וכבר היה ר' ישמעאל ורבי עקיבא ורבי אלעזר בן עזריה מהלכין בדרך ולוי הסדר ורבי ישמעאל בנו של רבי אלעזר בן עזריה מהלכין אחריהן נשאלה שאלה זו בפניהם מניין לפקוח נפש שדוחה את השבת נענה ר' ישמעאל ואמר (שמות כב, א) אם במחתרת ימצא הגנב ומה זה שספק על ממון בא ספק על נפשות בא ושפיכות דמים מטמא את הארץ וגורם לשכינה שתסתלק מישראל ניתן להצילו בנפשו ק"ו לפקוח נפש שדוחה את השבת
R. Ishmael, R. Akiba and R. Eleazar b. Azariah were once on a journey, with Levi ha-Saddar20 and R. Ishmael son of R. Eleazar b. Azariah following them. Then this question was asked of them: Whence do we know that in the case of danger to human life the laws of the Sabbath are suspended? — R. Ishmael answered and said: If a thief be found breaking in.
Now if in the case of this one it is doubtful whether he has come to take money or life; and although the shedding of blood pollutes the land, so that the Shechinah departs from Israel, yet it is lawful to save oneself at the cost of his life — how much more may one suspend the laws of the Sabbath to save human life!
A question was asked of the Ra'avad of blessed memory, which Nachamanides dealt with. A person was sick and needed to eat meat, and had the opportunity to eat a food which was a TREIFA, or to slaughter ritually and then eat. Should we say that if we have a Neveila which is ready prepared we should not slaughter the animal (because that would break Shabbat), or is it better to give him Kosher food?
Rabbi Meir of Rottenberg explained as follows: He should slaughter a Kosher animal, because if we do not slaughter it, a Jew wouldn't eat a non-kosher animal and then he would die.
However, it would appear to me that this is dependent upon a major arguement as to whether Shabbat is deferred in order to save a life, or whether the laws of Shabbat are not in play at all.
If the laws of Shabbat are not in play at all, there is no problem in Shechting on Shabbat, and we should do it.
However if the laws of Shabbat are in place, but are just deferred for the individual, we should not transgress in order to feed him food, and therefore he should eat the prepared unkosher food.
(יד) הָיָה חוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה וְצָרִיךְ בָּשָׂר, שׁוֹחֲטִים לוֹ וְאֵין אוֹמְרִים: נַאֲכִילֶנּוּ נְבֵלָה; אֲבָל אִם הָיָה הַחוֹלֶה צָרִיךְ לַאֲכִילָה לְאַלְתַּר, וְהַנְּבֵלָה מוּכֶנֶת מִיָּד וְהַשְּׁחִיטָה מִתְאַחֶרֶת לוֹ, מַאֲכִילִין אוֹתוֹ הַנְּבֵלָה.
And we do not do these things (breaking Shabbat for people who are in danger) by the agency of gentiles nor by the agency of Cuthites, but rather by the agency of prominent Jews.
(א) 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:
(1) The Sabbath is pushed off when it comes to danger to life, like the rest of the commandments.. Therefore, they do all the needs of a sick person who is in [lifethreatening] danger on the Sabbath, according to the instructions of the professional doctor of that place. If there is a doubt whether he needs to have Sabbath desecrated for him or not, and so if one doctor said to desecrate the Sabbath and one say he does not need it, they desecrate the Sabbath for him, because a doubt regarding lives pushes off the Sabbath.
(ג) 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":
(3) When you do these things [for a sick person], do not do them through the hands of non-Jews, children, slaves or women, so that the Sabbath should not be taken lightly in your eyes. Rather, [they should be done] through the hands of the greatest of Jews and scholars. It is forbidden to delay desecrating the Sabbath for a person who is dangerously ill, as it is said [Leviticus 18:5]: "and Mine ordinances, which if a man do, he shall live by them," i.e. and not die by [My ordinances]. Learn that the laws of the Torah only exist in the world for mercy, loving kindness, and peace in the world. It is the heretics who say that this is desecration of shabbat and it is forbidden. It is on them that [Ezekiel 20:25] writes: "Wherefore I gave them also statutes that were not good, and ordinances whereby they should not live."
(יז) חוֹלֶה שֶׁנָּפַל מֵחֲמַת חֹלִי לְמִשְׁכָּב וְאֵין בּוֹ סַכָּנָה, הַגָּה: אוֹ שֶׁיֵּשׁ לוֹ מֵחוּשׁ שֶׁמִּצְטַעֵר וְחָלָה מִמֶּנּוּ כָּל גּוּפוֹ שֶׁאָז אַף עַל פִּי שֶׁהוֹלֵךְ כְּנֵפֶל לְמִשְׁכָּב דָּמִי (הַמַּגִּיד פ''ב), אוֹמְרִים לְעַכּוּ''ם לַעֲשׂוֹת לוֹ רְפוּאָה אֲבָל אֵין מְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת בְּאִסוּר דְּאוֹרַיְיתָא, אֲפִלּוּ יֵשׁ בּוֹ סַכָּנַת אֵבֶר; וּלְחַלֵּל עָלָיו יִשְׂרָאֵל בְּאִסוּר דְּרַבָּנָן בְּיָדַיִם, יֵשׁ מַתִּירִים אֲפִלּוּ אֵין בּוֹ סַכָּנַת אֵבֶר; וְיֵשׁ אוֹמְרִים שֶׁאִם יֵשׁ בּוֹ סַכָּנַת אֵבֶר עוֹשִׂין וְאִם אֵין בּוֹ סַכָּנַת אֵבֶר אֵין עוֹשִׂין; וְיֵשׁ אוֹמְרִים שֶׁאִם אֵין בּוֹ סַכָּנַת אֵבֶר עוֹשִׂין בְּשִׁנּוּי, וְאִם יֵשׁ בּוֹ סַכָּנַת אֵבֶר עוֹשִׂין בְּלֹא שִׁנּוּי; וְיֵשׁ אוֹמְרִים אֲפִלּוּ יֵשׁ בּוֹ סַכָּנַת אֵבֶר אֵין עוֹשִׂין לוֹ דָּבָר שֶׁהוּא נִסְמָךְ לִמְלָאכָה דְּאוֹרַיְיתָא, וּדְבָרִים שֶׁאֵין בָּהֶם סְמַךְ מְלָאכָה עוֹשִׂין אֲפִלּוּ אֵין בּוֹ סַכָּנַת אֵבֶר; וְדִבְרֵי הַסְבָרָא הַשְּׁלִישִׁית נִרְאִין. הַגָּה: מֻתָּר לוֹמַר לְעַכּוּ''ם לַעֲשׂוֹת תַּבְשִׁיל לְקָטָן שֶׁאֵין לוֹ מַה לֶאֱכֹל, דִּסְתָם צָרְכֵי קָטָן כְּחוֹלֶה שֶׁאֵין בּוֹ סַכָּנָה דָּמִי (ר' יְרוּחָם ני''ב ח''ט וְרַמְבַּ''ם וְרַשְׁבָּ''א). וְכָל שֶׁאָסוּר לַעֲשׂוֹת עַל יְדֵי יִשְׂרָאֵל, אֲפִלּוּ עַל יְדֵי הַחוֹלֶה בְּעַצְמוֹ אָסוּר; אֲבָל כְּשֶׁעוֹשֶׂה לוֹ הָעַכּוּ''ם מֻתָּר לַחוֹלֶה לְסַיְּעוֹ קְצָת, דִּמְסַיֵּעַ אֵין בּוֹ מַמָּשׁ. (בֵּית יוֹסֵף גמ' בֵּיצָה דַּף כ''ב).
(17) A sick person who is in bed with his illness but is not in danger Rem"a: Or if he has a pain that is bothering him and his whole body pains him, even if he still walks, he is similar to someone bedridden (HaMagid Chapter 2), we tell a non-Jew to provide medical treatment, but we do not violate Toraitic Shabbat prohibitions even if he has an endangered body part. Regarding a Jew actively breaking a rabbinic prohibition, there are some who allow it even if he does not have an endangered body part. There are those who say that if he has an endangered body part we break and if he doesn't, we do not break. There are those who say that if he doesn't have an endangered body part, we desecrate with a slight change, and if he has an endangered body part, we break without a change. And there are those who say that even if he has an endangered body part, we do not break any prohibition that is related to a Toraitic labor, and things that have no connection, we do even if he does not have an endangered body part. This third position is right. Rem"a: It is permitted to tell a non-Jew to cook something for a child that has nothing to eat, because the needs of a child are comparable to a non-endangered sick person. And everything that is forbidden for a Jew to do is also forbidden for the sick person himself to do, but if a non-Jew is doing something, the sick person is allowed to help a bit, because aiding is not considered substantial.
If the doctor states that if he doesn't heal from his sickness, he could die, he is like any person who is sick and in mortal danger.
In our times, there is no sickness affecting a bone which doesn't affect the rest of his body, and we therefore break Shabbat for that - even a Jew and even with Torah prohibitions. This doesn't apply if there is a danger that you will lose a limb - even if there is a fear that his functioning in that limb will lessen as a result, and he won't be able to work in the way that he did in the past.
Jewish Doctors cannot say that we are only allowed to break Shabbat for other Jews. This would not be acceptable in our countries for those unwell non-jews, as well as for their relatives, and not for the rulers of the country. If there is no-one else in the hospital but him, and he is not interested in being a doctor on Shabbat no-one will pay attention to him. He would be judged as a murderer if he didn't treat someone for this reason, and then that person passed away.
If at all possible, Doctors might be able to swap Shabbat for sunday work instead.....
However, if a Doctor needs to be in the hospital on Shabbat, or there is some sort of emergency, there will be huge levels of resentment and hatred if he/she does not act, and we can therefore permit even the breaking of a Torah prohibition.
We can allow a non-jew to drive a doctor home in a taxi after work, because if not, he will not want to save lives in the future. this only applies to a Rabbinic prohibition and not to a Torah Prohibition.