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it is also permissible to turn off a light for a patient’s comfort or to physicians have clear and absolute knowledge that there is no danger, 12
extinguish a fire where there is no danger. The Tur (Orach Chaim in which case even Rav Chaim Berlin would say that it is prohibited
#496) and Yam Shel Shlomo (Beitzah 2:31) disagree. They say that the for the physician who knows that there is no pikuach nefesh to dese-
Sages only allow things that are for a great need, such as painting an crate Shabbos. Rav Berlin’s words, however, apply in a situation where
eye or burying the dead, but not for other needs of Yom Tov. [See the physician disagree in their estimation of something, in which case
Shulchan Aruch (Orach Chaim #514:1), who is stringent and Rama, even the Pardes Yosef would agree that each physician has to consider
who is lenient.] It seems that according to the first opinion, the fact the view of his colleague and desecrate Shabbos because of the pos-
that our Sages allow caring for the needs of a patient on the second sibility of pikuach nefesh for the patient. This is similar to what Rav
day of Yom Tov is because this is like preparing the utensils for essen- Berlin himself wrote in his letter.
tial eating. According to this reasoning, it follows that extinguishing Up to this point, we have explained things according to Rav Berlin.
a fire and other things can be included in this as well. According to However, the author of Even Shoham (#20-22) answers Rav Berlin’s
the second opinion, however, our Sages’ allowance is a special ruling question as to whether or not a physician who believes that there is no
based only on the fact that this is a “great need.” danger to the patient’s life is allowed to desecrate Shabbos for him. His
It thus seems to me that according to the first opinion it is prohib- answer is: If it is possible for the physician who believes there is real
ited to violate the second day of Yom Tov for the needs of a resident danger to treat the patient, then he should do so, and the physician
of Eretz Yisrael, because for him it is a weekday, so healing him would who believes otherwise should not desecrate Shabbos. If, however, the
not be considered necessary for Yom Tov. According to the second only physician available to treat the patient is the one who feels there
opinion, however, there is no difference between treating a Diaspora is no danger, it is a mitzvah for him to desecrate Shabbos. This is not
patient or one who is a resident of Eretz Yisrael. Both constitute a a sin since he is acting on the ruling of the Rav posek, who compels
“great need.” Being that the Bi’ur Halacha (#514:1, s.v. oh keday) tends him to treat the patient in line with the dictum that a case of possible
to be lenient on the second day of Yom Tov, like the second opinion, pikuach nefesh suspends the Shabbos and all its rules and regulations.
it seems that we can allow the Diaspora physican to treat the patient.
I heard the following from my father-in-law, Rav Y. S. Elyashiv 1 SuMMaRy and Conclusions
zt”l: The allowance of the Rishonim to desecrate Yom Tov for healing
is based on the fact that healing is similar to preparing utensils for 1. If there is a difference of opinion between two physicians in
essential eating only applies if the medication will be effective on that their estimation of a patient’s status, such that one physician be-
same day. The reason for this is: It is prohibited to start treating a lieves the patient is developing a heart attack and needs a cardiac
patient at the end of the day, when the treatment will only heal him pacemaker, while the other believes the pain is abdominal, then
once Yom Tov is over, just as it is also prohibited to start cooking food if there is no other physician who can insert the pacemaker, the
that will not be ready until after Yom Tov. If we claim that this, too, is second physician is obligated to desecrate Shabbos in order to
permitted, since it is a Rabbinic prohibition done for the sake of a sick do so. In differences of opinion based on estimation, one must
patient, and it is similar to preparing utensils necessary for essential consider that the other physician is correct.
eating, then we would have to say that the Sages only allow medical
treatments that will be effective on the same day and not the next day. This applies only if we can assume the insertion of the pace-
And my father-in-law added: Since the words of the Rama (496:2) maker will not harm the patient. If there is possibility that the
350 1 Medical-HalacHic Responsa of Rav ZilbeRstein Shabbos Desecration by a Physician Who Says there is No Danger 2 359
