the previous shiur we learned that when Shabbos needs to
be violated for the ill, it is preferable to use Jewish
adults or wise men rather than women.
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 only children and gentiles
were 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
Is this opinion not accepted by all?
No, the Rama
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
What is the halacha, who do we follow?
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 the women present are more
educated medically than the men present, and the
situation requires medical knowhow, it is obvious that
the women should deal with the situation.
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
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.
Do the Ashkenazim follow the p’sak of the Rama with regards
to pikuach nefesh?
however argues with the Rama
and says that when a Jew’s life is in danger, even if a
gentile is present he should not be used and the Jew
should be speedy and save a life.
The Mishna Berura
cites the Taz, which
implies that he favors this opinion and indeed when a
Jew’s life is in imminent danger, a Jew should do all
that is possible and as quickly as possible to save
another Jew’s life.
Does that disqualify the
use of a gentile or doing anything b’shinui?
Not exactly. We must differentiate between an
imminent life threatening situation where every minute
counts, in which case we say that a Jew should deal with
the situation and not dally, and between a case of
pikuach nefesh where the patient is not in any
immediate danger, in which case one may request a
gentile to violate the Shabbos and one should do a
shinui if possible.
For example, a newborn baby is placed beneath a heater
in order to provide the heat the child had in the
mother’s womb. This heater must be turned on Shabbos for
the baby, but it can easily be done by asking a gentile
to turn it on or by activating the switch b’shinui.
A patient must be taken for a CAT scan, which involves
wheeling him from his room to the CT room. Although he
must ride the elevator, there is no need to press the
button in the normal manner and there is nothing wrong
asking a gentile to press the button instead of a Jew.
One of the reasons not
to use a gentile is because people are liable to think
that only a gentile may be used for pikuach nefesh. If
so, they may think the same when turning on the heater
for the newborn baby?
Correct, and the same problem exists when turning
it on b’shinui.
Rav Shlomo Zalman Auerbach ztz”l writes
that when doing it b’shinui
one should announce to people in the vicinity that
halachically one may do it in the normal manner when
there is a possibility that doing it b’shinui
will be cause for a delay in treating the patient.
We can say the same when using a gentile for the
abovementioned examples. The bottom line is that when
the threat is immediate a gentile must not be used nor
should anything be done b’shinui, but when there
is no rush one can request that a gentile to do the deed
or try do it b’shinui. Even in the latter case it
is expected that there be no adverse effects to the
treatment because a Jew did not do it or because of the
Can you provide a few examples of the above?
When it is necessary to call a doctor or an
ambulance on Shabbos, one should lift the phone
receiver b’shinui – with one’s elbow etc. or
turn on the phone and dial with a spoon in one’s
hand, because this is called a shinui. Some
situations cause panic and one’s wits are not always
in control to remember these things. If however one
can calculate one’s moves and it is not a dire
emergency, a shinui should be implemented.
The lights in the patient’s room must be turned on
for the doctor to examine the patient. In most cases
it suffices to turn on the lights with one’s elbow
and thus avoid an issur d’oraisso.
A patient requires the insertion of an intravenous
feed. There is reason to believe that this involves
an issur d’oraisso because blood is
drawn purposely through the needle to see whether
the needle has indeed entered the vein, and drawing
blood for a purpose involves the melacha of
Netilas Neshama. I do not suggest that an IV
be inserted b’shinui (unless one practices on
one’s own arm) but it is possible to ask a gentile
to do it if there is no rush.
In certain countries one must sign a document before
surgery. This is permitted on Shabbos as well in a
case of pikuach nefesh but obviously there is
no rush in actual signing. Therefore, if one is able
to sign with one’s left hand one must do so because
it downgrades the action from a d’oraisso to