁנֶּאֱמַר (ויקרא יח ה) "אֲשֶׁר יַעֲשֶׂה אוֹתָם הָאָדָם וָחַי בָּהֶם" וְלֹא שֶׁיָּמוּת בָּהֶם. הָא לָמַדְתָּ שֶׁאֵין מִשְׁפְּטֵי הַתּוֹרָה נְקָמָה בָּעוֹלָם אֶלָּא רַחֲמִים וְחֶסֶד וְשָׁלוֹם בָּעוֹלָם.

When such treatment is administered, it should not be administered by gentiles, by children, by servants, or by women, so that they will not view the Sabbath flippantly. Instead, the treatment should be administered by the leaders of Israel and the wise. It is forbidden to hesitate before transgressing the Sabbath [laws] on behalf of a person who is dangerously ill, as [reflected in the interpretation in the phrase of Leviticus 18:5,] "which a person shall perform to live through them," as "['to live through them'] and not to die through them." This teaches that the judgments of the Torah do not [bring] vengeance to the world but rather bring mercy, kindness, and peace to the world.

Source 7 · Rishonim
Verified

Rambam, Mishneh Torah — Laws of Shabbat

Mishneh Torah, Sabbath 2:1-3

The Rambam rules that whenever there is a possibility of mortal danger, it is obligatory to violate Shabbat, and one who is zealous (זריז) in doing so is praiseworthy. He emphasizes that the Torah was given to live by, not to die by, and that saving life overrides virtually all prohibitions.

דְחוּיָה הִיא שַׁבָּת אֵצֶל סַכָּנַת נְפָשׁוֹת כִּשְׁאָר כָּל הַמִּצְוֹת. לְפִיכָךְ חוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה עוֹשִׂין לוֹ כָּל צְרָכָיו בְּשַׁבָּת עַל פִּי רוֹפֵא אֻמָּן שֶׁל אוֹתוֹ מָקוֹם. סָפֵק שֶׁהוּא צָרִיךְ לְחַלֵּל עָלָיו אֶת הַשַּׁבָּת סָפֵק שֶׁאֵינוֹ צָרִיךְ. וְכֵן אִם אָמַר רוֹפֵא לְחַלֵּל עָלָיו אֶת הַשַּׁבָּת וְרוֹפֵא אַחֵר אוֹמֵר אֵינוֹ צָרִיךְ מְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת שֶׁסְּפֵק נְפָשׁוֹת דּוֹחֶה אֶת הַשַּׁבָּת: אֲמָדוּהוּ בְּיוֹם הַשַּׁבָּת שֶׁהוּא צָרִיךְ לְכָךְ וְכָךְ לִשְׁמוֹנָה יָמִים אֵין אוֹמְרִים נַמְתִּין עַד הָעֶרֶב כְּדֵי שֶׁלֹּא לְחַלֵּל עָלָיו שְׁתֵּי שַׁבָּתוֹת אֶלָּא מַתְחִילִין מֵהַיּוֹם שֶׁהוּא שַׁבָּת וּמְחַלְּלִין עָלָיו אֲפִלּוּ מֵאָה שַׁבָּתוֹת כָּל זְמַן שֶׁהוּא צָרִיךְ וְיֵשׁ בּוֹ סַכָּנָה אוֹ סְפֵק סַכָּנָה מְחַלְּלִין. וּמַדְלִיקִין לוֹ אֶת הַנֵּר וּמְכַבִּין מִלְּפָנָיו אֶת הַנֵּר וְשׁוֹחֲטִין לוֹ וְאוֹפִין וּמְבַשְּׁלִין וּמְחִמִּין לוֹ חַמִּין בֵּין לְהַשְׁקוֹתוֹ בֵּין לִרְחִיצַת גּוּפוֹ. כְּלָלוֹ שֶׁל דָּבָר שַׁבָּת לְגַבֵּי חוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה הֲרֵי הוּא כְּחל לְכָל הַדְּבָרִים שֶׁהוּא צָרִיךְ לָהֶן: כְּשֶׁעוֹשִׂים דְּבָרִים הָאֵלּוּ אֵין עוֹשִׂין אוֹתָן לֹא עַל יְדֵי נָכְרִים וְלֹא עַל יְדֵי קְטַנִּים וְלֹא עַל יְדֵי עֲבָדִים וְלֹא עַל יְדֵי נָשִׁים כְּדֵי שֶׁלֹּא תְּהֵא שַׁבָּת קַלָּה בְּעֵינֵיהֶם. אֶלָּא עַל יְדֵי גְּדוֹלֵי יִשְׂרָאֵל וְחַכְמֵיהֶם. וְאָסוּר לְהִתְמַהְמֵהַּ בְּחִלּוּל שַׁבָּת לְחוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה שֶׁנֶּאֱמַר (ויקרא יח ה) "אֲשֶׁר יַעֲשֶׂה אוֹתָם הָאָדָם וָחַי בָּהֶם" וְלֹא שֶׁיָּמוּת בָּהֶם. הָא לָמַדְתָּ שֶׁאֵין מִשְׁפְּטֵי הַתּוֹרָה נְקָמָה בָּעוֹלָם אֶלָּא רַחֲמִים וְחֶסֶד וְשָׁלוֹם בָּעוֹלָם. וְאִלּוּ הָאֶפִּיקוֹרוֹסִים שֶׁאוֹמְרִים שֶׁזֶּה חִלּוּל שַׁבָּת וְאָסוּר עֲלֵיהֶן הַכָּתוּב אוֹמֵר (יחזקאל כ כה) "גַּם אֲנִי נָתַתִּי לָהֶם חֻקִּים לֹא טוֹבִים וּמִשְׁפָּטִים לֹא יִחְיוּ בָּהֶם":

The [laws of] the Sabbath are suspended in the face of a danger to life, as are [the obligations of] the other mitzvot. Therefore, we may perform - according to the directives of a professional physician of that locale - everything that is necessary for the benefit of a sick person whose life is in danger. When there is a doubt whether or not the Sabbath laws must be violated on a person's behalf, one should violate the Sabbath laws on his behalf, for the Sabbath laws are suspended even when there is merely a question of danger to a person's life. [The same principles apply] when one physician says the Sabbath laws should be violated on a person's behalf and another physician states that this is not necessary. [The following laws apply when physicians] determine on the Sabbath that a person needs [a treatment to be administered] for eight days. We do not say that we should wait until the evening so that it will not be necessary to violate two Sabbaths on his behalf. Instead, the treatment is begun immediately, on the Sabbath, and even one hundred Sabbaths may be violated on his behalf. As long as a person is dangerously [ill] - or even if there is a question whether or not he is dangerously [ill] - and requires treatment, [the Sabbath] should be violated [on his behalf]. A lamp may be lit on his behalf and extinguished on his behalf. [Animals] may be slaughtered on his behalf, [food] baked and cooked on his behalf, and water heated for him, whether to drink or to use for bathing. The general principle for a person who is dangerously ill is that the Sabbath should be considered as a weekday regarding all his needs. When such treatment is administered, it should not be administered by gentiles, by children, by servants, or by women, so that they will not view the Sabbath flippantly. Instead, the treatment should be administered by the leaders of Israel and the wise. It is forbidden to hesitate before transgressing the Sabbath [laws] on behalf of a person who is dangerously ill, as [reflected in the interpretation in the phrase of Leviticus 18:5,] "which a person shall perform to live through them," as "['to live through them'] and not to die through them." This teaches that the judgments of the Torah do not [bring] vengeance to the world, but rather bring mercy, kindness, and peace to the world. Concerning those non-believers who say that [administering such treatment] constitutes a violation of the Sabbath and is forbidden, one may apply the verse [Ezekiel 20:25]: "[As punishment,] I gave them harmful laws and judgments through which they cannot live."

Source 8 · Rishonim
Verified

Rambam, Moreh Nevuchim — The Law is for the Living

Guide for the Perplexed, Part 3 34

Rambam discusses how the Torah's laws are designed for the general welfare and survival of society. The principle that mortal danger overrides commandments reflects the Torah's fundamental purpose: preserving life and enabling human flourishing, not causing death.

תועלת המצוות נבחנת באופן כללי התורה, כמו הטבע, אינה עוסקת בחריג 1 עוד עליך לדעת, שהתורה אינה מתייחסת לחריג, וציווייה אינם לפי הדבר הנדיר. אלא כל דעה או מידה או מעשה מועיל שיש רצון להשיג, מכוון בו לדברים השכיחים, ואין שועים לדבר שהיקרותו נדירה, או לנזק שיקרה לאחד מן האנשים בשל אותן קביעות והנהגות תורניות. כי התורה היא דבר אלוהי. השוואה לטבע) עליך להתבונן בדברים הטבעיים, שיש בכלל התועלות הכלליות המצויות בהם, ואף מתחייבים מהן, נזקים פרטיים, כמו שהתברר מדברינו (א,עב18-16; ג,יב7) ומדברי אחרים. התורה, כמו הטבע, אינה נשלמת בכל אדם 2 גם לפי ההתבוננות הזאת אין לך להתפלא על כך שמטרת התורה אינה נשלמת בכל אדם ואדם, אלא בהכרח יהיו אנשים שאותה הנהגה תורנית לא תביא לשלמות, כי לא כל מה שמתחייב מצורות המינים בטבע מתממש בכל פרט ופרט. הסבר) כי הכול (=התורה והטבע) מאלוה אחד ומפועל אחד, וכולם נִתְּנוּ מֵרֹעֶה אֶחָד (קהלת יב,יא; בבלי חגיגה ג,ב). לא ייתכן אחרת, וכבר הבהרנו (ג,טו1) שלבלתי אפשרי יש טבע קבוע שאינו משתנה לעולם. מצוות התורה: בין רפואה למשפט 3 לפי התבוננות זו גם לא ייתכן שהמצוות תהיינה תלויות בשוני במצבי בני האדם ובזמנים בדומה לטיפול רפואי המיוחד לכל אדם בהתאם למזגו הנוכחי. אלא ההנהגה של התורה צריכה להיות מוחלטת, כללית, לכול, אפילו היה הדבר מתאים לאנשים מסוימים ולאנשים אחרים לא; כי אילו היה הדבר בהתאם לאנשים הפרטיים היה מגיע קלקול לכול, ונתת דבריך לשיעורין (תוספתא סוכה ד,יב ועוד). מטרות מצוות התורה אינן תלויות בזמן או במקום 4 מטרה) מסיבה זו אין ראוי שהדברים המכוונים מן התורה בכוונה ראשונה (=כמטרה) יהיו תלויים לא בזמן ולא במקום, אלא יהיו הדינים מוחלטים וכלליים, כמו שאמר יתעלה: "הַקָּהָל, חֻקָּה אַחַת לָכֶם" (במדבר טו,טו). אך הכוונה בהם תהיה לאינטרסים הכלליים, השכיחים, כמו שביארנו.

IT is also important to note that the Law does not take into account exceptional circumstances; it is not based on conditions which rarely occur. Whatever the Law teaches, whether it be of an intellectual, a moral, or a practical character, is founded on that which is the rule and not on that which is the exception: it ignores the injury that might be caused to a single person through a certain maxim or a certain divine precept. For the Law is a divine institution, and [in order to understand its operation] we must consider how in Nature the various forces produce benefits which are general, but in some solitary cases they cause also injury. This is clear from what has been said by ourselves as well as by others. We must consequently not be surprised when we find that the object of the Law does not fully appear in every individual; there must naturally be people who are not perfected by the instruction of the Law, just as there are beings which do not receive from the specific forms in Nature all that they require. For all this comes from one God, is the result of one act; “they are all given from one shepherd” (Eccles. 12:11). It is impossible to be otherwise; and we have already explained (chap. xv.) that that which is impossible always remains impossible and never changes. From this consideration it also follows that the laws cannot like medicine vary according to the different conditions of persons and times; whilst the cure of a person depends on his particular constitution at the particular time, the divine guidance contained in the Law must be certain and general, although it may be effective in some cases and ineffective in others. If the Law depended on the varying conditions of man, it would be imperfect in its totality, each precept being left indefinite. For this reason it would not be right to make the fundamental principles of the Law dependent on a certain time or a certain place; on the contrary, the statutes and the judgments must be definite, unconditional and general, in accordance with the divine words: “As for the congregation, one ordinance shall be for you and for the stranger” (Num. 15:15); they are intended, as has been stated before, for all persons and for all times.

Source 9 · Acharonim
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Shulchan Arukh — Laws of Shabbat and Pikuach Nefesh

Shulchan Arukh, Orach Chayim 328:1-4

The Shulchan Arukh codifies that any life-threatening illness requires Shabbat to be violated, and that one who acts quickly is praiseworthy while one who asks a non-Jew instead of acting himself is a 'shedder of blood.' Rema adds important Ashkenazic glosses on the same principle.

מי שיש לו חולי של סכנה מצוה לחלל עליו את השבת והזריז הרי זה משובח והשואל הרי זה שופך דמים:

For someone who has a dangerous illness, it is a commandment to break Shabbat for him. One who hurries to do this is praised. One who asks about this is a murderer.

Source 10 · Acharonim
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Maharal — Torah as the Life-Force of Israel

Netivot Olam, Netiv Hatorah 1:1

The Maharal explains that Torah and life are intrinsically bound together. Since Shabbat is a sign of Israel's connection to the Divine source of life, when actual life is at stake, saving that life is itself the deeper fulfillment of the Torah's intent.

כי לב האדם שם החיים, והתורה תחזיק לבך ותתן לך חיים, ותשמור מצותי וחיה. כי דברי תורה תומכים ומאשרים כל העולם כולו, ואיך לא יהיו מאשרים ותומכים את האדם עצמו, שהוא עוסק בתורה, והיא עם האדם.

Source 11 · Modern
Verified

Nefesh HaChayyim — Man as Active Partner in the World

Nefesh HaChayim, Gate I 4

Rav Chaim of Volozhin teaches that human actions have cosmic significance; preserving a human life — itself described as an entire world (Sanhedrin 37a) — is therefore a supreme spiritual act that by its very nature can and must override Shabbat restrictions.

ובזה יובן הכתוב וייצר ה' אלקים את האדם עפר גו' ויפח באפיו נשמת חיים ויהי האדם לנפש חיה. ופשוטו של מקרא ודאי הוא כתרגומו והוה באדם לרוח ממללא. ור"ל שכאשר היה הגוף לבדו היה עדיין עפר ממש בלא שום חיות ותנועה: וכאשר נופח בו נשמת חיים. אז נעשה איש חי להתנועע ולדבר. ועיין רמב"ן בפי' התורה. אמנם בקרא ויהי באדם לא כתיב. אלא ויהי האדם לזאת יש מקום לפרשו ע"פי שנתבאר. שהאדם בנשמת החיים שבתוכו. הוא נעשה נפש חיה לרבוי עולמות אין מספר. שכמו שכל פרטי הנהגות הגוף ותנועותיו הוא ע"י כח הנפש שבקרבו. כן האדם הוא הכח ונפש החיה של עולמות עליונים ותחתונים לאין שיעור. שכולם מתנהגים על ידו כנ"ל:

And from this will be understood what is written (Bereshit 2:7): “And God-Elohi”m formed man [from] dust..., and blew into his nostrils the soul-Neshama of life, and man became a living soul-Neffesh.” The plain meaning of the text is definitely according to his translation: “and it was within man a speaking soul-Ruakh”, desiring to convey that when he was just a body, he was still actually dust without any life or movement. And when the soul-Neshama of life was blown within him, then he became a living person able to move about and speak. Refer to Nakhmanides’ commentary on the Torah. However, the text does not say “and it was in man” but rather “and it was the man.” For this reason there is room to explain it as we did, that the man with the living soul-Neshama that is within him, he becomes a living soul-Neffesh for a multitude of worlds without number. For just as all the details of the body and its movements are by the power of the soul-Neffesh within him, so too man is the power, the living soul-Neffesh for all the higher and lower worlds without limitation, that he drives all of them.

Source 12 · Modern
Verified

Mishnah Berurah — Chafetz Chaim on Pikuach Nefesh

Mishnah Berurah 328:1

The Chafetz Chaim elaborates extensively on the obligation to violate Shabbat for pikuach nefesh, stressing that hesitation or over-caution in such matters is itself a grave sin. He clarifies which types of danger qualify and who is obligated to act.

(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: