Halacha

הלכה 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:
כסף משנה
1.
The [laws of] the Sabbath are suspended1The Rambam uses the expression דחויה, which, as evident from Pesachim 77a and Hilchot Bi'at HaMikdash 4:15, implies that although a prohibition is not enforced, it has not been lifted entirely. In contrast, the term הותרה would imply that no trace of the prohibition remains.
The Kessef Mishneh and other authorities question the implications and the appropriateness of the Rambam's choice of terms. [In a responsum (Vol. 1, 689), the Rashba illustrates the difference between these terms. A person was in need of meat on the Sabbath and there was non-kosher meat available. If the Sabbath laws are דחויה, it would be proper to eat the non-kosher meat. If the Sabbath laws are הותרה, it would be preferable to slaughter a kosher animal on the sick person's behalf. The Shulchan Aruch (Orach Chayim 328:14) states that, in such a situation, one should slaughter a kosher animal, implying that the laws are הותרה. (Note, however, the Shulchan Aruch HaRav 328:16 and the Mishnah Berurah 328:39.)]
See the Avnei Nezer, Orach Chayim, Responsa 455, which explains the concept of הותרה as meaning that, with regard to this person, it is as if the laws of the Sabbath were never commanded. (See also Chiddushim UVeurim BaShas, Vol. 3, which explains that although the Rambam stated that a threat to Jewish life overrides the observance of all the mitzvot of the Torah in Hilchot Yesodei Torah, Chapter 5, he emphasizes this concept with regard to the Sabbath laws for the following reason. The other prohibitions are דחויה in the face of a threat to life, while the Sabbath laws are הותרה.
in the face of a danger to life,2Yoma 85b uses the expression, "Violate one Sabbath on his behalf, so that he will be able to observe many Sabbaths [in the future]." This expression, however, is not halachically exact. Even when one knows that the person will not live to observe many other Sabbaths, as long as he is alive we are obligated to violate the Sabbath laws on his behalf. See Halachah 18. as are [the obligations of] the other mitzvot. Therefore, we may perform - according to the directives of a professional physician3Note the Shulchan Aruch (Orach Chayim 328:10), which cites an opinion that states that we may rely on the evaluation of experienced God-fearing individuals, even if they are not physicians. of that locale4Rav Kapach explains that, with this expression, the Rambam implies that we may rely on a local physician and need not seek the advice of a greater expert who lives further away. - everything that is necessary for the benefit of a sick person whose life is in danger.
When there is a doubt whether or not the Sabbath laws must be violated on a person's behalf, one should violate the Sabbath laws on his behalf, for the Sabbath laws are suspended even when there is merely a question of danger to a person's life. [The same principles apply] when one physician says the Sabbath laws should be violated on a person's behalf and another physician states that this is not necessary.5See Hilchot Sh'vitat Asor 2:8, which gives further details regarding a difference of opinion between physicians.

הלכה ב
אֲמָדוּהוּ בְּיוֹם הַשַּׁבָּת שֶׁהוּא צָרִיךְ לְכָךְ וְכָךְ לִשְׁמוֹנָה יָמִים אֵין אוֹמְרִים נַמְתִּין עַד הָעֶרֶב כְּדֵי שֶׁלֹּא לְחַלֵּל עָלָיו שְׁתֵּי שַׁבָּתוֹת אֶלָּא מַתְחִילִין מֵהַיּוֹם שֶׁהוּא שַׁבָּת וּמְחַלְּלִין עָלָיו אֲפִלּוּ מֵאָה שַׁבָּתוֹת כָּל זְמַן שֶׁהוּא צָרִיךְ וְיֵשׁ בּוֹ סַכָּנָה אוֹ סְפֵק סַכָּנָה מְחַלְּלִין. וּמַדְלִיקִין לוֹ אֶת הַנֵּר וּמְכַבִּין מִלְּפָנָיו אֶת הַנֵּר וְשׁוֹחֲטִין לוֹ וְאוֹפִין וּמְבַשְּׁלִין וּמְחִמִּין לוֹ חַמִּין בֵּין לְהַשְׁקוֹתוֹ בֵּין לִרְחִיצַת גּוּפוֹ. כְּלָלוֹ שֶׁל דָּבָר שַׁבָּת לְגַבֵּי חוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה הֲרֵי הוּא כְּחל לְכָל הַדְּבָרִים שֶׁהוּא צָרִיךְ לָהֶן:
כסף משנה
2.
[The following laws apply when physicians] determine on the Sabbath that a person needs [a treatment to be administered] for eight days. We do not say that we should wait until the evening so that it will not be necessary to violate two Sabbaths on his behalf.6Shulchan Aruch HaRav 328:13 states that this applies even if there is no danger that the person will die immediately. Since there is a danger that he may die later if the treatment is not administered at this time, the Sabbath laws may be violated. Instead, the treatment is begun immediately, on the Sabbath, and even one hundred Sabbaths may be violated on his behalf.
As long as a person is dangerously [ill] - or even if there is a question whether or not he is dangerously [ill] - and requires treatment, [the Sabbath] should be violated [on his behalf]. A lamp may be lit on his behalf and extinguished on his behalf.7Note that the Rambam's Commentary on the Mishnah, Shabbat 2:5, specifies that the leniency to extinguish a lamp is granted only when it is impossible to move it - or, alternatively, the sick person - to another place or veil the lamp's light. [Animals] may be slaughtered on his behalf, [food] baked and cooked on his behalf, and water heated for him, whether to drink or to use for bathing.
The general principle for a person who is dangerously ill is that the Sabbath should be considered as a weekday regarding all his needs.8There is a question among the Rabbis if this statement is to be interpreted literally or not. As mentioned in the commentary on the previous halachah, there is a difference of opinion if the Sabbath laws are דחויה or הותרה in the face of a danger to life. According to the opinion that they are merely דחויה, an attempt should be made to minimize the violation of the Sabbath laws if doing so does not constitute a threat to the person's life. (See Tzafenat Paneach, Shulchan Aruch HaRav, ibid. and the Mishnah Berurah 328:14.)

הלכה 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":
כסף משנה
3.
When such treatment is administered, it should not be administered by gentiles,9Gentiles are not obligated to observe the Sabbath, and thus having them administer the treatment would not involve the violation of a Torah commandment. Nevertheless, they should not be entrusted with the care of the sick for the reason stated by the Rambam. by children,10Since they are below the age of Bar or Bat Mitzvah, according to the Torah itself the observance of the mitzvot is not incumbent upon them, and only a Rabbinic prohibition is involved. by servants, or by women,11Although women and servants are obligated to observe the Sabbath laws, since in many areas of Torah and mitzvot, their obligations are less than men, having them violate the Sabbath laws in this instance could cause the Sabbath to be regarded flippantly, as explained in the next note. so that they will not view the Sabbath flippantly.12The Rambam's choice of wording, based on Yoma 84b, has raised several questions among the commentaries. The most literal interpretation is given by the Merkevat HaMishneh, who explains that when people see that the Sabbath laws are violated by the gentiles for Jews or by women or children, they may get the impression that the observance of these laws is not very crucial, and leniencies may be taken on other occasions - even when there is no valid reason. If, however, it is Torah Sages who violate the laws, the common people will realize that it is only the seriousness of the situation that allowed for this leniency.
Among the other interpretations given why the laws should not be violated by women and children, is that this might cause them to violate the Sabbath laws in the future (Kessef Mishneh).
Significantly, the Ramah (Orach Chayim 328:12) explains that the reason the treatment should not be administered by gentiles is the possibility for delay. Accordingly, if there is no delay involved and one can be sure that the same quality of treatment will be given, it is preferable that the treatment be administered by gentiles.
The commentaries explain that the difference between his opinion and that of the Rambam (quoted by the Shulchan Aruch, loc. cit.) depends on the question discussed above: Are the Sabbath laws הותרה or merely דחויה in the face of a danger to life.
[See also Chiddushim UVeurim BaShas, Vol. 3, which states that the Rambam's wording here indicates that he sees the violation of the Sabbath laws in such situations as an expression of reverence and regard for the Sabbath.]
Instead, the treatment should be administered by the leaders of Israel13This also is based on the Rambam's interpretation of Yoma, ibid. Others (see Shulchan Aruch, Orach Chayim 328:12) understand the phrase גדולי ישראל in that passage as meaning simply "adult males." and the wise.
It is forbidden to hesitate before transgressing the Sabbath [laws] on behalf of a person who is dangerously ill,14The Jerusalem Talmud (Yoma 8:5) states, "A person who [administers treatment] quickly is praiseworthy, and one who raises questions is considered as if he shed blood. as [reflected in the interpretation in the phrase of Leviticus 18:5,] "which a person shall perform to live through them," as "['to live through them'] and not to die through them."
This teaches that the judgments of the Torah do not [bring] vengeance to the world, but rather bring mercy, kindness, and peace to the world. Concerning those non-believers who say that [administering such treatment] constitutes a violation of the Sabbath and is forbidden,15The Rambam is referring to the Sadducees, the Karaites, and others who do not accept the oral tradition. one may apply the verse [Ezekiel 20:25]: "[As punishment,] I gave them harmful laws and judgments through which they cannot live."16The Rambam seems to be interpreting the verse as meaning that since these individuals purposefully misinterpret the Torah, God causes their misinterpretations to be cruel and harsh so that they will not live and spread such an approach.

הלכה ד
הַחוֹשֵׁשׁ בְּעֵינָיו וְהוּא שֶׁיִּהְיֶה בִּשְׁתֵּיהֶם אוֹ בְּאַחַת מֵהֶם צִיר אוֹ שֶׁהָיוּ דְּמָעוֹת שׁוֹתְתוֹת מֵהֶן מֵרֹב הַכְּאֵב אוֹ שֶׁהָיָה דָּם שׁוֹתֵת מֵהֶן אוֹ שֶׁהָיָה בָּהֶן קַדַּחַת וְכַיּוֹצֵא בָּחֳלָאִים אֵלּוּ הֲרֵי זֶה בִּכְלַל חוֹלִים שֶׁיֵּשׁ בָּהֶן סַכָּנָה וּמְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת וְעוֹשִׂין לוֹ כָּל צָרְכֵי רְפוּאָה:
כסף משנה
4.
When a person's eyes are ailing - i.e., when he has a secretion from either one or both of them, when tears flow from them due to great pain, when blood flows from them, or when they are affected by fever,17Significantly, the Yemenite manuscripts of the Mishneh Torah state קדח, "piercing pain" (the commentary of Rabbenu Chanan'el on Avodah Zarah 28b), rather than קדחת, "fever." or by other afflictions of this like - he is considered among those individuals who are dangerously ill.18Avodah Zarah, loc. cit., explains that there is a connection between the eyes and the heart, and such a person is therefore considered to be dangerously ill. The Sabbath may be violated on his behalf, and anything necessary for his treatment may be performed for him.19From the wording of the Shulchan Aruch (Orach Chayim 328:9), it appears that once an eye ailment is nearly healed, we may not violate the Sabbath laws to treat it. See also Hilchot Milah 16.

הלכה ה
וְכֵן אִם יֵשׁ מַכָּה בַּחֲלַל גּוּפוֹ מִן הַשָּׂפָה וּלְפָנִים בֵּין בְּפִיו בֵּין בְּמֵעָיו בֵּין בִּכְבֵדוֹ וּטְחוֹלוֹ אוֹ בִּשְׁאָר מְקוֹמוֹת כָּל שֶׁיֵּשׁ בַּחֲלָלוֹ הֲרֵי זֶה חוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה וְאֵינוֹ צָרִיךְ אֹמֶד שֶׁחָלְיוֹ כָּבֵד הוּא לְפִיכָךְ מְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת מִיָּד בְּלֹא אֲמִידָה. וּמַכָּה שֶׁהִיא בְּגַב הַיָּד וְגַב הָרֶגֶל הֲרֵי הִיא כְּמַכָּה שֶׁל חָלָל וְאֵינָהּ צְרִיכָה אֹמֶד וּמְחַלְּלִין עָלֶיהָ אֶת הַשַּׁבָּת. וְהַחֹם שֶׁמְּסַמֵּר אֶת הַבָּשָׂר כְּמַכָּה שֶׁל חָלָל דָּמִי וּמְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת וְכֵן כָּל חֹלִי שֶׁהָרוֹפְאִים אוֹמְרִין שֶׁזֶּה יֵשׁ בּוֹ סַכָּנָה אַף עַל פִּי שֶׁהוּא בְּעוֹר הַבָּשָׂר מִבַּחוּץ מְחַלְּלִין עָלָיו אֶת הַשַּׁבָּת עַל פִּיהֶם:
כסף משנה
5.
Similarly, a person who has a wound20The Shulchan Aruch (Orach Chayim 328:3) states that this can also apply to an infection. Disquiet and pain are not, however, considered sufficient cause to violate the Sabbath laws. in his body cavity - from his lips inward,21When quoting this law, the Shulchan Aruch (loc. cit.) substitutes "teeth" for "lips," and explains that a toothache can also be considered cause to violate the Sabbath laws. The Ramah and subsequent commentaries, however, qualify this statement, explaining which types of toothaches can be treated by Jews and which can be treated only by gentiles. (See Shulchan Aruch HaRav 328:3 and Mishneh Berurah 328:8.) whether in his mouth, his digestive organs, his liver or spleen, or any of the other organs in his body cavity - is considered to be dangerously ill and does not require [a physician's] assessment [of his condition]. His ailment is serious, and we should violate the Sabbath laws on his behalf immediately without [waiting for] an assessment.22The Maggid Mishneh cites the Ramban as explaining that this applies only when we are unsure if the wound is dangerous or not. In such a situation, we are not required to wait for a physician's assessment and may treat the wound immediately. If, however, we know - or a physician says - that a wound is not dangerous, a Jew may not violate the Sabbath laws to treat it. It may, however, be treated by a gentile. This ruling is also quoted in the Shulchan Aruch (ibid.:4).
A wound on the back of the hand or on the back of the foot is considered equivalent to a wound in the body cavity. It does not require [a physician's] assessment [of his condition] for us to violate the Sabbath laws on his behalf. A fever that causes the flesh to wince23This phrase is based on the Rambam's interpretation of Avodah Zarah 28a and refers to an extremely high fever. The Shulchan Aruch (ibid.:7) appears to interpret it as referring to a type of malaria that causes fever and chills simultaneously. is considered equivalent to a wound in the body cavity, and we should violate the Sabbath laws on this person's behalf.
Similarly, we should violate the Sabbath laws whenever a physician24From the statements of the Shulchan Aruch (ibid.:5), it would appear that if the sick person himself says that the Sabbath laws should be violated on his behalf, his word should be heeded. assesses an ailment as dangerous, even when it affects only the exterior of a person's skin.

הלכה ו
הַבּוֹלֵעַ נִימָה שֶׁל מַיִם מְחִמִּין לוֹ חַמִּין בְּשַׁבָּת וְעוֹשִׂין לוֹ כָּל צָרְכֵי רְפוּאָה מִפְּנֵי שֶׁהִיא סַכָּנַת נְפָשׁוֹת. וְכֵן מִי שֶׁנְּשָׁכוֹ כֶּלֶב שׁוֹטֶה אוֹ אֶחָד מִזּוֹחֲלֵי הֶעָפָר שֶׁמְּמִיתִין אֲפִלּוּ הָיוּ סָפֵק מְמִיתִין סָפֵק אֵין מְמִיתִין עוֹשִׂין לוֹ כָּל צָרְכֵי רְפוּאָה לְהַצִּילוֹ:
כסף משנה
6.
When a person swallows a leech, water may be heated for him on the Sabbath, and any medical treatment that is necessary may be administered, since his life is in danger. Similarly, when a person is bitten by a rabid dog25See Yoma 10:4 and the Rambam's commentary on that mishnah. or a poisonous snake or other reptile, any medical treatment that is necessary to save him may be administered. [The same laws apply] even when there is merely a question of whether or not [the bite] can cause death.

הלכה ז
חוֹלֶה שֶׁאֲמָדוּהוּ רוֹפְאִים לְהָבִיא לוֹ גְּרוֹגֶרֶת אַחַת וְרָצוּ עֲשָׂרָה בְּנֵי אָדָם וְהֵבִיאוּ לוֹ עֶשֶׂר גְּרוֹגָרוֹת בְּבַת אַחַת כֻּלָּן פְּטוּרִין מִכְּלוּם. וַאֲפִלּוּ הֵבִיאוּ בָּזֶה אַחַר זֶה וַאֲפִלּוּ הִבְרִיא בָּרִאשׁוֹנָה שֶׁהֲרֵי כֻּלָּם בִּרְשׁוּת הֵבִיאוּ:
כסף משנה
7.
When physicians assessed that a sick person required a fig, and ten people ran and brought26Either they brought the figs from the public domain or picked them from the tree. Both of these activities involve the performance of labors forbidden on the Sabbath. him ten figs at once,27This situation refers to an instance where none of the ten know of the others' activities. Alternatively, each one thought that he would be able to bring the fig before the other person (Mishnah Berurah 328:42). they are all absolved of liability entirely.28I.e., they need not bring a sin offering, nor do their actions cause them any spiritual blemishes. Indeed, to quote the Shulchan Aruch (Orach Chayim 328:15), "all of them receive a bountiful reward from God" for their actions. 29. If, however, there are two figs on a single stem, it would be preferable to pick them so as not to bring any additional figs (Shulchan Aruch, Orach Chayim 328:16). (See also Halachah 9.)
[The same decision applies] if the ten people brought the figs one after another, even when he recuperated after the first fig, for all of them had license to bring them.

הלכה ח
חוֹלֶה שֶׁהָיָה צָרִיךְ לִשְׁתֵּי גְּרוֹגָרוֹת וְלֹא מָצְאוּ אֶלָּא שְׁתֵּי גְּרוֹגָרוֹת בִּשְׁנֵי עֵקְצִין וְשָׁלֹשׁ גְּרוֹגָרוֹת בְּעֹקֶץ אֶחָד כּוֹרְתִין הָעֹקֶץ שֶׁיֵּשׁ בּוֹ שָׁלֹשׁ אַף עַל פִּי שֶׁאֵין צְרִיכִין אֶלָּא לִשְׁתַּיִם כְּדֵי שֶׁלֹּא יַרְבּוּ בִּבְצִירָה אֶלָּא יִכְרְתוּ עֹקֶץ אֶחָד וְלֹא יִכְרְתוּ שְׁנַיִם. וְכֵן כָּל כַּיּוֹצֵא בָּזֶה:
כסף משנה
8.
If a sick person required two figs, and two figs could be found only on two separate stems - while three figs were found on another stem - we should remove the stem that has three figs, even though only two are required.29 [It is preferable] to cut only one stem and not two stems, so as not to increase [the performance of the forbidden labor of] gleaning.30The Ramah (Orach Chayim, loc. cit.) emphasizes that if there is any danger of delay or difficulty, the threat to a Jew's life overrides all these considerations. The same applies in all similar situations.

הלכה ט
הַמְבַשֵּׁל לְחוֹלֶה בְּשַׁבָּת וְאָכַל הַחוֹלֶה וְהוֹתִיר אָסוּר לְבָרִיא לֶאֱכל מִן הַמֻּתָּר גְּזֵרָה שֶׁמָּא יַרְבֶּה בִּשְׁבִילוֹ. אֲבָל הַשּׁוֹחֵט לַחוֹלֶה בְּשַׁבָּת מֻתָּר לַבָּרִיא לֶאֱכל מִמֶּנּוּ בָּשָׂר חַי שֶׁאֵין בַּדָּבָר תּוֹסֶפֶת כְּדֵי שֶׁנִּגְזֹר שֶׁמָּא יַרְבֶּה בִּשְׁבִילוֹ. וְכֵן כָּל כַּיּוֹצֵא בָּזֶה:
כסף משנה
9.
When food is cooked for a sick person on the Sabbath and the sick person leaves some over after eating, a healthy person is forbidden to eat from the remainder, lest [this cause] more food to be added for him.31On Saturday night, however, a healthy person may eat from the remainder. Moreover, there is no need for him to wait the amount of time necessary to cook the food [(כדי שיעשו) Shulchan Aruch, Orach Chayim, 318:2, and commentaries].
When, however, an animal is slaughtered for a sick person on the Sabbath, it is permissible for a healthy person to partake of uncooked meat32The meat need not be salted to remove the blood. Although this is generally done as a preparation for the cooking process, it is necessary only because blood will move from place to place within the meat during cooking. There is no prohibition against eating raw meat even though it has not been salted (Shulchan Aruch, Yoreh De'ah 67:1-2).
The Kiryat Melech Rav notes that this explanation is appropriate according to the interpretation of the Tosafot (Chulin 14a). The Rambam (Hilchot Ma'achalot Asurot 6:12), however, requires even uncooked meat to be salted before one partakes of it. Several different explanations are offered for this difficulty. See Chapter 11, Halachah 5.
[from that animal].33For this leniency to be granted, the Ra'avad requires that the sick person have been ill before the commencement of the Sabbath, and his attendants to have thought of slaughtering the animal for him at that time. Otherwise, the animal is considered muktzeh. Although the latter prohibition is waived on behalf of the sick person, it is still enforced as regards the healthy individual.
The Maggid Mishneh and the Shulchan Aruch (Orach Chayim 318:2 and Shulchan Aruch Harav ibid 318:5) explain that in this instance, the prohibition of muktzeh does not apply at all.
A decree was not enacted, because there is no possibility of an additional [activity] being performed [for a healthy person].34Slaughtering an animal is a single activity which will provide enough meat for both the sick person and the healthy individual. Allowing the healthy person to eat from the meat will not cause any increase in the violation of the Sabbath laws. The same applies in all similar situations.

הלכה י
חוֹלֶה שֶׁאֵין בּוֹ סַכָּנָה עוֹשִׂין לוֹ כָּל צְרָכָיו עַל יְדֵי נָכְרִי. כֵּיצַד. אוֹמְרִין לַנָּכְרִי לַעֲשׂוֹת לוֹ וְהוּא עוֹשֶׂה. לְבַשֵּׁל לוֹ וְלֶאֱפוֹת וּלְהָבִיא רְפוּאָה מֵרְשׁוּת לִרְשׁוּת וְכַיּוֹצֵא בָּאֵלּוּ. וְכֵן כּוֹחֵל עֵינָיו מִן הַנָּכְרִי בְּשַׁבָּת אַף עַל פִּי שֶׁאֵין שָׁם סַכָּנָה. וְאִם הָיוּ צְרִיכִים לִדְבָרִים שֶׁאֵין בָּהֶן מְלָאכָה עוֹשִׂין אוֹתָן אֲפִלּוּ יִשְׂרָאֵל. לְפִיכָךְ מַעֲלִין אָזְנַיִם בְּשַׁבָּת וּמַעֲלִין אֻנְקְלִי וּמַחְזִירִין אֶת הַשֶּׁבֶר וְכָל כַּיּוֹצֵא בָּזֶה מֻתָּר:
כסף משנה
10.
When a sick person is not dangerously ill,35This refers to ailments which, although not threatening to a person's life, are after all serious, and cause him to be confined to bed (Shulchan Aruch, Orach Chayim 328:17) or which cause him to feel weakness throughout his entire body (Ramah, loc. cit.). In contrast, if the person merely feels ill or has a minor ailment in a particular limb, there is a Rabbinic prohibition against taking medication even when the performance of forbidden labors is not involved. (See Chapter 21, Halachah 31.) all his needs should be cared for by a gentile. What is implied? We may tell a gentile to perform [forbidden labors]36As is explained in Chapter 6, the Rabbis forbade a Jew to tell a gentile to perform work on his behalf on the Sabbath. This prohibition is, however, relaxed because of the sick person's condition. on his behalf and he performs them. [This includes] cooking, baking, bringing medicine from one domain to another and the like. Similarly, one may have one's eyes treated37The Hebrew word כוחל refers to the application of powder or eye-paint to the area around the eyes. Although certain Talmudic passages appear to indicate that this was merely a cosmetic practice, in certain instances it had medical value. The leniency to treat the eyes is granted, because, as explained in the notes on Halachah 4, there is a connection between the eyes and the heart. by a gentile on the Sabbath even though there is no danger involved.
Furthermore, if [the sick] require treatment that does not involve the performance of [forbidden] labors,38There is a question regarding activities in which a Rabbinic prohibition must be transgressed. Although asking a gentile to perform a forbidden labor is also prohibited by the Rabbis, some commentaries make a distinction between such a prohibition and a prohibition that involves the performance of an activity.
The wording chosen by the Rambam in this halachah and in Chapter 21, Halachah 31, has left room for speculation concerning his ruling on this question. The Maggid Mishneh explains that the Rambam allows the performance of any activity even when there is a Rabbinic prohibition involved. The Kessef Mishneh differs, and explains that according to the Rambam, any activity forbidden by the Rabbis may not be performed despite the fact that a person is bedridden by illness.
The Shulchan Aruch (ibid.) does not follow either of the interpretations of the Rambam's view, but instead suggests following the opinion of the Ramban, who permits the performance of any activity forbidden by the Rabbis, provided that it is performed in an abnormal manner. Furthermore, if there is a danger to a specific limb, the Rabbinic prohibitions are waived, and such activities may be performed in the normal manner. Shulchan Aruch HaRav 328:19 is even more lenient and allows one to perform activities that are forbidden by the Torah itself, provided one performs them in an uncharacteristic manner.
they may be treated even by Jews. For this reason, it is permitted to perform [physical activities for the benefit of the sick]; for example, one may lift [the tendons of] the ears, lift up cartilage around the heart,39There are times when the cartilage around the heart becomes compressed against the body and it must be lifted up in order to facilitate breathing (Avodah Zarah 29a). restore broken bones to their places, or perform other activities of this like.

הלכה יא
הַיּוֹלֶדֶת כְּשֶׁכּוֹרַעַת לֵילֵד הֲרֵי הִיא בְּסַכָּנַת נְפָשׁוֹת וּמְחַלְּלִין עָלֶיהָ אֶת הַשַּׁבָּת. קוֹרְאִין לָהּ חֲכָמָה מִמָּקוֹם לְמָקוֹם וְחוֹתְכִים אֶת הַטַּבּוּר וְקוֹשְׁרִין אוֹתוֹ. וְאִם הָיְתָה צְרִיכָה לְנֵר בְּשָׁעָה שֶׁהִיא צוֹעֶקֶת בַּחֲבָלֶיהָ מַדְלִיקִין לָהּ אֶת הַנֵּר. וַאֲפִלּוּ הָיְתָה סוּמָא מִפְּנֵי שֶׁדַּעְתָּהּ מִתְיַשֶּׁבֶת עָלֶיהָ בַּנֵּר וְאַף עַל פִּי שֶׁאֵינָהּ רוֹאָה. וְאִם הָיְתָה צְרִיכָה לְשֶׁמֶן וְכַיּוֹצֵא בּוֹ מְבִיאִין לָהּ. וְכָל שֶׁאֶפְשָׁר לְשַׁנּוֹת מְשַׁנִּין בִּשְׁעַת הֲבָאָה כְּגוֹן שֶׁתָּבִיא לָהּ חֲבֶרְתָּהּ כְּלִי תָּלוּי בִּשְׂעָרָהּ. וְאִם אִי אֶפְשָׁר מְבִיאָה כְּדַרְכָּהּ:
כסף משנה
11.
When a woman in the process of childbirth squats to give birth,40Our translation is based on the description of the techniques of midwifery used in Talmudic and post-Talmudic times. Others translate the term as a woman being bent over with labor pains. Compare to Halachah 13, which mentions the possibility of performing forbidden labors on a woman's behalf from the time "when there is a show of blood." See Shulchan Aruch (Orach Chayim 330:3), which mentions both these terms and also refers to the condition when a woman is overcome by labor pains to the point where she must be carried by her friends. Any one of these three conditions constitutes a danger to life for which the Sabbath laws may be broken. her life is considered in danger and the Sabbath laws may be violated on her behalf. A midwife may be called from a distant place41The Rambam's Commentary on the Mishnah (Shabbat 18:3) states that this leniency applies even when she lives beyond the Sabbath limits (see Chapter 27). Note Shulchan Aruch HaRav 330:3 and the Mishnah Berurah 330:9, which state that a mid-wife may be called in the preliminary stages of labor. and the umbilical cord may be cut and tied.
If she requires a light when she cries out because of labor pains, a candle may be lit for her. [This leniency is granted] even if she is blind, because light has a calming influence42She feels more secure knowing that she will be cared for properly in the light than if she were cared for in the dark (Tosafot, Shabbat 128b). even if she does not see.
If she needs oil or the like, it may be brought for her. If possible, the items that are brought should be brought in an uncharacteristic manner; for example, a friend should bring a utensil tied in her hair.43These rulings are based on Shabbat, ibid. In his commentary on that text, the Ramban explains that this principle applies regarding all instances when the Sabbath laws are violated because of a danger to life. If it is possible to reduce the extent to which they are violated, one should do so.
The Maggid Mishneh postulates that the Rambam would not require such stringencies at all times. Were that the case, the Rambam would have stated this principle earlier. Instead, this is a specific ruling applicable with regard to a woman in childbirth. Greater stringency is applied in this instance, because although there is a threat to the woman's life, the probability of a woman's actually dying is very low. (It can be explained that the difference of opinion between the Ramban and the Maggid Mishneh revolves around the question whether the Sabbath laws are דחויה or הותרה in the face of a danger to life, as explained in the notes on Halachot 1 and 2.)
If this not possible, it may be brought in the ordinary manner.44Note Sefer HaChasidim, which states that it is preferable that a woman prepare everything necessary for childbirth from the ninth month onward, so that if she gives birth on the Sabbath, only a minimal amount of forbidden labor will have to be performed.

הלכה יב
אֵין מְיַלְּדִין אֶת הָעוֹבֶדֶת כּוֹכָבִים וּמַזָּלוֹת בְּשַׁבָּת וַאֲפִלּוּ בְּשָׂכָר וְאֵין חוֹשְׁשִׁין לְאֵיבָה וְאַף עַל פִּי שֶׁאֵין שָׁם חִלּוּל. אֲבָל מְיַלְּדִין אֶת בַּת גֵּר תּוֹשָׁב מִפְּנֵי שֶׁאָנוּ מְצֻוִּין לְהַחֲיוֹתוֹ. וְאֵין מְחַלְּלִין עָלֶיהָ אֶת הַשַּׁבָּת:
כסף משנה
12.
We should not help an idolatress45The term "idolatress" is used here to refer to a gentile who actually worships idols. In contrast, the term ger toshav refers to a gentile who accepts the seven universal laws commanded to Noah and his descendants. (See Hilchot Melachim 9:1-2 and Hilchot Avodat Kochavim 10:6.)
In Hilchot Avodat Kochavim 10:2, the Rambam writes that it is forbidden to offer medical treatment to an idolater even for a fee. Accordingly, this halachah extends that principle to include a woman in childbirth. The question is raised, however, concerning the majority of the gentiles in the present age. Although the Rambam considers Christianity as idol worship, many authorities do not. According to the latter opinions, although these gentiles are not idolaters, they have not gone through the formal process of acceptance of the seven laws commanded to Noach and cannot therefore be considered as gerim toshavim.
Many authorities (see the commentary on the Moznaim edition of Hilchot Avodat Kochavim) maintain that it is permitted to treat such people during the week. On the Sabbath, however, one may not perform forbidden labors on their behalf. (See the Mishnah Berurah 330:8, which speaks very critically about physicians who violate the Sabbath laws on behalf of gentiles.) According to these authorities, one would be allowed to treat these gentiles on the Sabbath provided that there was not any forbidden labor involved. Note, however, Rav Kapach, who quotes Yemenite manuscripts of the Mishneh Torah that state "gentile" instead of "idolatress."
give birth on the Sabbath, even if payment is offered. We do not worry about the possibility of ill-feelings being aroused.46According to the generally accepted interpretation of Avodah Zarah 26b, the intent is that the non-Jews will understand that the Sabbath is a sacred day for the Jews. Even when they see that the Sabbath laws are violated for the sake of saving a Jew's life, they will accept the rationalization that the Sabbath laws may be violated only on behalf of an individual who observes the Sabbath.
Shulchan Aruch HaRav 330:2 and the Mishnah Berurah 330:8 mention that if a physician fears that ill-feeling will be generated by his refusal to care for gentiles, he may deliver their babies, provided that he does not perform labors that are forbidden by the Torah itself.
[This applies even when] there is no violation [of the Sabbath laws] involved.
[In contrast,] one may offer assistance to a daughter of a ger toshav who gives birth, since we are commanded to secure his well-being.47Based on Leviticus 25:35, Avodah Zarah 65a states that the Jews are required to maintain the well-being of such gentiles and, if necessary, the Jews should support the gentiles from their charitable funds. We may not, however, violate the Sabbath laws on her behalf.

הלכה יג
חַיָּה מִשֶּׁיַּתְחִיל הַדָּם לִהְיוֹת שׁוֹתֵת עַד שֶׁתֵּלֵד וְאַחַר שֶׁתֵּלֵד עַד שְׁלֹשָׁה יָמִים מְחַלְּלִין עָלֶיהָ אֶת הַשַּׁבָּת וְעוֹשִׂין לָהּ כָּל צְרָכֶיהָ. בֵּין שֶׁאָמְרָה צְרִיכָה אֲנִי בֵּין שֶׁאָמְרָה אֵינִי צְרִיכָה. וּמִשְּׁלֹשָׁה עַד שִׁבְעָה אִם אָמְרָה אֵינִי צְרִיכָה אֵין מְחַלְּלִין עָלֶיהָ אֶת הַשַּׁבָּת. וְאִם שָׁתְקָה וְאֵין צָרִיךְ לוֹמַר אִם אָמְרָה צְרִיכָה אֲנִי שֶׁמְּחַלְּלִין עָלֶיהָ אֶת הַשַּׁבָּת. וּמִשִּׁבְעָה וְעַד שְׁלֹשִׁים יוֹם הֲרֵי הִיא כְּחוֹלָה שֶׁאֵין בּוֹ סַכָּנָה וַאֲפִלּוּ אָמְרָה צְרִיכָה אֲנִי אֵין עוֹשִׂין לָהּ מְלָאכָה אֶלָּא עַל יְדֵי נָכְרִים:
כסף משנה
13.
From the time a woman in childbirth has a flow of blood48The Rambam chooses the more lenient of the opinions mentioned in Shabbat 129a, for a woman can begin bleeding well before she gives birth. until the birth - [and indeed,] after birth for three days49Although the Lechem Mishneh states that the counting of the three days should begin from the time the uterus opens, the consensus of halachic opinion is that the three days start from birth. (See the Be'ur Halachah 330.) - the Sabbath laws may be violated on her behalf, and all her needs should be met.50Shulchan Aruch HaRav 330:4 and the Mishnah Berurah 330:12 explain that this refers to activities that a woman's friends will customarily perform on her behalf after she gives birth. A doctor need not be consulted about these matters. Nevertheless, if a doctor says that these activities are unnecessary, they should not be performed. [This applies] regardless of whether she says she requires such treatment or she maintains that she does not require such treatment.
Between the third and the seventh day [after childbirth], if she maintains that she does not require treatment, the Sabbath laws should not be violated on her behalf. If she remains silent,51From the Rambam's wording (and indeed, this is the ruling of Shulchan Aruch HaRav 330:5 and the Mishnah Berurah 330:14), it appears that the woman is still considered to be dangerously ill. Hence, unless she protests to the contrary, it is assumed that this treatment is necessary. and certainly if she maintains that she requires treatment,52Shulchan Aruch HaRav and the Mishnah Berurah, loc. cit., state that the woman's word is accepted even against the opinions of many doctors. the Sabbath laws should be violated on her behalf. Between the seventh and the thirtieth day, her status is analogous to that of a sick person who is not dangerously ill. Even if she maintains that she requires treatment, [forbidden] labors should be performed on her behalf only by a gentile.53According to the halachic authorities (Shulchan Aruch HaRav 330:5 and the Mishnah Berurah 330:21), there is one exception. A fire may be kindled for a woman within thirty days after she has given birth. See the notes on the following halachah.

הלכה יד
עוֹשִׂין מְדוּרָה לְחַיָּה וַאֲפִלּוּ בִּימוֹת הַחַמָּה מִפְּנֵי שֶׁהַצִּנָּה קָשָׁה לְחַיָּה הַרְבֵּה בַּמְּקוֹמוֹת הַקָּרִים. אֲבָל אֵין עוֹשִׂין מְדוּרָה לְחוֹלֶה לְהִתְחַמֵּם בָּהּ. הִקִּיז דָּם וְנִצְטַנֵּן עוֹשִׂין לוֹ מְדוּרָה אֲפִלּוּ בִּתְקוּפַת תַּמּוּז. וּמַרְחִיצִין אֶת הַוָּלָד בְּשַׁבָּת בַּיּוֹם שֶׁנּוֹלַד אַחַר שֶׁחוֹתְכִין אֶת טִבּוּרוֹ אֲפִלּוּ בְּחַמִּין שֶׁהוּחַמּוּ בְּשַׁבָּת. וּמוֹלְחִין אוֹתוֹ וּמְלַפְּפִין אוֹתוֹ מִפְּנֵי שֶׁסַּכָּנָה הִיא לוֹ אִם לֹא יַעֲשׂוּ לוֹ כָּל אֵלּוּ. וְכֵן מַרְחִיצִים אוֹתוֹ לִפְנֵי הַמִּילָה וּלְאַחַר הַמִּילָה וּבַיּוֹם הַשְּׁלִישִׁי לַמִּילָה בְּחַמִּין שֶׁהוּחַמּוּ בְּשַׁבָּת מִפְּנֵי הַסַּכָּנָה:
כסף משנה
14.
A fire may be kindled54Preferably, the fire should be kindled by a gentile. If, however, there is no gentile available, the fire may be kindled by a Jew (Mishnah Berurah 330:21). for a woman after she has given birth55The Maggid Mishneh states that it appears to him that the Rambam (and Shabbat 129b, upon which this halachah is based) is speaking about a woman who gave birth less than a week previously. Although weight is given to this view (see Be'ur Halachah 330), the Shulchan Aruch (Orach Chayim 330:6) states that it refers to a woman within a month of childbirth. even in the summer, since cold is very difficult for a woman to bear after childbirth in the cold regions. In contrast, a fire should not be kindled for other sick people to warm themselves.56The commentaries question whether this refers to a person who is dangerously ill or to a person who is merely seriously ill, but in no danger of dying. According to the latter view, a fire may be kindled on behalf of someone who is dangerously ill. Nevertheless, if a person let blood and became chilled, a fire may be kindled for him even in the summer.
After cutting his umbilical cord,57Sefer HaKovetz states that cutting the umbilical cord involves the violation of a forbidden labor and is permitted only because of the danger involved. Most authorities, however, maintain that only a Rabbinic prohibition is involved. we may wash a new born baby on the day he is born, even when this requires heating the water on the Sabbath.58As mentioned above, most authorities maintain that only a Rabbinic prohibition may be waived on behalf of a new-born. Thus, this is interpreted as referring to water that was heated on the Sabbath by a gentile. Herbal powder59מלח is usually rendered as "salt." Our translation is based on the Rambam's Commentary on the Mishnah, Shabbat 18:3. (See also Mishnah Berurah 330:24.) can be applied to his skin and his limbs can be tied,60This is useful in straightening the child's limbs. for it is dangerous not to perform these activities for him.
Similarly, a baby may be washed before circumcision, after circumcision,61See Hilchot Milah 2:8. The Shulchan Aruch (Orach Chayim 331:9) writes that although in Talmudic times, washing a baby at this time was considered as a matter of vital importance, it is no longer common practice. The Ramah (loc. cit.) explains that it is customary to wash the baby before the circumcision with water that was heated on Friday, and to wash him after the circumcision on Saturday night. and on the third day after circumcision62There is greater discomfort on the third day after the circumcision, as explained by the commentaries on Genesis 18:1 and 34:25. with water that is heated on the Sabbath,63At present, the Ramah (loc. cit.) states that if it appears necessary, the baby may be washed with water that was heated before the Sabbath. Needless to say, in all situations, should a doctor state that such a washing is necessary, his advice should be followed. because of the danger [to him].

הלכה טו
הָאִשָּׁה שֶׁיָּשְׁבָה עַל הַמַּשְׁבֵּר וּמֵתָה מְבִיאִין סַכִּין בְּשַׁבָּת אֲפִלּוּ דֶּרֶךְ רְשׁוּת הָרַבִּים וְקוֹרְעִין אֶת כְּרֵסָהּ וּמוֹצִיאִין אֶת הַוָּלָד שֶׁמָּא יִמָּצֵא חַי שֶׁסְּפֵק נְפָשׁוֹת דּוֹחֶה אֶת הַשַּׁבָּת וַאֲפִלּוּ לָזֶה שֶׁאֵין חֶזְקָתוֹ חַי:
כסף משנה
15.
When a woman dies while in labor on the Sabbath, a knife should be brought - even if it must be carried through the public domain - and the woman's womb cut open and the fetus removed, for it is possible that it will still be alive.64The Ramah (Orach Chayim 330:5) states that it is no longer customary to follow this practice even during the week. We wait a considerable time after the woman loses consciousness, because we are afraid that she did not die, but merely fainted. Hence, by the time we are certain that she has died, we can assume that the fetus is also no longer alive.
Needless to say, at present, when our improved technology makes it possible to monitor the physical functioning of both the mother and the fetus, the physicians should decide on the basis of the information before them. Regardless of the practical application of this ruling today, the principles on which it is based are significant and should be applied in other circumstances.

[The rationale for this ruling is] that the Sabbath laws are violated even when there is only a possibility of saving a life,65Note Shulchan Aruch HaRav 330:7, which adds that this ruling is granted despite the fact that the fetus will normally die in such a situation. Although probability (רוב in Hebrew) is a significant factor in halachah, the possibility of saving a life overweighs it. and even in such instances, where there is no chazakah on which to base our presumption that the fetus is alive.66Generally, a living person can be assumed to continue to live (chezkat chayim) until we are certain that he has died. Although such a presumption cannot be made with regard to this fetus, permission is, nevertheless, granted for the Sabbath laws to be violated on its behalf.

הלכה טז
מְפַקְּחִין פִּקּוּחַ נֶפֶשׁ בְּשַׁבָּת וְאֵין צָרִיךְ לִטּל רְשׁוּת מִבֵּית דִּין. וְהַמַּקְדִּים לְהַצִּיל הַנֶּפֶשׁ הֲרֵי זֶה מְשֻׁבָּח. כֵּיצַד. רָאָה תִּינוֹק שֶׁנָּפַל לַיָּם פּוֹרֵשׂ מְצוּדָה וּמַעֲלֵהוּ וְאַף עַל פִּי שֶׁהוּא צָד הַדָּגִים עִמּוֹ. שָׁמַע שֶׁטָּבַע תִּינוֹק בַּיָּם וּפָרַשׂ מְצוּדָה לְהַעֲלוֹתוֹ וְהֶעֱלָה דָּגִים בִּלְבַד פָּטוּר מִכְּלוּם. נִתְכַּוֵּן לְהַעֲלוֹת דָּגִים וְהֶעֱלָה דָּגִים וְתִינוֹק פָּטוּר אֲפִלּוּ לֹא שָׁמַע שֶׁטָּבַע הוֹאִיל וְהֶעֱלָה תִּינוֹק עִם הַדָּגִים פָּטוּר:
כסף משנה
16.
[All] activities necessary to save a life should be performed on the Sabbath; there is no necessity to receive license from the court. The more zealous one is [in this regard], the more praiseworthy.
What is implied?67The Shulchan Aruch (Orach Chayim 328:13) rephrases the concepts stated in this halachah slightly, connecting the praise given a person for being zealous in saving a life with the situation concerning catching fish described afterwards. According to the Shulchan Aruch, this situation teaches us that a person is considered praiseworthy for saving a life on the Sabbath even if he accrues personal benefit through his actions - for example, in the case at hand, in addition to saving a life, the person also receives a catch of fish. If one sees that a child has fallen into the sea, one may spread out a net and hoist him up, although one catches fish together with him. If a person hears that a child fell into the sea and spreads out a net to hoist him up, but raises up only fish, he is absolutely free of liability.68The Rambam adds the term "absolutely" to indicate that it is desirable to spread out and raise one's nets to try to save the child (Lechem Mishneh). Significantly, the Jerusalem Talmud, Shabbat 13:6, states that the person is not held liable even if he intended to catch the fish together with the child.
If he intended to raise up fish and [in fact] lifted up both fish and a child, he is not held liable.69The Or Sameach writes that he is given "stripes for rebelliousness" (the punishment usually given for the violation of a Rabbinic ordinance), since he intended to perform a forbidden activity. See a parallel ruling, Hilchot Nedarim 12:18.
Significantly, when mentioning this instance in Hilchot Shegagot 2:15, the Rambam states that the person acted בשוגג when catching the fish - i.e., he was unaware that it was the Sabbath or was unaware that it is forbidden to fish on the Sabbath.
Since he lifted up a child together with the fish, he is not held liable even when he did not hear that the child had fallen into the water.70This reflects the Rambam's decision regarding a difference of opinion between the Sages in Menachot 64a. One opinion holds the person liable for it considers his intent of primary importance, while the other frees him of liability for it views his actions as most significant.

הלכה יז
נָפַל תִּינוֹק לַבּוֹר עוֹקֵר חֻלְיָה וּמַעֲלֵהוּ וְאַף עַל פִּי שֶׁהוּא מְתַקֵּן בָּהּ מַדְרֵגָה בִּשְׁעַת עֲקִירָתוֹ. נִנְעַל דֶּלֶת בִּפְנֵי תִּינוֹק שׁוֹבֵר הַדֶּלֶת וּמוֹצִיאוֹ וְאַף עַל פִּי שֶׁהוּא מְפַצֵּל אוֹתָהּ כְּמִין עֵצִים שֶׁרְאוּיִין לִמְלָאכָה שֶׁמָּא יִבָּעֵת הַתִּינוֹק וְיָמוּת. נָפְלָה דְּלֵקָה וְיֵשׁ שָׁם אָדָם שֶׁחוֹשְׁשִׁין שֶׁמָּא יִשָּׂרֵף מְכַבִּין אוֹתָהּ לְהַצִּילוֹ מִן הָאֵשׁ וְאַף עַל פִּי שֶׁהוּא כּוֹבֵשׁ דֶּרֶךְ וּמְתַקְּנָהּ בִּשְׁעַת כִּבּוּי. וְכָל הַקּוֹדֵם לְהַצִּיל הֲרֵי זֶה מְשֻׁבָּח וְאֵינוֹ צָרִיךְ לִטּל רְשׁוּת מִבֵּית דִּין בְּכָל דָּבָר שֶׁיֵּשׁ בּוֹ סַכָּנָה:
כסף משנה
17.
If71These instances are cited by Yoma 84b as a continuation of the development of the concept mentioned in the previous halachah, that one may perform an activity to save someone else's life, although in the process of doing so, one derives benefit. The Talmud explains why it is necessary to mention all these different instances. a child fell into a pit, a person may dislodge a clod of earth, and lift [the child] up, even though he creates a step when he dislodges it. If a door was locked with a child inside, a person may break the door down and take the child out, even though he chops it into pieces of wood which are appropriate to use for work,72The Lechem Mishneh notes that the Rambam alters the text of the Talmud slightly to imply that the person breaking down the door did not do so with the intent of using the wood. Rav Kapach differs, noting that, as mentioned in the commentary on the previous halachah, the Rambam absolves the person of liability even when he has an intent to benefit from his actions. (See also the notes of Rabbi Akiva Eiger.) lest the child become frightened and die.
If a fire broke out and a person is inside the building and we fear that he may be consumed by the flames,73Yoma, ibid., explains that this leniency is granted even when the fire breaks out in a courtyard other than that in which the person was located. If the fire appears to pose a danger to his life, it may be extinguished. a person may extinguish the fire to save him, although he prepares a pathway while extinguishing the fire. Whoever acts first to save him is praiseworthy. One does not need to ask permission from the court in all instances when there is a danger to a person's life.

הלכה יח
מִי שֶׁנָּפְלָה עָלָיו מַפּלֶת סָפֵק הוּא שָׁם סָפֵק אֵינוֹ שָׁם מְפַקְּחִין עָלָיו. מְצָאוּהוּ חַי אַף עַל פִּי שֶׁנִּתְרוֹצֵץ וְאִי אֶפְשָׁר שֶׁיִּבָּרֵא מְפַקְּחִין עָלָיו וּמוֹצִיאִין אוֹתוֹ לְחַיֵּי אוֹתָהּ שָׁעָה:
כסף משנה
18.
When an avalanche has fallen, and there is a doubt whether or not74I.e., a person was seen in the vicinity of the avalanche and we are unsure whether or not he was able to escape or not. it has fallen over a person,75The Maggid Mishneh mentions that this leniency is granted even when there are several doubts involved: Perhaps the person was not trapped under the avalanche. Even if he was trapped, perhaps he is no longer alive and the performance of the labor of clearing will be to no avail. it may be cleared. If the person was discovered to be alive, but was crushed [by the fallen debris] to the extent that it is impossible that he will recover, [the debris] may be cleared and the person taken out to enable him to live [however] long he does.76This communicates a fundamental concept in Torah law: Even a fleeting moment of a Jew's life is precious enough for all possible efforts to be performed to save him even if it is necessary to violate Torah law.

הלכה יט
בָּדְקוּ עַד חָטְמוֹ וְלֹא מָצְאוּ בּוֹ נְשָׁמָה מַנִּיחִין אוֹתוֹ שָׁם שֶׁכְּבָר מֵת. בָּדְקוּ וּמָצְאוּ עֶלְיוֹנִים מֵתִים לֹא יֹאמְרוּ כְּבָר מֵתוּ תַּחְתּוֹנִים אֶלָּא מְפַקְּחִין עַל הַכּל שֶׁאֶפְשָׁר בְּמַפּלֶת שֶׁיָּמוּת הָעֶלְיוֹן וְיִהְיֶה הַתַּחְתּוֹן חַי:
כסף משנה
19.
If [in the process of clearing the debris,] they [reached] his nose and saw that he was not breathing, he should be left there,77Although we are commanded to show respect for a corpse and not to leave it exposed, we are not allowed to violate the Sabbath laws for such a purpose. (See the Rambam's Commentary on the Mishnah, Yoma 8:5.) for he has died already.78Based on Genesis 7:22, "all that has the breath of the spirit of life," Yoma 88b states that whether a person is breathing or not is the determining factor of whether he is considered alive or not. Significantly, Shulchan Aruch HaRav 329:3 and the Mishnah Berurah 329:11 rule that even if we see that his heart is not beating, he is not considered dead until we are certain that he is not breathing.
The conception of breath as the determinant of life is significant in the present age, when it is possible that a person will continue to breathe despite brain death. The question of whether such a person is considered alive has been raised today within the context of many contemporary medical issues. Rav Moshe Feinstein (Igros Moshe, Yoreh De'ah, Vol. II, Responsum 174) and other authorities of the present age have ruled that breath is still the fundamental determinant whether or not a person is alive.

Although it is discovered that people on the upper level of a landslide have died, one should not assume that those on the lower levels have died. Instead, [the debris] should be cleared away from all of the people, for in a landslide it is possible that those on the upper level will die, while those on the lower level will remain alive.

הלכה כ
הָיְתָה חָצֵר שֶׁיֵּשׁ בָּהּ עוֹבְדֵי כּוֹכָבִים וּמַזָּלוֹת וְיִשְׂרְאֵלִים אֲפִלּוּ יִשְׂרָאֵל אֶחָד וְאֶלֶף עוֹבְדֵי כּוֹכָבִים וּמַזָּלוֹת וְנָפְלָה עֲלֵיהֶם מַפּלֶת מְפַקְּחִין עַל הַכּל מִפְּנֵי יִשְׂרָאֵל. פֵּרַשׁ אֶחָד מֵהֶם לֶחָצֵר אַחֶרֶת וְנָפְלָה עָלָיו אוֹתָהּ חָצֵר מְפַקְּחִים עָלָיו שֶׁמָּא זֶה שֶׁפֵּרַשׁ הָיָה יִשְׂרָאֵל וְהַנִּשְׁאָרִים עוֹבְדֵי כּוֹכָבִים וּמַזָּלוֹת:
כסף משנה
20.
When an avalanche fell on a courtyard in which were located both gentiles and Jews - even if there were a thousand gentiles and only one Jew, we should remove all [the debris] for the sake of the Jew.79This halachah is based on the following principles:
a) As mentioned in Halachah 12, we may not violate the Sabbath laws to save a gentile's life.
b) כל קבוע כמחצה על מחצה - "Whenever there is a doubt concerning the identity of objects in a fixed position, we consider the probability as 50%." Since there is at least one Jew in this courtyard, until his body is located, it is considered as if there is a 50% probability that every body found is the Jew. (See also Hilchot Ma'achalot Asurot 8:11.)
Should one80Even if several people departed, the same rule would apply, as long as the entire group did not leave its original place. See the following halachah. of the individuals leave and enter another courtyard and that courtyard collapse upon him, we should remove [the debris]. Perhaps the person who departed was a Jew, and [all] those who remain were gentiles.81The Rambam's decision depends on Rabbenu Yitzchak Alfasi's text of Yoma 84b. There the Talmud explains that although in general we follow the principle, כל דפריש מרובא פריש - "Whenever an entity separates itself from a group, we assume that it was part of the majority" - in this instance, since the matter involves a possible threat to a Jewish life, this principle is given a slightly different interpretation. Since the group remains in its place, its fixed nature (קביעות) is not disrupted.
It must be emphasized that the Ra'avad, Rashi, and the Ramban have a different approach to the passage in Yoma. The Shulchan Aruch (Orach Chayim 329:2) follows the opinion quoted by the Rambam.

הלכה כא
נֶעֶקְרוּ כֻּלָּן מֵחָצֵר זוֹ לֵילֵךְ לֶחָצֵר אַחֶרֶת וּבְעֵת עֲקִירָתָם פֵּרַשׁ אֶחָד מֵהֶן וְנִכְנַס לֶחָצֵר אַחֶרֶת וְנָפְלָה עָלָיו מַפּלֶת וְאֵין יָדוּעַ מִי הוּא אֵין מְפַקְּחִין עָלָיו. שֶׁכֵּיוָן שֶׁנֶּעֶקְרוּ כֻּלָּם אֵין כָּאן יִשְׂרָאֵל וְכָל הַפּוֹרֵשׁ מֵהֶן כְּשֶׁהֵן מְהַלְּכִין הֲרֵי הוּא בְּחֶזְקַת שֶׁפֵּרַשׁ מִן הָרֹב. לְפִיכָךְ אִם הָיָה הָרֹב יִשְׂרָאֵל אַף עַל פִּי שֶׁנֶּעֶקְרוּ כֻּלָּם וּפֵרַשׁ אֶחָד מֵהֶם לְחָצֵר אַחֶרֶת וְנָפְלָה עָלָיו מַפּלֶת מְפַקְּחִין:
כסף משנה
21.
When they all left this courtyard to go to another courtyard, and as they were proceeding, one of them whose identity is unknown departed and entered a third courtyard and was covered by an avalanche, [the debris] should not be removed from him.82Again this ruling depends on Rav Yitzchak Alfasi's interpretation of Yoma 84b. Other authorities differ, as mentioned above.
Since they left their original place, [the presence of] a Jew is not accepted as an established fact. Hence, we assume that anyone who separated from this group as it was proceeding was part of the majority. Accordingly, if the majority were Jewish,83This implies that if a person of unknown origin is found buried under a landslide in a place whose population is primarily gentile, we are not allowed to remove the debris from him. (See Hilchot Issurei Bi'ah 15:26.) This is a matter of question on which there is a responsum attributed to the Rambam (although its origins are disputed). (See also Shulchan Aruch, Even HaEzer 4:34, which quotes the Rambam's opinion, and the Ramah, loc. cit., who allows the debris to be removed.) even a person separated from them [who entered] another courtyard after they left their original place - should he be covered by an avalanche, we should remove [the debris] from him.

הלכה כב
הַמְהַלֵּךְ בַּמִּדְבָּר וְלֹא יָדַע מָתַי הוּא יוֹם שַׁבָּת מוֹנֶה מִיּוֹם שֶׁטָּעָה שִׁשָּׁה וּמְקַדֵּשׁ שְׁבִיעִי וּמְבָרֵךְ בּוֹ בִּרְכוֹת הַיּוֹם וּמַבְדִּיל בְּמוֹצָאֵי שַׁבָּת. וּבְכָל יוֹם וָיוֹם וַאֲפִלּוּ בְּיוֹם זֶה שֶׁהוּא מְקַדֵּשׁ וּמַבְדִּיל בּוֹ מֻתָּר לוֹ לַעֲשׂוֹת כְּדֵי פַּרְנָסָתוֹ בִּלְבַד כְּדֵי שֶׁלֹּא יָמוּת. וְאָסוּר לוֹ לַעֲשׂוֹת יוֹתֵר עַל פַּרְנָסָתוֹ שֶׁכָּל יוֹם וָיוֹם סְפֵק שַׁבָּת הוּא. וְאִם יָדַע שֶׁהוּא שְׁמִינִי לִיצִיאָתוֹ אוֹ חֲמִשָּׁה עָשָׂר לִיצִיאָתוֹ וְכַיּוֹצֵא בְּזֶה הַמִּנְיָן הֲרֵי זֶה מֻתָּר לַעֲשׂוֹת מְלָאכָה בְּאוֹתוֹ הַיּוֹם שֶׁהֲרֵי הַדָּבָר וַדַּאי שֶׁלֹּא יָצָא בְּשַׁיָּרָא בְּשַׁבָּת. וּשְׁאָר הַיָּמִים חוּץ מִיּוֹם זֶה עוֹשֶׂה כְּדֵי פַּרְנָסָה בִּלְבַד:
כסף משנה
22.
A person who is traveling in the desert and does not know which day is the Sabbath should count84He should start counting the six days immediately on the day on which he realizes that he has lost touch with the weekly calendar. six days and consider the seventh day as holy. He should recite the blessing of the day [Kiddush] and recite Havdalah at the conclusion of this "Sabbath" day.85Similarly, in his daily prayers, he should recite the prayers of the Sabbath on that day. The recitation of these prayers was instituted so that the person should not lose consciousness of the observance of the Sabbath entirely.
Every day, even on the day on which he recites Kiddush and after which he recites Havdalah, he is allowed86The Shulchan Aruch (Orach Chayim 344:1) states that as long as the person has means, he is not allowed to work at all. Permission to work is granted only when it is a life and death matter. This explains why this halachah is included in this chapter. to earn87The Maggid Mishneh and the Shulchan Aruch (loc. cit.) emphasize that although there is a prohibition against walking beyond the Sabbath limits, it is not as serious as the prohibition against forbidden labors. Hence, it is waived in order to allow this person the opportunity to reach a settled area and observe the Sabbath in a proper manner. only enough for his livelihood, so that he will not die. It is forbidden for him to earn more than his livelihood, for there is a possibility that every day is the Sabbath.
If the person knows that the day is the eighth day or the fifteenth day after his departure, he is allowed to work on that day, for it is certain that he did not depart on the Sabbath.88If he earns enough on that day to support himself for several days, he must cease work until his means are exhausted (Mishnah Berurah 344:11). On the other days, he is allowed to earn merely his livelihood.

הלכה כג
עוֹבְדֵי כּוֹכָבִים וּמַזָּלוֹת שֶׁצָּרוּ עַל עֲיָרוֹת יִשְׂרָאֵל אִם בָּאוּ עַל עִסְקֵי מָמוֹן אֵין מְחַלְּלִין עֲלֵיהֶן אֶת הַשַּׁבָּת וְאֵין עוֹשִׂין עִמָּהֶן מִלְחָמָה. וּבְעִיר הַסְּמוּכָה לַסְּפָר אֲפִלּוּ לֹא בָּאוּ אֶלָּא עַל עִסְקֵי תֶּבֶן וְקַשׁ יוֹצְאִין עֲלֵיהֶן בִּכְלֵי זַיִן וּמְחַלְּלִין עֲלֵיהֶן אֶת הַשַּׁבָּת. וּבְכָל מָקוֹם אִם בָּאוּ עַל עִסְקֵי נְפָשׁוֹת אוֹ שֶׁעָרְכוּ מִלְחָמָה אוֹ שֶׁצָּרוּ סְתָם יוֹצְאִין עֲלֵיהֶן בִּכְלֵי זַיִן וּמְחַלְּלִין עֲלֵיהֶן אֶת הַשַּׁבָּת. וּמִצְוָה עַל כָּל יִשְׂרָאֵל שֶׁיְּכוֹלִין לָבוֹא וְלָצֵאת וְלַעֲזֹר לְאַחֵיהֶם שֶׁבַּמָּצוֹר וּלְהַצִּילָם מִיַּד הָעוֹבְדֵי כּוֹכָבִים וּמַזָּלוֹת בְּשַׁבָּת. וְאָסוּר לָהֶן לְהִתְמַהֲמֵהַּ לְמוֹצָאֵי שַׁבָּת. וּכְשֶׁיַּצִּילוּ אֶת אֲחֵיהֶן מֻתָּר לָהֶן לַחֲזֹר בִּכְלֵי זַיִן שֶׁלָּהֶן לִמְקוֹמָם בְּשַׁבָּת כְּדֵי שֶׁלֹּא לְהַכְשִׁילָן לֶעָתִיד לָבוֹא:
כסף משנה
23.
[The following rules apply] when gentiles lay siege to Jewish cities:89Although these laws surely apply to Jewish communities in Eretz Yisrael, these same laws are also relevant to Jewish communities in the diaspora. If their intent was financial gain, the Sabbath laws should not be violated because of them, nor are we allowed to wage war against them.90Since their intent is only financial, the Sabbath laws may not be violated for this reason. Note, however, Shulchan Aruch HaRav 329:7 and the Mishnah Berurah 329:17, which state that at present, even when gentiles initially come only for pillage and plunder, since they have no compunctions about killing Jews, particularly if one will defend his property, any gentile raid on a Jewish community is considered a question of life and death warranting the violation of the Sabbath laws. If a city is located near the border, however, we should march against them with weapons and wage war against them even when they are demanding hay or straw.91The rationale is that if a border city is conquered, the enemies will have a vantage point from which to conquer the entire land. This concept has relevance beyond the Sabbath laws. For example, the Lubavitcher Rebbe Shelita has explained that these principles are relevant to the territorial disputes between Jews and gentiles in Eretz Yisrael today. Returning any territory to the Arabs would jeopardize the safety of the entire land.
In any location, if the gentiles' intent was Jewish lives, or if they engaged in battle with a city or laid siege to it without stating a specific intention,92War must be waged against them because it is possible that their intent is to kill. Hence, we follow the principle that the Sabbath laws may be violated even where there is merely a question of a threat to life. we must wage war against them, and the Sabbath laws should be violated because of them. It is a mitzvah93I.e., an obligation. See Hilchot Rotzeach UShemirat HaNefesh 1:14, which describes the mitzvah (Leviticus 19:16 : "Do not stand by idly while your neighbor's life is in danger."
It is told that in the Maccabean revolt, the Greeks once attacked the Jews on the Sabbath. The people, unaware of this law, refused to take up arms in defense and thousands died. Afterwards, the Rabbis publicized this ruling.
for every member of the Jewish people who can come [to their assistance] to go out and aid their brethren who are under siege and save them from the gentiles [although it is the] Sabbath. It is forbidden to wait until Saturday night.
After they have saved their brethren, they may return home with their weapons on the Sabbath, so that a dangerous situation will not be created in the future.94Eruvin 45a relates that originally it was forbidden for the people to return with their weapons, and they would leave them in a home within the city's wall. Once the enemy forces saw that the Jews were returning unarmed and attacked them. More Jews were killed in the confused scramble for their weapons than by the enemy attack. After this event, the Sages allowed those who come to assist a besieged city to return with their weapons.

הלכה כד
וְכֵן סְפִינָה הַמְטֹרֶפֶת בַּיָּם אוֹ עִיר שֶׁהִקִּיפָהּ כַּרְקוֹם אוֹ נָהָר מִצְוָה לָצֵאת בְּשַׁבָּת לְהַצִּילָן בְּכָל דָּבָר שֶׁיָּכוֹל לְהַצִּילָן. וַאֲפִלּוּ יָחִיד הַנִּרְדָּף מִפְּנֵי הָעוֹבְדֵי כּוֹכָבִים וּמַזָּלוֹת אוֹ מִפְּנֵי נָחָשׁ אוֹ דֹּב שֶׁהוּא רוֹדֵף אַחֲרָיו לְהָרְגוֹ מִצְוָה לְהַצִּילוֹ. וַאֲפִלּוּ בַּעֲשִׂיַּת כַּמָּה מְלָאכוֹת בְּשַׁבָּת וַאֲפִלּוּ לְתַקֵּן כְּלֵי זַיִן לְהַצִּילוֹ מֻתָּר. וְזוֹעֲקִים עֲלֵיהֶן וּמִתְחַנְּנִים בְּשַׁבָּת וּמַתְרִיעִין עֲלֵיהֶן לַעֲזֹר אוֹתָם. וְאֵין מִתְחַנְּנִים וְלֹא זוֹעֲקִין עַל הַדֶּבֶר בְּשַׁבָּת:
כסף משנה
24.
Similarly, if a ship is sinking at sea95Rabbi Akiva Eiger states that this applies only when one knows that there are Jews on the ship. If we do not have such information, it would appear that we should assume that the passengers of the ship are gentiles and should not endeavor to save their lives. or a city is surrounded by a [flooding] river, it is a mitzvah to go out on the Sabbath and use every possible means to save them.
Even when a single individual is being pursued by gentiles, by a snake, or by a bear with the intent to kill him, it is a mitzvah to save him, even when it is necessary to perform several forbidden labors on the Sabbath. It is even permitted to forge weapons to save him. Similarly, we should cry out [to God] on their behalf, make supplications,96Hilchot Ta'aniot 1:1 states that it is a mitzvah to cry out to God for assistance in the event of any distressing situation that affects a Jewish community. On the Sabbath, however, it is only proper to make such requests when there is an immediate threat to human life. Just as such requests are made on behalf of a community, they should also be made on behalf of a single individual whose life is threatened (Hilchot Ta'aniot 1:6, Hilchot Shabbat 30:12). and sound the trumpets97Hilchot Ta'aniot 1:1 states that, as part of the mitzvah of entreating God's mercy, trumpets should be sounded. Nevertheless, trumpets should be not be sounded for this purpose on the Sabbath, since sounding the trumpets violates a Rabbinic prohibition (Hilchot Shofar 2:7). Here, however, the intent in sounding the trumpets is to alert the Jews in the surrounding area and to summon them. The prohibition is waived for this purpose. (See Hilchot Ta'aniot 1:6.) to summon help for them.98Just as one may violate the Sabbath laws to save a Jew's life, one may violate the Sabbath laws to save a Jew who is being forced to adopt a gentile way of life (Shulchan Aruch HaRav 306:29 and the Mishnah Berurah 306:57).
We should not cry out [to God] or make supplications because of plague99See Ta'anit 22b. on the Sabbath.

הלכה כה
צָרִין עַל עֲיָרוֹת הָעוֹבְדֵי כּוֹכָבִים וּמַזָּלוֹת שְׁלֹשָׁה יָמִים קֹדֶם לַשַּׁבָּת. וְעוֹשִׂין עִמָּהֶן מִלְחָמָה בְּכָל יוֹם וָיוֹם וַאֲפִלּוּ בְּשַׁבָּת עַד שֶׁכּוֹבְשִׁין אוֹתָהּ וְאַף עַל פִּי שֶׁהִיא מִלְחֶמֶת הָרְשׁוּת. מִפִּי הַשְּׁמוּעָה לָמְדוּ (דברים כ כ) "עַד רִדְתָּהּ" וַאֲפִלּוּ בְּשַׁבָּת. וְאֵין צָרִיךְ לוֹמַר בְּמִלְחֶמֶת מִצְוָה. וְלֹא כָּבַשׁ יְהוֹשֻׁעַ יְרִיחוֹ אֶלָּא בְּשַׁבָּת:
כסף משנה
25.
We should lay siege to gentile cities [at least] three days before the Sabbath.100In Chapter 30, Halachah 13, the Rambam states that this requirement was instituted "so that the soldiers' minds will be settled and they will not be overly preoccupied on the Sabbath." Although the war will require violation of the Sabbath laws, efforts should be made to minimize the tension and anxiety experienced by the soldiers to the greatest degree possible.
See Hilchot Melachim 6:11 which states that we can lay siege to gentile cities "on the Sabbath." The Kessef Mishneh notes the contradiction and suggests amending the text of Hilchot Melachim in light of our halachah. The Lechem Mishneh, however, explains that this clause of our halachah speaks of a milchemet reshut, a war which we are not obligated to wage, while Hilchot Melachim speaks of a milchemet mitzvah, a war which we are obligated to wage.
We may wage war with them on any day, even on the Sabbath, until we conquer [the city], even if the war is voluntary in nature.101Hilchot Melachim describes a voluntary war, a milchemet reshut, as a war fought "to expand the borders of Israel or magnify [the king's] greatness and reputation." In contrast, a war that is obligatory in nature, a milchemet mitzvah, refers to "the war against the seven nations [who occupied Eretz Yisrael], the war against Amalek, and [a war] fought to assist Israel against an enemy which attacks her." The oral tradition,102Sifre on Deuteronomy (loc. cit.), Shabbat 19a. interprets [Deuteronomy 20:20] "until you have subjugated it," as teaching that [one should wage war] even on the Sabbath.
Surely, the above applies103According to the Kessef Mishneh's (Hilchot Melachim 6:11), this refers to the leniency of waging war on the Sabbath. The restriction of laying siege to a city three days before the Sabbath, in contrast, applies only with regard to voluntary wars. In an obligatory war, we may lay siege to a city even on the Sabbath itself. with regard to a war that we are obligated to wage. Indeed, it was on the Sabbath that Joshua conquered Jericho.104Rav Kapach notes that the citation of a historical event as proof of a law is extremely out of character for the Rambam in the Mishneh Torah. He explains that the Rambam's statements are directed against statements of Rav Sa'adiah Gaon, who writes that Jericho did not fall on the Sabbath.
It is possible to explain the Rambam's statements from another perspective. Joshua was instructed concerning the conquest of Jericho by Divine command. Indeed, according to human reason, there was no reason why Jericho should have been conquered on the Sabbath. Hence, the fact that God delivered such a command is a clear directive that one may begin a milchemet mitzvah on the Sabbath.

זמנים הלכות שבת פרק ב
Zemanim Shabbos Chapter 2