Halachos of Shabbos Pikuach Nefesh and Refuah

...Continued from previous week

1) A sickness that is known to be life-threatening, but people are not so afraid of it due to the availability of antibiotics and other drugs to treat it, still retains its status as a life-threatening illness, and a person stricken by it is treated as a Choleh Sheyaish Bo sakanah, an ill person in danger.

2) Thus, it is permitted to violate the Shabbos to procure antibiotics or other drugs that this patient needs, if the doctor says it's immediately necessary. It is also permitted to shut the lights if they are not allowing the patient to sleep, and do other melachos deemed necessary for his health and healing. (See Sefer Chut Shani Vol. 4 page 173)

3) When caring for a Choleh Sheyaish Bo Sakanah, a patient in a situation that is deemed life-threatening, the Poskim debate if any and all Melachos may be done on Shabbos to ensure his comfort, or only specific Melachos that if not done will weaken him and put him in immediate danger.

4) The Biur Halacha (Siman 328:4 Dibur Hamaschil Kol) quotes both lenient and stringent opinions of the Rishonim, and rules that with biblical melachos it is best to be stringent and only violate those that are deemed necessary to the patient's actual health and well-being and not those that are just for his comfort.

However, he does rule that if the melachos strengthen the patient's limbs, even biblical melachos may be violated for this purpose.

5) For a Choleh Sheyaish Bo Sakanah, a patient in a situation that is deemed life-threatening, who is lying in a room with the light on, and thus cannot fall asleep, we may close the light on Shabbos to enable him to sleep, as sleep is necessary for ill people and actually contributes to their healing process, and lack of sleep can have the adverse effect. (Shulchan Aruch Siman 278:1. See also Biur Halacha Dibur hamaschil Beshvil.

6) The above is only in a situation where we can't move him to a different room that has the lights out, or cover the light in another manner that won't violate the Shabbos, as if those options are available, it is better to do that than to extinguish the light. (See Mishna Berura Siman 278 S"K 1)

If the lamp in the room can be moved into a different room, instead of distinguishing it, that would be a better option, as moving the lamp is only a Muktzeh violation, whereas extinguishing it is a biblical Melacha. (Mishna Berura ibid.)

7) A Choleh Sheyaish Bo Sakanah, a patient in a situation that is deemed life-threatening, that is also suffering from another, non-life-threatening ache or pain that is unrelated to his larger medical issue, may take medicine on Shabbos to deal with the secondary issue.

8) Moreover, in certain situations it may even be allowed to do Melachos on Shabbos on behalf of this patient, to deal with the secondary issue, surely if they are interfering with his sleep and possibly even if just interfering with his general well-being and calmness, and thus may be deemed necessary to aid with his primary ailment, for which the Shabbos may be violated. A Rav should be consulted for Halacha L'Ma'aseh.

9) Often, a Choleh Sheyaish Bo Sakanah, a patient in a situation that is deemed life-threatening, is attached to machinery in a way that connecting and disconnecting the wires involve biblical Melachos of Shabbos.

10) If the patient wants to be disconnected from the wires for a few minutes in order to stretch his legs, and then reconnected to the machine when the walk is over, it would depend on the nature of this walk.

If this walk is deemed necessary for his health and healing, the machines may be disconnected and reconnected on Shabbos by a Jew. If, however, the doctor does not deem it necessary for him to take a walk, but the patient himself feels he needs to stretch, the machines should be disconnected and subsequently reconnected by an Aino Yehudi.

If the Melacha in question is a Melacha D'Rabanan and not a biblical violation, there is room for leniency, even for a Jew to assist the patient. (Based on the opinion of the Magid Mishneh quoted in Biur Haacha Siman 328:4 Dibur Hamaschil Kol)

To be continued next week B’Ezras Hashem