Medicine on Shabbat: Difference between revisions

One of several rabbinic decrees that our Sages enacted in order to guard the sanctity of [[Shabbat]] concerns the use of [[medications]]. In the opinion and experience of the Rabbis, easy access to medicine could lead to the transgression of certain [[Shabbat]] Labors. While issuing the decree, however, the Rabbis were lenient in certain cases of those suffering pain or distress. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt). In regard to the [[muktzah]] status of pills and other [[medications]] see Minchas [[Shabbos]] 88:footnote 77, Har Tzvi tal harim tochain 2, Shalmei Yehuda 10:15:footnote 46, Zera Yaakov 13:page 153, Nachlas Yisroel pages 633-650 in depth, Shulchan Shlomo 318:7:2:page 298, Ohr Yisroel 6:pages 17-20, Aruch Ha’shulchan 308:59, Bais Avi 3:52, Avnei Yushfei 5:62.</ref> (See the footnote for some background)<ref>*Rashi ([[Shabbat]] 53b s.v. Gezerah) explains that there is a rabbinic decree not to do an medical practice on [[Shabbat]] because one might come to violate the prohibition of [[Tochen]] ([[grinding]]) the ingredients for the medicine. [[Maggid]] Mishna ([[Shabbat]] 2:10) draws a distinction between one is sick but isn't in danger of his life and a person who is pain. Tur and Shulchan Aruch 338:1 rule that a healthy person who is in pain may not do any activity of healing because of the rabbinic decree.</ref>. The details of what's permissible and what's forbidden are described below. These laws are true for the first day of [[Yom Tov]] and the two days of [[Rosh Hashana]] as well. <ref>The same halacha applies to the first day of [[Yom Tov]] (Refer to Magen Avraham 532:2, Chai Adom 23:1, Kitzur Shulchan Aruch 98:33, Mishna Brurah 532:5, [[Yom Tov]] Shenei K’hilchoso 1:22, Nishmas Avraham 1:pages 275-276) and both days of [[Rosh Hashana]]h (Nishmas Avraham 1:600:1, see Shemiras [[Shabbos]] K’hilchoso 31:28, [[Yom Tov]] Shenei K’hilchoso 1:22:footnote 76, Shevet Ha’kehusi 1:156 ) </ref>

#If one has fever, feels weak all over, or feels bad enough to require bed rest, he can be classified as a “patient not dangerously ill” (Choleh Shein Bo Sakana) and he is permitted to take oral [[medications]]. <ref>Mishna Brurah 328:121 permits taking an oral medication without any shinui (alteration from the normal procedure). Yalkut Yosef ([[Shabbat]], vol 4, pg 129) and 39 Melachos (Rabbi Ribiat, vol 2, pg 492) agree with the Mishna Brurah. [http://hebrewbooks.org/pdfpager.aspx?req=1095&pgnum=112 Mishkenot Yacov O.C. 117] seems to disagree.

#Since “requiring bed rest” and “weak all over” are subjective terms, it is up to each individual to determine his personal pain threshold. There is no requirement to be overly stringent when judging the degree of illness. <ref>[http://www.torah.org/advanced/weekly-halacha/5760/chukas.html Rabbi Doniel Neustadt on Torah.org]. See also Sh"t Tzitz Eliezer 14:50-7 and 17:13. </ref>

#Some poskim hold that it is forbidden to perform a biblically prohibited action on [[Shabbat]] (melacha deoritta) for someone who is in the category of "patient not dangerously ill" even if one does it in an abnormal manner (Shinui).<ref>Shemirat Shabbat KeHilchata 32:2</ref> Some, however, hold that it is permitted to do actions in an abnormal way (Shinui) for a "patient not dangerously ill".<ref>Eglei Tal ([[Tochen]] #18), [http://www.yutorah.org/lectures/lecture.cfm/797263/Rabbi_Hershel_Schachter/Shiur_#3_-_Shabbos_-_melacha_sh'eina_tzericha_l'gufa Rabbi Hershel Schachter in a shiur on yutorah.org (towards end of shiur)]</ref>

#It is permitted and a mitzvah to violate Shabbat in order to safe a Jewish life.<ref>Gemara Yoma 84a, Rambam (Shabbat 2:1), Tur and Shulchan Aruch 328:2</ref> Even if there is only a doubt if the patient is critically ill<ref>Shulchan Aruch 328:6, Mishna Brurah 328:17, 328:26</ref> or if there is a doubt if the procedure will safe the patient's life<ref>Mishna Brurah 328:37</ref>, nonetheless, it is a mitzvah to violate Shabbat in order to try to save a Jewish life. Someone who delays in saving a life out of a concern of violating Shabbat is sinning in a way that is tantamount to murder.<ref>Shulchan Aruch 328:2</ref>

#After calling for help one may hang up the phone if there will be further needs (various instruction, medical history, etc). However if the patient has already been transported to the hospital and is absolutely certain that no further information will be needed then one should not end the call.<ref>Mishna Halachot 3:46, Shmirat Shabbat KiHilchata 32:42</ref>

#Although one who is not classified as “ill” may not begin taking medicine on [[Shabbat]], still, some poskim hold that one who requires daily medication for an ongoing condition may continue doing so on [[Shabbat]] as well, <ref>Chazon Ish (oral ruling, quoted in Imrei Yosher on Moed 97, Daat Chazon Ish 7:19, Dinim Vihanhagot Chazon Ish 15:1), Shulchan Shlomo 328:59, Beer Moshe 1:33:8, 4:31, Avnei Yushfei 1:90:3, Rivevos Ephraim 3:227, 4:97:54, 5:202, Oz Nedberu 1:31:5, 4:24. Refer to Shemiras [[Shabbos]] K’hilchoso 34:footnote 76, chelek 3:34:footnote 76. <br />

Rav S. Kluger (Sefer ha-Chayim 328:10 and Shenos Chayim 1:152) go even further and permit continuing taking medicine on [[Shabbat]], even of the patient is not medically required to take the medicine on a daily basis. Minchas [[Shabbat]] 91:9; Tzitz Eliezer 8:15-15:15; Rav Y.S. Elyashiv (Koveitz Teshuvos, O.C. 1:40, and oral ruling, quoted in Refuas Yisrael, pg. 14) agree with Rav Kluger. </ref> while others disagree. <ref>Igros Moshe, O.C. 3:53. Refer also to Da’as Torah 328:37 who is stringent.</ref>

#Some say that one may only take an ongoing medication on [[Shabbat]] if skipping a day of medication would be detrimental to the patient's health or if the medication must be taken for a number of consecutive days such that it is impossible not to take it on [[Shabbat]]. <ref>Rav S.Z. Auerbach (Shemiras [[Shabbat]] K’hilchasah 34, note 77, in the new edition). Rav Shlomo Zalman Auerbach held that it was only permitted to take an ongoing medication on [[Shabbat]] if skipping a day in middle of continuous medication would cause the patient damage or if the medication must be done for a certain number of days which would automatically include [[Shabbat]]. Rav Hershel Schachter ([http://www.yutorah.org/lectures/lecture.cfm/798018/Rabbi_Hershel_Schachter/Shiur_#11_-_Shabbos_-_Memachaik,_Memare'ach in a shiur on yutorah.org (min 44-48)]) explained that the gemara Avoda Zara 28a seems to clearly support the opinion of those who say that one may not take medication on [[Shabbat]] even if one began to take the medication before [[Shabbat]]. However, he also cited the opinion of the Brit Olam who held that if the only way to take a certain medication was to take it for a number of consecutive days which includes [[Shabbat]], it would be permitted to take the medication on [[Shabbat]]. </ref>

#It is permitted to put on a band aid on a wound. <ref>Shemirat Shabbat KeHilchata 34:3,Tzitz Eliezer 8:15:14:6, Chazon Ovadiah Shabbat vol. 3, page 403, Piskeh Teshuvot 328:46 </ref>

#According to Ashkenazim, one should not remove a band aid on [[Shabbat]] if there is hair in the area of the band aid. However, if it is painful one may remove it. <ref>Shemirat Shabbat KeHilchata 35:30 (in the new edition) writes that a band aid shouldn’t be removed on [[Shabbat]] in an area where there’s hair because removing the band aid will certainly pull out hairs. However, the Shemirat Shabbat KeHilchata writes that it’s permissible to use a Benzine to remove the band aid so it won’t rip out any hairs that’s assuming the cream was set aside before [[Shabbat]] and isn’t [[Muktzeh]]. Nonetheless in the footnote he quotes Rav Shlomo Zalman saying that if it’s painful it may be removed because it’s a pesik reisha delo nicha leih (פסיק רישא דלא ניחא ליה), keleacher yad (כלאחר יד), and mekalkel (מקלקל). </ref> However, Sephardim are more lenient as long as there is a need to remove it, it's permissible. <ref>The Yalkut Yosef ([[Shabbat]] 4 pg 179, kitzur S”A 328:101, 340:6) writes that if there’s a need, it’s permissible to remove a band aid from an area of hair on [[Shabbat]] because it’s a pesik reisha delo nicha leih (פסיק רישא דלא ניחא ליה) for a Derabbanan. In the footnote he writes that even though the Or Letzion (vol 2, pg 259) is strict, his father (Rav Ovadyah, in Haskama to Lev Avraham), Rav Yitzchak Elchanan (Bear Yitzchak Siman 15), and Rav Shlomo Zalman (from Shemirat Shabbat KeHilchata) are lenient. </ref>

#Most authorities permit removing the Band-Aid from the protective tabs, while some are stringent and so to satisfy all opinions one may prepare Band-Aids for [[Shabbat]] use by peeling off their protective tabs and re-sealing them before [[Shabbat]]. <ref>Most poskim (oral ruling by Rav M. Feinstein, quoted in Kitzur Hilchos [[Shabbat]] 44, note 117); Rav S.Z. Auerbach in Shulchan Shelomo 328:45; Ohr l’Tziyon 2:36-15; Az Nidberu 7:34, 35; Rav C.P. Scheinberg, quoted in Children in Halachah, pg. 88; Rav N. Karelitz, quoted in Orchos [[Shabbat]] 11:35) permit removing the protective tabs from a Band-Aid, while others (Minchas Yitzchak 5:39-2; 9:41; Rav Y.S. Elyashiv, quoted in Machazeh Eliyahu 70) are stringent. To satisfy all opinions, one may prepare Band-Aids for [[Shabbat]] use by peeling off their protective tabs and re-sealing them before [[Shabbat]]; once they have been prepared in this fashion, they may be used on [[Shabbat]] (Tzitz Eliezer 16:6-5). Sh”t Bear Moshe 1:36 writes that it is obvious that it is permitted to remove the plastic tabs from the sides of a bandaid on [[Shabbat]] and it isn't [[Koreah]]. </ref>

#It is permitted to clean and bandage a wound or to pour hydrogen peroxide over it. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)based on Shulchan Aruch 328:23</ref>

#Braces may be worn on [[Shabbat]] because there is no medicine for aligning teeth properly. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)writes that it is permissible to wear braces on [[Shabbat]] because the goal of the treatment or procedure can only be achieved without the use of medicine. </ref>

#Some poskim permit putting soft contact lenses in contact solution.<ref>[[Asicha_Hilchos_Shabbos_Part_2| Rav Mordechai Willig (Asicha Shabbos 2 p. 3)]]</ref> Others permit putting them in saline solution but not the disinfectant solution. Hard contacts are like dishes which can be cleaned. <Ref>Orchot Shabbat 13:11, [https://torah.org/torah-portion/weekly-halacha-5761-chayeisara/ Rabbi Doniel Neustadt]</ref>

#Cough–medication may not be taken.<ref>Shmirat Shabbat KiHilchata 34:1,3). </ref> If the cough may be an indication of pneumonia or asthma, medication is permitted. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

#For diarrhea one may not take medication unless one is in severe pain or weak all over. Any food or drink is permitted. A hot water bottle is permitted when one experiences strong pains. <ref>Mishna Brurah 326:19, The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

===Chapped hands===

#For dried (or chapped) hands it is prohibited to rub them with either oil, ointment (Vaseline) or lotion. <ref>39 Melachos (Rabbi Ribiat, vol 2, pg 481) </ref>One who regularly uses a pourable, liquid lotion or oil on his hands (whether they are chapped or not) may do so on [[Shabbat]], too, even if his hands are chapped.<ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)based on S”A 327:1</ref>

 

 

#For dried or cracked lips one may not apply chap stick or any other medication, liquid or otherwise. <ref>39 Melachos (Rabbi Ribiat, vol 2, pg 481), The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

 

 

#Some poskim permit taking pills for conception.<ref>Chacham Ovadia Yosef, Rav Moshe Stern, and Rav Shlomo Zalman Auerbach cited on [http://www.halachayomit.co.il/EnglishDefault.asp?HalachaID=3319 Halacha Yomit], Orot Hatahara 16:52 </ref>

#For a headache medication should not be taken. If the headache is severe enough so that one feels weak all over or is forced to go to bed, medication may be taken. One who is unsure if he has reached that stage of illness may be lenient and take pain- relieving medication. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)See Ketzos ha-Shulchan 138, pg. 100; Minchas Yitzchak 3:35; Be’er Moshe 1:33; 2:32. </ref>

#For heartburn foods which will have a soothing effect may be eaten. Some poskim permit taking anti-acid medication while others are stringent. If the medicine is prescribed by a doctor, one may be lenient. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)See Ketzos ha-Shulchan 138, pg. 98; Tzitz Eliezer 8:15 (15-21); Az Nidberu 1:31; Shemiras [[Shabbat]] K’hilchasah 34:4 </ref>

#For a mild case of hemorrhoids medication may not be taken. For a severe case, it is permitted to sit in a “sitz bath” (with water that heated before [[Shabbat]]), or use medicated pads or suppositories. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

===Herniated disc===

#For a herniated disc (back and leg pain) ice packs or hot packs are permitted. Physical therapy exercises, e.g. stretching, are permitted. If the pain is severe to the degree that the entire body is in pain, painkillers or other [[medications]] are permitted as well. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

#There are conflicting views among contemporary poskim about taking sleeping pills or No-Doze pills.<ref>[http://www.halachayomit.co.il/EnglishDefault.asp?HalachaID=3320 Rav Shlomo Zalman Auerbach and Chacham Ovadia Yosef are lenient]  See Minchas Yitzchak 3:21, Tzitz Eliezer 9:17, Be’er Moshe 1:33 and Shalmei Yehudah, pg. 176, for the various views. </ref> One who is weak all over or bedridden may take them. Cotton balls may be used as ear plugs. It is permitted to use pliable ear plugs, which are made from a wax-like material that spreads to fill the cavity of the ear. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt) quoting Rav S.Z. Auerbach (Shemiras [[Shabbat]] K’hilchasah 14:45); Shraga ha-Meir 5:23. Rav Y.S. Elyashiv, however, recommends not using pliable ear plugs on [[Shabbat]]; see Ashrei ha-Ish 17:117; 33:7 </ref>

#For a sore throat medication may not be taken. Gargling is prohibited. <ref>S”A 328:32</ref> Drinking tea or any other hot drink, or sucking a candy, is permitted even if the intention is for medicinal purposes. <ref>S”A 328:37 </ref>

#For a sprain if the patient is not experiencing severe pain, nothing may be done. If the patient is experiencing severe pain, medication may be taken and a massage may be given. A makeshift splint may be applied, provided that no [[Shabbat]] Labors are transgressed. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

#A non-Jew is allowed to stitch any wound, even if the stitching is done only for cosmetic reasons.<ref>Minchat Shelomo 2:34-33 and Nishmas Avraham, vol. 4, O.C. 340. See also Shemiras [[Shabbat]] K’hilchasah 33, note 26, and 35, note 65-66.</ref> Some say even a Jew can add extra stitches for cosmetic reasons.<ref>Shemirat Shabbat Kehilchata ch. 33 fnt. 26</ref> A Jew may place a butterfly bandage or steri-strips to close a simple laceration or cut. Surgical skin closure glue may also be used. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt). See [http://www.torah.org/advanced/weekly-halacha/5760/chukas.html].</ref>

#For a strep throat all oral [[medications]] may be taken. Even if the infection is no longer present, the prescribed medicine begun on a weekday must be continued until finished. A culture may be taken by a non-Jew. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

#For a ordinary sunburn [[medications]] are not permitted. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

#It is permitted to press a knife, etc. against the skin to prevent or minimize swelling. <ref>Mishna Brurah 328:144 </ref>

#It is permitted to wash or soak the swollen area in water.<ref>Tzitz Eliezer 8:15 (15-12) </ref> It is permitted to place a compress, <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)writes in order to avoid [[sechitah]] and/or libun, only paper towels or napkins should be used and care should be taken not to squeeze them.</ref> ice (placed in plastic bag) or any frozen item over a swollen area. <ref>Be’er Moshe 1:33-18, Contemporary Questions in Halacha and Hashkafa pg. 144, [http://www.learntorah.com/lt-shiur-details.aspx?id=4985 Rabbi Meyer Yedid]. Rabbi Yedid says that this is because the [[refuah]] cannot be replicated through medicines and therefore wasn't included in the rabbinic enactment against [[refuah]]. See also  Shemiras [[Shabbat]] K’hilchasah 35:35  </ref> Some forbid applying an ice pack if it is clearly being done for medicinal reasons.<ref>Rabbi Heinemann cited by the [https://www.star-k.org/articles/kashrus-kurrents/kashrus-kurrents-2019/6238/medicine-on-shabbos-questions-and-answers-from-rav-moshe-heinemann-shlita/ Star-K]. See Shulchan Shlomo 328:37 and Halachos of Refuah on Shabbos p. 29.</ref>

#A minor (cavity) toothache may not be treated with painkillers, but one is permitted to drink whiskey, etc., provided that it is swallowed immediately. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)based on S”A O.C. 328:32. See also Mishna Brurah 328:102 </ref>A severe toothache (to the point where one feels weak all over) or gum infection may be treated with oral medication. If the tooth needs to be extracted, a non-Jew may be asked to do so. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)based on Rama, O.C. 328:3. See Tzitz Eliezer 9:17 (2-11)</ref>

#Cuts and abrasions may be washed or soaked in water. Hydrogen peroxide may be poured over a cut. It is not permitted, however, to soak absorbent cotton or paper in such a solution and then wash the wound with it. The wound may be covered with a non-medicated Band-Aid. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

#In situations where one is considered “ill” and is permitted to take medicine on [[Shabbat]], it is also permitted to ask a non-Jew to drive to a drugstore, buy medicine and bring it to him. <ref>The Weekly Halachah Discussion (Rabbi Doniel Neustadt)</ref>

#It is forbidden to cut or tear medical plaster on shabbat. <ref>Shemirat Shabbat KeHilchata, 35:24</ref>

#Even someone with a minor ailment may eat food which healthy people eat even if one’s intention is for improving one’s health. For example, someone who has a head ache may eat honey, a lemon, or suck on candy. Someone who has a hoarse throat may swallow a raw egg. <ref>Shemirat Shabbat KeHilchata 34:4 based on Shulchan Aruch 328:37, Aruch Hashulchan 328:48. Refer to Mishna Brurah 328:117-118. See Ketzos Ha’shulchan 134:16:pages 31-32 in depth on what constitutes a health persons food. </ref>

#Foods and drinks are permitted even when they are consumed for medicinal purposes. For example, one may have tea for a sore throat on [[Shabbat]]. <ref>[http://www.torah.org/advanced/weekly-halacha/5760/chukas.html Rabbi Doniel Neustadt on Torah.org], 39 Melachos (Rabbi Ribiat, vol 2, pg 477) </ref>

==Elective surgery==

#It is permissible for a pregnant woman who is past her term to receive a hormone infusion to induce labor if the doctor feels that there danger to the life of the mother or fetus. <ref>Shemirat Shabbat KeHilchata (chap 32, note 98 (note 100, in new one)).For background of this topic [[Brit_Milah#Delayed Milah on Thursday or Friday|see here]]. </ref>

==Caesarian section==

#If according to the doctor a women has to have a caesarian section and she can choose to schedule the surgery, she should schedule for the first three days of the week and not Wednesday through Friday. <ref>Shemirat Shabbat KeHilchata 36:4 based on the principle of the Baal HaMoer. For background of this topic [[Brit_Milah#Delayed Milah on Thursday or Friday|see here]]. </ref>

==A doctor on call==

* Igrot Moshe explains that there are two types of cases where a person goes beyond techum for pikuach nefesh to save Jews. Some are cases where he knew in advance that it would likely take a long time and he would have to be there for the rest of Shabbat and others that he knew were short. The case where he went knowing that he would probably be there for the rest of Shabbat he is only granted 2000 amot but may not go beyond 2000 amot to return home. In the case where he went to save for a short emergency he may return home. The reason for this is ''hiteru sofam mishum techilatam'' (Heb. התירו סופן משום תחלתן; transl. they allowed in the end because of the beginning), meaning, that if they weren't allowed to return they wouldn't go in the first place. He proves that this allowance includes even biblical violations of Shabbat. His proofs are Tosfot Eruvin 44b, Rashba Beitzah 11b, and Rambam (Hilchot Shabbat 2:23 and 27:17). Therefore, he permitted a hatzolah member who drove for an emergency call to even drive back to his home so that they're not discouraged from going another time for an emergency.</ref> However, most poskim including those who do not allow the hatzolah member or doctor to drive home, allow him to ask a non-Jew to drive him home. Nonetheless, this leniency does not allow him to travel home even if he's driven by a non-Jew if he went beyond his techum.<ref>Chatom Sofer (CM 94), Minchat Shlomo 1:8, Shevet Halevi 6:24, Chazon Ovadia (v. 3 p. 253). Chatom Sofer's reason is that he can use a non-Jewish driver is because if he isn't allowed then he might not go another time. Rav Shlomo Zalman questions this but writes that once the Chatom Sofer already ruled that way he isn't going to argue.</ref> Only those who are lenient for him to drive home allow him to return from beyond techum.<ref>Rav Moshe Feinstein (Igrot Moshe 4:80) allows the hatzolah member or doctor to return from beyond the techum because the call was a short call which he thought would finish before the end of Shabbat. Since if he wouldn't be allowed to return home he might not go another time, he is allowed to return from beyond techum. However, Rav Shlomo Zalman Auerbach (Minchat Shlomo 1:8) argues that he may not return from beyond techum. Chazal only permitted someone went for war and the non-Jews won to return to his original techum, however, a doctor who left his techum to save someone only has 2000 amot where he is but can't return.</ref>

## According to the lenient view who allows a hatzolah member to drive home, the same could be applied to a doctor who is on call and goes into the hospital for an emergency that he can drive home. However, this does not apply to a doctor who needs to go in for rounds or scheduled hours. Since he must go in for his job, according to absolutely everyone he may not drive home.<Ref>[https://www.yutorah.org/sidebar/lecture.cfm/851379/rabbi-yaakov-b-neuburger/hilchot-amira-l-akum-and-pikuach-nefesh-on-shabbos-2nd-shiur/ Rabbi Yaakov Neuberger (Pikuach Nefesh #2 min 53-55)] explains that if a doctor has rounds that obligates him to come into the hospital on Shabbat for patients that he may not drive home according to Rav Moshe. Since he is going to come in either way at some point on Shabbat he may not drive home. He is coming in for his job and his patients. However, if he is going in because of an emergency call, even if he is on call, he may drive home according to Rav Moshe. Since whether he goes in depends on a judgement call he may drive home. [https://www.yutorah.org/lectures/lecture.cfm/1064716/rabbi-mordechai-i-willig/doctors-and-hatzalah-members-driving-back-home-on-shabbos/ Rav Willig] agrees. Rav Mordechai Eliyahu (Sht Harav Haroshei v. 2 ch. 42 n. 11 p. 595) also writes that a doctor on call ideally he should go back with a non-Jew but if he can't he could even drive himself back home. He is based on Igrot Moshe. Divrei Binayahu 23:37 applies Rav Moshe to a doctor on call as well.</ref> Others argue that even the lenient view wouldn't allow a doctor on call to return home.<Ref>Rav Schachter (B'ikvei Hatzon p. 52) writes that just like the Chatom Sofer (CM 94) writes that the principle of hiteru sofam mishum techilatam doesn't apply to someone going for ayvah since ultimately he is going for himself and would go anyway, the same applies to a doctor on call. The reason he's going into the hospital is for himself to keep his job. Therefore, he may not return home even according to Rav Moshe since he would have gone for the emergency either way.</ref>

## Some write that even according to the lenient view this only applies to going to save a Jew but not for a non-Jew. Even though it is permitted to violate Shabbat to save a non-Jew he may not violate Shabbat to return home.<ref>Chatom Sofer (CM 94) explains that ayvah only permits violating Shabbat but not returning home. The only reason he is allowed to return home is because otherwise he wouldn’t go next time. But to save a non-Jew he would go anyway next time since otherwise he would endangered because of ayvah. Rav Schachter (B’ikvei Hatzon p. 52) applies this to Rav Moshe’s leniency of a doctor driving home from an emergency.</ref>  

# If the hatzolah member evalues that probably the ambulance will be necessary for another call later that Shabbat he can drive it back according to everyone.<Ref>Rav Moshe (Igrot Moshe 4:80) writes that it is permitted to drive back the ambulance if it is common that they're need it later that Shabbat. Shevet Halevi 6:26 also allows it and explains that it is considered pikuach nefesh where the need is common. It is considered like choleh lifanenu.</ref>