Should one preferably have a gentile violate the Shabbos for an ill person?

It was stated in the previous shiur that it is imperative to learn the halachos pertaining to pikuach nefesh and shiurim must be set up in each community. The halachos here presented are not a substitute to orderly shiurim on the subject and are merely intended to give an idea of the important matters involved.

The advantage of a gentile violating the Shabbos as opposed to a Jew is that instructing a gentile is merely an issur d’rabanan whereas a Jew violating the Shabbos is an issur d’oraisso.

However, as mentioned in the last shiur, when it comes to pikuach nefesh (lifesaving) the Rambam prefers the wise men, the Talmidei Chachamim, to violate the Shabbos and not an average Jew. The Beis Yosef is not as demanding [1] as it is suffices if Jewish males deal with the pikuach nefesh as opposed to women, children and gentiles.

What is the advantage of wise men and adult Jewish males?

The Shulchan Aruch HaRav 328:13 explains that when the sages attend to pikuach nefesh it serves as a lesson as to the correct attitude one is to have when attending to pikuach nefesh. A similar idea can be said when a male must deal with pikuach nefesh. The following narrative will elucidate this concept.

A lady in shul was not feeling well on the night of kol nidrei and medical attention was urgently needed. Nobody at the scene was prepared to “violate” Yom Kippur in order to summon an ambulance, save for one woman who dialed the medical service.

From that day on she was labeled the “Shabbos Goy”.

This halacha teaches us that the contrary is correct. It is men, and some learn that talmidei chachamim, who must violate the Shabbos in order to demonstrate the vitality of the need to violate the Shabbos to save a Jewish life.

In this case, the woman who called the ambulance service performed a huge mitzvah [2] and the others who stood by, Hashem Yerachem…

Women must adhere to the laws of Shabbos just as much as men, so why does the Mechaber say that Jewish men should deal with pikuach nefesh?

The poskim [3] explain that if one would instruct a woman to violate the Shabbos, people are liable to think that, for whatever reason, only woman may violate the Shabbos, and when a case of pikuach nefesh arises and woman are not present, the men will not want to violate the Shabbos.

Would the same apply to children and to gentiles?

The Mechaber learns (and we will soon see that there is a machlokes) that the same applies to gentiles and children. If they are instructed to deal with the pikuach nefesh people might think that it is only they who are permitted to violate the Shabbos.

There is another reason. A Jew appreciates the life of another Jew and will deal with pikuach nefesh in a much quicker fashion, which will often save the patient’s life.

Is this opinion not accepted by all?

No, the Rama [4] writes that when possible to deal with the patient without any adverse effects by performing a melacha b’shinui (in a backhanded manner, such as turning on the lights with one’s elbow) or telling a gentile to treat the patient, one should do so. He maintains that if the treatment will be the same, whether administered by a gentile or a Jew, why should the Jew violate the Shabbos unnecessarily?

What is the halacha, who do we follow?

The Sephardim, who follow the rulings of the Mechaber, are in a more clear cut position and they should follow the Mechaber, i.e. Jewish males must violate the Shabbos for pikuach nefesh and not women, children or gentiles. We are obviously talking about a case where the men share as much medical knowledge as the women present or it is a matter such as turning on lights, calling an ambulance and so forth, where medical knowledge is not required.

If, for example, a critically ill person needs the heating turned on, why should one not instruct a gentile to do so - there is no rush involved?

Rav Bentzion Abba Shaul ztz”l writes [5] that Sephardim should follow the p’sak of the Mechaber but it depends for what. He writes that when dealing with direct medical care such as operating a lung machine, inserting an IV etc. a Jew must be used, for the reasons mentioned above. But when turning on a heater, recording details regarding medication administered to a patient etc, since these functions can be carried out just as well by a gentile or b’shinui, Rav Benzion Abba Shaul says that even the Mechaber would agree that a gentile may be used.