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that when the fifteenth of Nissan falls out on Shabbos, the Omer is a rules that we are exempt from providing for him. However, in our 11
tenth of the finest flour taken out of three se’ah of barley stalks, while situation regarding Shabbos, it is permitted to provide for him the way
on a weekday, it is a tenth of the finest flour taken out of five se’ah. he demands, because Shabbos prohibitions are set aside for pikuach
Rav Yishmael’s opinion is based on the fact that it is preferable to nefesh, even if he refuses to be hospitalized in the closer hospital be-
sift the three se’ah of barley countless times, thus transgressing one cause of his own stinginess. The mitzvah of charity, on the other hand,
prohibition of sifting many times over, than to transgress many other does not obligate us to provide for a man who has his own assets.
prohibitions (harvesting, threshing, winnowing etc.) in order to ob-
tain more barley. The other Sages disagree with Rav Yishmael. They 1 SuMMaRy and Conclusions
hold that both on Shabbos and on weekday, the Omer came from only
three se’ah of barley, and the halachic ruling is in accordance with their 1. If the distant hospital associated with the kupat cholim is better,
opinion, as explained by the Rambam (Hilchos Temidin Umusafin, Ch. it is permissible for the physician to write a referral on Shabbos,
7, 1). The Sages believe that sifting three se’ah is enough in order to and it is permissible for the driver to desecrate Shabbos in order
obtain the finest flour. Nonetheless, they do not disagree with Rav to drive the patient there.
Yishmael’s reasoning. According to them as well, on Shabbos it is pref-
erable to repeat one prohibition many times rather than violate many 2. If the closer hospital is better, but the patient adamantly refuses
prohibitions. to be hospitalized there, the physician and the driver have to
desecrate Shabbos in order to save his life. Therefore, the phy-
Logic also indicates that this is so. If one desecrates Shabbos with sician should try to convince the patient to be admitted to the
the same prohibition many times unintentionally, he brings only closer hospital. If he does not succeed in convincing him, he
one sin offering. But if he violates Shabbos with many prohibitions should write him a referral to the more distant hospital, and the
unintentionally, he brings a sin offering for every prohibition. Thus, driver should take him there.
transgressing a variety of prohibitions is more stringent and requires
more atonement than transgressing the same prohibition many times.
It also seems correct to say, according to what the Ran wrote (Yoma
4b, in the pages of the Rif, s.v. garsinan) that if a patient needs meat
on Shabbos and there is a neveilah available to him, it is preferable to
desecrate Shabbos by properly slaughtering an animal than to give the
patient carrion. Even though slaughtering is a prohibition for which
the punishment is stoning, and eating carrion is only a violation of a
negative precept, it is still preferable to violate Shabbos because Shab-
bos was in any case to be set aside in order to cook for the dangerously
ill patient. Once Shabbos has been set aside, doing an additional
prohibition is not as stringent as the prohibition of a negative precept
of carrion. So too, when forced to desecrate prohibitions on Shabbos,
that prohibition which has already been violated is less severe than
other prohibitions which were not violated. Likewise, in Tractate

318 1 Medical-HalacHic Responsa of Rav ZilbeRstein Where should a person go on Shabbos? 2 327