פיקוח נפש דוחה שבת

So he and his sons fled into the mountains, and left all that ever they had in the city. Then many that sought after justice and judgment went down into the wilderness, to dwell there: Both they, and their children, and their wives; and their cattle; because afflictions increased sore upon them. Now when it was told the king’s servants, and the host that was at Jerusalem, in the city of David, that certain men, who had broken the king’s commandment, were gone down into the secret places in the wilderness, They pursued after them a great number, and having overtaken them, they camped against them, and made war against them on the sabbath day. And they said unto them, Let that which ye have done hitherto suffice; come forth, and do according to the commandment of the king, and ye shall live. But they said, We will not come forth, neither will we do the king’s commandment, to profane the sabbath day So then they gave them the battle with all speed. Howbeit they answered them not, neither cast they a stone at them, nor stopped the places where they lay hid; But said, Let us die all in our innocency: heaven and earth will testify for us, that ye put us to death wrongfully. So they rose up against them in battle on the sabbath, and they slew them, with their wives and children and their cattle, to the number of a thousand people. Now when Mattathias and his friends understood hereof, they mourned for them right sore. And one of them said to another, If we all do as our brethren have done, and fight not for our lives and laws against the heathen, they will now quickly root us out of the earth. At that time therefore they decreed, saying, Whosoever shall come to make battle with us on the sabbath day, we will fight against him; neither will we die all, as our brethren that were murdered in the secret places.

(5) Gentiles who come against Israelite towns - go forth to do battle against them carrying weapons, and they violate the prohibitions of the Sabbath on their account. When? When they come to kill. But if they do not come to kill, they do not go forth against them carrying weapons, and they do not violate the prohibitions of the Sabbath on their account. If they come against towns located near the frontier, even to grab straw, even to grab a loaf of bread, they go forth against them carrying weapons, and they violate the prohibitions of the Sabbath on their account. At first, they would leave their weapons in the house nearest the wall. One time, they ran about and were in haste to grab their weapons, and they ended up killing one another. They established that each one should go to one's house.

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. The proof of Rabbi Akiva can also be refuted. He brought the case of removing a priest from altar service in order to have him testify on another’s behalf, since his testimony might acquit the accused and save him from execution. But perhaps that halakha is in accordance with the opinion of Abaye, as Abaye said: If the accused says he has a witness in his favor, we send a pair of rabbis on his behalf to determine if his words of testimony have substance. These rabbis would first check that the testimony of the priest is substantive before removing him from the altar. If so, we have found that one interrupts the Temple service to save a life from certain danger, but from where do we derive that one interrupts the Temple service when the likelihood of saving life is uncertain? 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.

(1) 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.

(2) [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.

(3) 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."

(4) When a person's eyes are ailing - i.e., when he has a secretion from either one or both of them, when tears flow from them due to great pain, when blood flows from them, or when they are affected by fever, or by other afflictions of this like - he is considered among those individuals who are dangerously ill. The Sabbath may be violated on his behalf, and anything necessary for his treatment may be performed for him.

(5) Similarly, a person who has a wound in his body cavity - from his lips inward, whether in his mouth, his digestive organs, his liver or spleen, or any of the other organs in his body cavity - is considered to be dangerously ill and does not require [a physician's] assessment [of his condition]. His ailment is serious, and we should violate the Sabbath laws on his behalf immediately without [waiting for] an assessment.
A wound on the back of the hand or on the back of the foot is considered equivalent to a wound in the body cavity. It does not require [a physician's] assessment [of his condition] for us to violate the Sabbath laws on his behalf. A fever that causes the flesh to wince is considered equivalent to a wound in the body cavity, and we should violate the Sabbath laws on this person's behalf.
Similarly, we should violate the Sabbath laws whenever a physician assesses an ailment as dangerous, even when it affects only the exterior of a person's skin.

(6) When a person swallows a leech, water may be heated for him on the Sabbath, and any medical treatment that is necessary may be administered, since his life is in danger. Similarly, when a person is bitten by a rabid dog or a poisonous snake or other reptile, any medical treatment that is necessary to save him may be administered. [The same laws apply] even when there is merely a question of whether or not [the bite] can cause death.

(7) When physicians assessed that a sick person required a fig, and ten people ran and brought him ten figs at once, they are all absolved of liability entirely.
[The same decision applies] if the ten people brought the figs one after another, even when he recuperated after the first fig, for all of them had license to bring them.

(8) If a sick person required two figs, and two figs could be found only on two separate stems - while three figs were found on another stem - we should remove the stem that has three figs, even though only two are required. [It is preferable] to cut only one stem and not two stems, so as not to increase [the performance of the forbidden labor of] gleaning. The same applies in all similar situations.

(9) When food is cooked for a sick person on the Sabbath and the sick person leaves some over after eating, a healthy person is forbidden to eat from the remainder, lest [this cause] more food to be added for him.
When, however, an animal is slaughtered for a sick person on the Sabbath, it is permissible for a healthy person to partake of uncooked meat [from that animal]. A decree was not enacted, because there is no possibility of an additional [activity] being performed [for a healthy person]. The same applies in all similar situations.

(10) When a sick person is not dangerously ill, all his needs should be cared for by a gentile. What is implied? We may tell a gentile to perform [forbidden labors] on his behalf and he performs them. [This includes] cooking, baking, bringing medicine from one domain to another and the like. Similarly, one may have one's eyes treated by a gentile on the Sabbath even though there is no danger involved.
Furthermore, if [the sick] require treatment that does not involve the performance of [forbidden] labors, they may be treated even by Jews. For this reason, it is permitted to perform [physical activities for the benefit of the sick]; for example, one may lift [the tendons of] the ears, lift up cartilage around the heart, restore broken bones to their places, or perform other activities of this like.

(11) When a woman in the process of childbirth squats to give birth, her life is considered in danger and the Sabbath laws may be violated on her behalf. A midwife may be called from a distant place and the umbilical cord may be cut and tied.
If she requires a light when she cries out because of labor pains, a candle may be lit for her. [This leniency is granted] even if she is blind, because light has a calming influence even if she does not see.
If she needs oil or the like, it may be brought for her. If possible, the items that are brought should be brought in an uncharacteristic manner; for example, a friend should bring a utensil tied in her hair. If this not possible, it may be brought in the ordinary manner.

(12) We should not help an idolatress give birth on the Sabbath, even if payment is offered. We do not worry about the possibility of ill-feelings being aroused. [This applies even when] there is no violation [of the Sabbath laws] involved.
[In contrast,] one may offer assistance to a daughter of a ger toshav who gives birth, since we are commanded to secure his well-being. We may not, however, violate the Sabbath laws on her behalf.

(13) From the time a woman in childbirth has a flow of blood until the birth - [and indeed,] after birth for three days - the Sabbath laws may be violated on her behalf, and all her needs should be met. [This applies] regardless of whether she says she requires such treatment or she maintains that she does not require such treatment.
Between the third and the seventh day [after childbirth], if she maintains that she does not require treatment, the Sabbath laws should not be violated on her behalf. If she remains silent, and certainly if she maintains that she requires treatment, the Sabbath laws should be violated on her behalf. Between the seventh and the thirtieth day, her status is analogous to that of a sick person who is not dangerously ill. Even if she maintains that she requires treatment, [forbidden] labors should be performed on her behalf only by a gentile.

(14) A fire may be kindled for a woman after she has given birth even in the summer, since cold is very difficult for a woman to bear after childbirth in the cold regions. In contrast, a fire should not be kindled for other sick people to warm themselves. Nevertheless, if a person let blood and became chilled, a fire may be kindled for him even in the summer.
After cutting his umbilical cord, we may wash a new born baby on the day he is born, even when this requires heating the water on the Sabbath. Herbal powder can be applied to his skin and his limbs can be tied, for it is dangerous not to perform these activities for him.
Similarly, a baby may be washed before circumcision, after circumcision, and on the third day after circumcision with water that is heated on the Sabbath, because of the danger [to him].

(15) When a woman dies while in labor on the Sabbath, a knife should be brought - even if it must be carried through the public domain - and the woman's womb cut open and the fetus removed, for it is possible that it will still be alive.
[The rationale for this ruling is] that the Sabbath laws are violated even when there is only a possibility of saving a life, and even in such instances, where there is no chazakah on which to base our presumption that the fetus is alive.

(16) [All] activities necessary to save a life should be performed on the Sabbath; there is no necessity to receive license from the court. The more zealous one is [in this regard], the more praiseworthy.
What is implied? If one sees that a child has fallen into the sea, one may spread out a net and hoist him up, although one catches fish together with him. If a person hears that a child fell into the sea and spreads out a net to hoist him up, but raises up only fish, he is absolutely free of liability.
If he intended to raise up fish and [in fact] lifted up both fish and a child, he is not held liable. Since he lifted up a child together with the fish, he is not held liable even when he did not hear that the child had fallen into the water.

(17) If a child fell into a pit, a person may dislodge a clod of earth, and lift [the child] up, even though he creates a step when he dislodges it. If a door was locked with a child inside, a person may break the door down and take the child out, even though he chops it into pieces of wood which are appropriate to use for work, lest the child become frightened and die.
If a fire broke out and a person is inside the building and we fear that he may be consumed by the flames, a person may extinguish the fire to save him, although he prepares a pathway while extinguishing the fire. Whoever acts first to save him is praiseworthy. One does not need to ask permission from the court in all instances when there is a danger to a person's life.

(18) When an avalanche has fallen, and there is a doubt whether or not it has fallen over a person, it may be cleared. If the person was discovered to be alive, but was crushed [by the fallen debris] to the extent that it is impossible that he will recover, [the debris] may be cleared and the person taken out to enable him to live [however] long he does.

(19) If [in the process of clearing the debris,] they [reached] his nose and saw that he was not breathing, he should be left there, for he has died already.
Although it is discovered that people on the upper level of a landslide have died, one should not assume that those on the lower levels have died. Instead, [the debris] should be cleared away from all of the people, for in a landslide it is possible that those on the upper level will die, while those on the lower level will remain alive.

(20) When an avalanche fell on a courtyard in which were located both gentiles and Jews - even if there were a thousand gentiles and only one Jew, we should remove all [the debris] for the sake of the Jew. Should one of the individuals leave and enter another courtyard and that courtyard collapse upon him, we should remove [the debris]. Perhaps the person who departed was a Jew, and [all] those who remain were gentiles.

(21) When they all left this courtyard to go to another courtyard, and as they were proceeding, one of them whose identity is unknown departed and entered a third courtyard and was covered by an avalanche, [the debris] should not be removed from him.
Since they left their original place, [the presence of] a Jew is not accepted as an established fact. Hence, we assume that anyone who separated from this group as it was proceeding was part of the majority. Accordingly, if the majority were Jewish, even a person separated from them [who entered] another courtyard after they left their original place - should he be covered by an avalanche, we should remove [the debris] from him.

(22) A person who is traveling in the desert and does not know which day is the Sabbath should count six days and consider the seventh day as holy. He should recite the blessing of the day [Kiddush] and recite Havdalah at the conclusion of this "Sabbath" day.
Every day, even on the day on which he recites Kiddush and after which he recites Havdalah, he is allowed to earn only enough for his livelihood, so that he will not die. It is forbidden for him to earn more than his livelihood, for there is a possibility that every day is the Sabbath.
If the person knows that the day is the eighth day or the fifteenth day after his departure, he is allowed to work on that day, for it is certain that he did not depart on the Sabbath. On the other days, he is allowed to earn merely his livelihood.

(23) [The following rules apply] when gentiles lay siege to Jewish cities: If their intent was financial gain, the Sabbath laws should not be violated because of them, nor are we allowed to wage war against them. If a city is located near the border, however, we should march against them with weapons and wage war against them even when they are demanding hay or straw.
In any location, if the gentiles' intent was Jewish lives, or if they engaged in battle with a city or laid siege to it without stating a specific intention, we must wage war against them, and the Sabbath laws should be violated because of them. It is a mitzvah for every member of the Jewish people who can come [to their assistance] to go out and aid their brethren who are under siege and save them from the gentiles [although it is the] Sabbath. It is forbidden to wait until Saturday night.
After they have saved their brethren, they may return home with their weapons on the Sabbath, so that a dangerous situation will not be created in the future.

(24) Similarly, if a ship is sinking at sea or a city is surrounded by a [flooding] river, it is a mitzvah to go out on the Sabbath and use every possible means to save them.
Even when a single individual is being pursued by gentiles, by a snake, or by a bear with the intent to kill him, it is a mitzvah to save him, even when it is necessary to perform several forbidden labors on the Sabbath. It is even permitted to forge weapons to save him. Similarly, we should cry out [to God] on their behalf, make supplications, and sound the trumpets to summon help for them.
We should not cry out [to God] or make supplications because of plague on the Sabbath.

(25) We should lay siege to gentile cities [at least] three days before the Sabbath. We may wage war with them on any day, even on the Sabbath, until we conquer [the city], even if the war is voluntary in nature. The oral tradition, interprets [Deuteronomy 20:20] "until you have subjugated it," as teaching that [one should wage war] even on the Sabbath.
Surely, the above applies with regard to a war that we are obligated to wage. Indeed, it was on the Sabbath that Joshua conquered Jericho.