Pikuach Nefesh: Are We Always Allowed to Violate Mitzvos in Order to Save a Life?

Now that we have grappled with the definition of life and analyzed the possible points in time at which life begins, we will now try to gain a deeper understanding of the limitless value that the Torah places on life, as well as the infinite importance of saving life – a mitzvah referred to as pikuach nefesh. As always, let us start with some fundamental questions:

Introductory Questions

1. Why is saving a life important?

If saving a life is important, this implies that life itself must have importance and extraordinary value. But how do we know that life is valuable? Where does life get its value from? And if we assume that life is valuable, is the value of one's life in its potential to achieve great things in the future, or a reflection of all the good that one has already accomplished? Or, perhaps it is a combination of both? Or, is it even possible that life has innate value, irrespective of what one has already accomplished or might one day accomplish?

Furthermore, even if we can agree that all life has extraordinary value, is all life equally valuable, or are certain people's lives more valuable than others? And if certain lives are more valuable than others, what would be the determining factor in deciding whose life is more valuable?

2. When is one allowed, or obligated, to save a life?

The obligation to save one's own life may be more than just an opportunity; if we are in this world for a purpose, then fulfilling that purpose is also a responsibility. As such, taking care of our health, protecting ourselves from danger, and saving our lives when we are at risk of dying would not only be part of our innate drive for self-preservation, but an actual chiyuv and responsibility. It is therefore no surprise that the Torah commands us to take care of our health.[1]

As we will soon see, the Torah commands us to save the lives of others as well. But what is the nature of this obligation, and where does this obligation stem from?

• Does it come from a practical sense of responsibility, where if you see someone's life in danger, you have a responsibility to save them; and thus, if you fail to help them, then, in some sense, it is as if you are responsible for their death – albeit in a passive sense? Accordingly, by not saving them, you would carry the weight of their lives on your shoulders.

• Or, perhaps this obligation stems from a communal responsibility. Meaning, because we are a unified nation, we also have a unified sense of communal responsibility; as such, if a member of Klal Yisrael is in any danger, then it is as if you yourself are in danger. And just as you have a responsibility to take care of, protect, and save your own life, you have the same, or at least similar responsibility to do so for your family and for all of Klal Yisrael. 

3. Are we allowed to violate aveiros (negative commandments) in order to save our lives?

At face value, when it comes to saving a life, we might assume that it is always muttar to save one's life, no matter the cost. However, is there ever a circumstance when it would be assur to save a life? There are three famous aveiros which one cannot violate, even in order to save one's own life: murder, idolatry, and adultery.[2] We will need to delve deeper into this topic to understand the potential reasons why saving a life does allow us to violate these three aveiros.

However, it is important for us to begin our analysis without any preconceived notions, and ask whether it is logical for one to be allowed to violate an aveirah in order to save a life. Even if the aveirah is not one of the “Big 3” cardinal aveiros, why should we ever be allowed to go against Hashem's will in order to save a life?

4. Is Hatzalas Nefashos on Shabbos Different than a Normal Case of Hatzalas Nefashos? 

Imagine the following case: It's Shabbos, you're eating at a friend's house, and suddenly he starts to cough. The cough continues to get worse, and you suddenly get worried that he's choking. He's motioning with his hands, but he isn't able to get any words out. You begin to panic. Is he choking? Is this an emergency? Should you call Hatzalah or an ambulance? Or perhaps you should go ask one of the next-door neighbors and ask them what to do?

Let's say, for argument's sake, that the Torah allows us to violate Shabbos in such a case. What are the parameters or limits to such a heter? Are we always allowed to violate Shabbos when it comes to pikuach nefesh? What if it's only a safek (doubt)? And even if it is muttar to violate Shabbos for the sake of pikuach nefesh, what kind of attitude should we have when we try to save someone's life on Shabbos? Should we feel bad that we are desecrating Shabbos, even though we are trying to save a life?

In order to approach all of these questions, let us begin by analzying some of the fundamental Torah sources for pikuach nefesh.

Torah Sources for Pikuach Nefesh

The Gemara (Yoma 85a) asks what appears to be a very simple question: what is the Torah source that one can override Shabbos in order to save a life? The Gemara states as follows:

תלמוד בבלי מסכת יומא דף פה עמוד א

 מניין לפקוח נפש שדוחה את השבת? …רבי שמעון בן מנסיא אומר: ושמרו בני ישראל את השבת[3], אמרה תורה: חלל עליו שבת אחת, כדי שישמור שבתות הרבה. אמר רב יהודה אמר שמואל: אי הואי התם הוה אמינא: דידי עדיפא מדידהו, וחי בהם[4] - ולא שימות בהם. אמר רבא: לכולהו אית להו פירכא, בר מדשמואל דלית ליה פרכא… וכולהו אשכחן ודאי, ספק מנא לן? ודשמואל ודאי לית ליה פירכא  

"From where is it derived that saving a life overrides Shabbos?... Rabbi Shimon ben Menasya said: It is stated: “And the children of Israel shall keep Shabbos.” (Shemos 31:16). The Torah said: Desecrate one Shabbos on his behalf so he will observe many Shabbasos. Rav Yehuda said that Shmuel said: If I would have been there among those Sages who debated this question, I would have said that my proof is preferable to theirs, as it states: “You shall keep My statutes and My ordinances, which a person shall do and live by them” (Vayikra 18:5), and not that he should die by them.

Rava commented on this: All of these arguments have refutations except for that of Shmuel, which has no refutation… And for all the other arguments, we have found proofs for saving a life from certain danger. But for cases of uncertainty, from where do we derive this? For this reason, these other arguments are limited. However, the proof that Shmuel brought from the verse: “And live by them,” there is certainly no refutation.

Before we analyze the discussion in this Gemara, let us begin by trying to understand the initial question that the Gemara poses: "From where do we know that one can override Shabbos in order to save a life?"

Now, it is not necessarily obvious that one can violate Shabbos in order to save a life. Thus, there are two ways to understand this initial question of the Gemara:

• On the one hand, the Gemara could be assuming that of course we are allowed to violate Shabbos in order to save a life. Therefore, the question is simply clarifying what the source is that allows us to push Shabbos aside to save a life.
• However, on the other hand, perhaps the Gemara is asking a more fundamental question: perhaps the Gemara is questioning whether, in fact, we are allowed to violate Shabbos in order to save a life. In other words, as opposed to asking what the source is that would allow us to push Shabbos aside to save a life, perhaps the Gemara is asking whether or not there is a source that would allow this – and if that is that case, then the Gemara is showing that it might not necessarily be true that we are allowed to push Shabbos aside in order to save a life.

Furthermore, we need to determine whether the Gemara is asking a Shabbos-specific question, or a general question about pikuach nefesh. In other words, is the Gemara only asking about whether we can override Shabbos in order to save a life? [In which case the Gemara might already assume that violating every other aveirah, especially those that are not included in the “Big 3,” would be muttar for the sake of pikuach nefesh.] Or, is the Gemara asking a universal pikuach nefesh question?

In other words, are we using Shabbos as a paradigm for all mitzvos, in which case the halacha for Shabbos would apply to all other areas of Torah and mitzvos as well? Or, is this Gemara specifically asking about Shabbos, in which case this Gemara might not apply to other mitzvos and aveiros.[5]

Let us begin by addressing an important question: why should it ever be muttar to violate an aveirah in order to save a life? To understand this question, we need to understand the nature and purpose of mitzvos (commandments) and aveiros (sins).

1. Mitzvos

A mitzvah, on the simplest level, is what Hashem commands us to do; it is a command from Hashem, requiring us to obey His will. Many Rishonim, however, suggests a fundamentally deeper understanding of mitzvos. A mitzvah is not simply obeying a command, as a soldier obeys the will of his commander. Rather, it is a way for us to connect, spiritually and existentially, to Hashem, our source of existence. The very word mitzvah is rooted in the word “tzavta,” which means to “connect.”[6] When we perform an action, we act as an extension and manifestation of the one who willed and commanded it. To illustrate, when a person decides to lift their arm, the act originates within their will, and their lifted arm is an expression of that original will. When Hashem commands something and we fulfill that command, we bond to and become part of something infinitely greater than ourselves, namely, Hashem. Hashem wanted this to happen, and by fulfilling that will – we are now accepting His will, attaching ourselves to it, and making His will our own[7].  By performing this act, we become a true embodiment and reflection of Hashem in this world.

This is why Chazal explain that it is greater to be commanded (metzuveh) than to act spontaneously. The Gemara[8] states that it is greater for one to do something that they have been commanded by Hashem than to do something of their own volition, without being commanded: “Gadol ha’metzuveh v’oseh mi’mi she’eino metzuveh v’oseh.” Meaning, it is better to perform a mitzvah out of obedience to Hashem’s will than to do so spontaneously of our own will.

At first glance, this appears counterintuitive. Would it not be better to do act of our own volition? Is this not a more genuine expression of Divine service? Instead of doing it because we have to, we are doing it because we want to?!

But the answer should now be self-evident, based on the above concept: when we do something — even something good — without being commanded, it is possible that all we are reflecting is ourselves. It is our personal form of avodah, self-contained, limited, and disconnected from Hashem. Instead of manifesting something transcendent, all that we manifest is ourselves. But when carrying out the will of Hashem, we become an embodiment and reflection of Hashem, something infinitely transcendent.

The ultimate depth of this idea is that, as a tzelem Elokim, our own root will is Hashem’s will. We don’t “sacrifice” our will to adopt Hashem’s will; rather, we become deeply self-aware to the extent that we realize that His will is our root will. This comes with the realization that we are neither the center of the world, nor the source of our own existence – Hashem is. Let us briefly explore this topic.

2. Aveiros

The root of all aveiros is the aveirah of avodah zarah (idolatry). Many think of idolatry as the worship of statues and inanimate objects. However, any intelligent person can see that a piece of wood or stone carved out by a human being could not possibly hold any power. The deeper understanding behind the problem of idolatry, as the Rambam[9] and many others explain, is the worshiping of intermediaries instead of sourcing oneself back to Hashem as the ultimate source of existence. Worshiping avodah zarah is betraying our true source and serving the intermediaries instead; it is the ultimate unfaithfulness to Hashem. Matan Torah established our marriage to Hashem, and idolatry is the betrayal of the commitment and connection contained within that marriage.

Many Rishonim explain that all aveiros are rooted within the concept of avodah zarah. Whenever one engages in anything that contradicts the will of Hashem, no matter what the nature of the aveirah is, it is a form of saying that one either doesn’t recognize or acknowledge Hashem's will; or, perhaps even worse, that they do acknowledge Hashem's will, but, nonetheless, choose to ignore or rebel against it. Thus, every aveirah has an aspect of idolatry at its core. Not every aveirah is of equal severity, but every aveirah has an aspect of ultimate evil at its core – which is the rejection of truth and the rejection of Hashem’s will.

3. Violating Aveiros to Save Your Life

With this background, it now makes a lot more sense to consider the possibility that one should never be allowed to violate an aveirah, no matter how severe the aveirah is, even in order to save a life. Not only does an aveirah create a form of spiritual and metaphysical damage, it is also a form of rejecting Hashem's will – which, in essence, is a form of rejecting the truth. As such, why would it ever be muttar to violate an aveirah to save one’s life? If violating an aveirah is a rejection of Hashem’s will and a rejection of the truth, then it would make sense for us to never be allowed to violate aveiros, even when it comes to saving a life.[10]

And in an even deeper sense, if our life gains its value from living in alignment with truth, then valuing our own lives more than the truth – to the extent that we would sacrifice the truth to save our own life – would take away the very value of life itself. Thus, it would seem that it is be better to die for the truth than to live within a lie.

As such, it would make sense for it to be preferrable to give up one’s life than to violate any aveirah; and if that is the case, we have to answer a fundamental question: what is the reason that we are ever allowed to violate an aveirah in order to save a life?

4. The Argument for Allowing Us to Violate Aveiros to Save Our Life

There are a few different arguments we can make for why Hashem would allow us to violate an aveirah in order to save a life:

A) The Good Will Outweigh the Bad

On a practical and utilitarian level, one reason why Hashem would allow us to violate an aveirah in order to save a life is because of a simple value assessment:

Is it true that violating an aveirah causes personal and objective spiritual damage? Of course. But if one were to violate one aveirah and then perform countless mitzvos, would that not be a justifiable tradeoff?

Thus, in order to save a life, Hashem would allow us to violate this aveirah as a one-time exception; even though violating the aveirah would cause spiritual damage, it will allow us to fulfill many more mitzvos in the future. This seems to be what the Gemara (Yoma 85a) is suggesting when it brings the svara of “Chaleil Alav Shabbos Achas Kidei Lishmor Shabbasos Harbei," that we should push aside one Shabbos so that we can keep many more in the future.

B) Hashem Values Life More than He Values the Mitzvah

There is, however, a more fundamental way of approaching this question. Does Hashem want us to perform mitzvos and live in alignment with the truth? Of course; that is the very reason Hashem created us. Does Hashem also want us to avoid aveiros? Of course. But does Hashem value mitzvos more than He values our lives? No.

This may be what the Gemara (Yoma 85b) means when it brings the passuk of "V’Chai Bahem." The Torah states that we should live by the mitzvos, not die by them.[11]

Humans are fallible. We make mistakes. When we violate an aveirah, we can do teshuvah. And if we have a choice between saving our life and violating an aveirah, Hashem is telling us that He values our life more than he values the mitzvah. Why? Let us explore the possibilies.

There are two possible ways to understand what happens when the only way to save a life is to violate an aveirah.

1. The first option is that the aveirah remains, and Hashem allows us to violate the aveirah in order to save this life.
2. The second option is that the aveirah actually disappears; in other words, Hashem only commands us against violating this aveirah in a normal situation. However, when it comes to a case of pikuach nefesh, the aveirah no longer even exists; because in such a case, it is Hashem's will that we perform the action in order to save our lives. Not only is our life more important than the aveirah, but in such a case, the only will of Hashem is for us to save this life.[12]

Why, then, are the “Big 3” cardinal aveiros (murder, idolatry, and adultery) different? It is likely that these three aveiros are so severe, and are so antithetical to truth itself, that no matter the circumstance, they cannot be violated; if the value of life is paramount, the value of not violating these three aveiros is even more important.[13]

In our next article, we will continue to analyze this fascinating halachic topic.

[1] This mitzvah is based on the following two pessukim:

דברים פרק ד פסוק ט

רַ֡ק הִשָּׁ֣מֶר לְךָ֩ וּשְׁמֹ֨ר נַפְשְׁךָ֜ מְאֹ֗ד פֶּן־תִּשְׁכַּ֨ח אֶת־הַדְּבָרִ֜ים אֲשֶׁר־רָא֣וּ עֵינֶ֗יךָ וּפֶן־יָס֙וּרוּ֙ מִלְּבָ֣בְךָ֔ כֹּ֖ל יְמֵ֣י חַיֶּ֑יךָ וְהוֹדַעְתָּ֥ם לְבָנֶ֖יךָ וְלִבְנֵ֥י בָנֶֽיךָ:

דברים פרק ד פסוק טו

וְנִשְׁמַרְתֶּ֥ם מְאֹ֖ד לְנַפְשֹׁתֵיכֶ֑ם כִּ֣י לֹ֤א רְאִיתֶם֙ כָּל־תְּמוּנָ֔ה בְּי֗וֹם דִּבֶּ֨ר יְקֹוָ֧ק אֲלֵיכֶ֪ם בְּחֹרֵ֖ב מִתּ֥וֹךְ הָאֵֽשׁ:

[2] Sanhedrin 74a, Yoma 82a, Pesachim 25a

[3]

שמות פרק לא פסוק טז

וְשָׁמְר֥וּ בְנֵֽי־יִשְׂרָאֵ֖ל אֶת־הַשַּׁבָּ֑ת לַעֲשׂ֧וֹת אֶת־הַשַּׁבָּ֪ת לְדֹרֹתָ֖ם בְּרִ֥ית עוֹלָֽם:

[4]

ויקרא פרק יח פסוק ה

וּשְׁמַרְתֶּ֤ם אֶת־חֻקֹּתַי֙ וְאֶת־מִשְׁפָּטַ֔י אֲשֶׁ֨ר יַעֲשֶׂ֥ה אֹתָ֪ם הָאָדָ֖ם וָחַ֣י בָּהֶ֑ם אֲנִ֖י יְקֹוָֽק

[5] And as such, the working assumption of the Gemara would be that “of course we can push aside all non-“Big 3” cardinal aveiros in order to save a life; and of course we can’t push aside “Big 3” cardinal aveiros in order to save a life; the question therefore remains: what is the halacha regarding Shabbos?

[6] See also Shelah Hakadosh, Yoma; Derech Chaim, Tochachas Mussar (16); Berachos6b; Sefas Emes, Parashas Eikev 632.

[7] See Avos 2:4

[8] Bava Kama 38a, 87a

[9] Mishneh Torah, Avodah Zarah, perek 1.

[10] And even if Hashem does allow us to violate aveiros in order to save a life, perhaps it would still be better not to violate the aveirah, as the aveirah still causes objective spiritual and metaphysical damage. Thus, perhaps it would be better to die without having violated the aveirah.

[11] Additionally, the Gemara might be saying that mtizvos were never designed, in the first place, to be something that we should die for.

[12] This is similar to how many heterim work by Isurei Dirabanan. The svara is that in since the Rabanan created the gezeirah, they also decided "when" it applies. As such, there are certain scenarios where we don't need to overcome the Issur Dirabanan because the Rabanan weren't gozer in such cases to begin with.

[13] There are other reasons as well, which we will discuss soon.