Emergency Response to Non-Jews on Shabbos
Question: Is a doctor [or a Hatzalah member or any other emergency responder] permitted to desecrate Shabbos to respond to an emergency involving a non-Jew?
Discussion: While, theoretically, it would be preferable that Jews desecrate the Shabbos only for the sake of other Shabbos-observing Jews, in practical terms this is inconceivable. As we live among the non-Jewish population and interact with them daily, it is practically impossible to snub them when they ask for our assistance in a medical emergency. If it were to happen that a religious Jew would ignore a request for help and the non-Jew will die or become severely ill as a result, it will cause a tremendous amount of animosity, or aivah, against the entire Jewish nation. Understanding the sensitivity of this issue, Chazal permitted Jewish doctors and responders to assist non-Jews in medical emergencies. While this basic principle is agreed upon by all authorities, there is much discussion among the poskim if the concept of aivah permits all chillul Shabbos across-the-board or is limited to certain situations only.
Some poskim maintain that only prohibitions which are forbidden miderabanan may be overridden due to aivah. Thus, it would be permitted for a Jewish doctor to dispense medication, bandage a wound or do other miderabanan prohibited activities to treat non-Jews, but it would be forbidden for him to engage in any min ha-Torah prohibitions for that purpose. Mishnah Berurah, following the opinion of Magen Avraham, rules in accordance with this view and harshly criticizes the widespread custom of the Shomer Shabbos doctors in his times who practiced medicine on Shabbos in the same manner they did during the week, relying on the leniency of aivah.
But virtually all the poskim who discuss this issue [before198 and after199 the ruling of the Mishnah Berurah] agree that when there is no way to avoid it, a doctor or an emergency responder may do whatever is necessary to treat or respond a non-Jew’s request for medical help, even if that will require him to transgress min ha-Torah prohibitions. The poskim fully understand that living in the world that we live in today, a world filled with anti-Semitism and hatred, a world where every action of every Jew is scrutinized and immediately reported around the globe200, is too dangerous of an environment to expose ourselves to charges of criminal negligence and malpractice. If even one non-Jew were to die and it would be known that this happened because a religious Jew refused to treat him on Shabbos, it would literally endanger the lives of Jews all over the world. This is much more than just simple aivah; this is sakanas nefashos.
It goes without saying, however, that this is not a blanket leniency for doctors to practice medicine Shabbos as they do during the week. Rav Moshe Feinstein rules that initially, a doctor is required to set his up his practice in a manner which will allow him not to work on Shabbos at all. An observant doctor must do whatever he can to arrange that Shabbos be his off day, and another non-Jewish physician should cover his rounds and patients for him201. But if after arranging everything to the best of his ability, the doctor finds himself in the hospital on Shabbos and is being asked to treat a non-Jewish patient, or if a shomer Shabbos first responder is called to assist a non-Jew in a medical emergency, he absolutely must heed the request or accept that call even if he will be required to desecrate the Shabbos with min ha-Torah prohibitions, employing the standard medical protocol that he would follow during the week. Obviously, whatever chillul Shabbos can be minimized without compromising patient care must be done. The doctor may not charge the patient for his Shabbos work, since one may not profit from chillul Shabbos.
198. See Chasam Sofer, O.C. 131; C.M. 194; Divrei Chayim 2:25; Tiferes Yisroel (Avodah Zarah 2:6) and others.
199. See Igros Moshe, O.C. 4:79; Minchas Yitzchak 1:53; 3:2; Shulchan Shelomo 330:7; Titz Eliezer 8:15-6 and others.
200. Note that the poskim who discuss this issue were speaking of the days before the Internet and social media was commonplace.
201. Rav Feinstein adds that if an observant physician cannot find a non-Jewish doctor to cover for him, he may ask a non-observant Jewish doctor to work on his behalf on Shabbos. Lifnei eiver does not apply here, since the non-observant doctor is not keeping Shabbos anyway while at home. Moreover, he will probably do less forbidden melachos in the hospital than at home; if so, not only are we not adding chillul Shabbos, we are actually decreasing it.