If, for example, there is only treif food in the hospital, is one permitted to traverse the reshus harabim to bring kosher food or must the patient eat the treif food?

In less modern times we could phrase the question as follows: if the only food available is treif meat and the doctors affirm that he must eat meat on Shabbos in order to recover from his dangerous illness, is one permitted to slaughter an animal, salt it and cook it just in order to save the patient from eating treif meat?

Let us weigh the “violations” on both sides. On the one hand we have the issur of eating non kosher meat, which is a lo sa'aseh'  and which the biblical punishment is 40 lashes when eaten under normal circumstances. On the other hand we have the issur of chillul Shabbos and which the biblical punishment is stoning. Seemingly we would say that since eating treif meat is less severe than desecrating the Shabbos we should opt for the treif meat rather than violating the Shabbos.

Is that then the halacha?

Not exactly and for the following reasons. We will begin by saying that this question, as with many other questions that involve pikuach nefesh (life saving) and Shabbos, a competent halachik authority must be asked. In the following lines we will present the opinions of the various Rishonim in order to appreciate the variety of opinions in the matter.

Ravad  - The Rosh ^[1] says (citing the Ra’avad) that we may slaughter meat for the ill because Shabbos is ãçåéä (waived aside) with regards to the ill person as far as slaughtering and cooking is concerned. This suggests that it is ossur to feed him the non-kosher meat when one can feed him kosher meat because one may violate the Shabbos in order to cure the ill but one may not violate the issur of ðáéìä (non kosher meat).

[This is quite a complicated concept because obviously the issur of non-kosher meat is also waived aside for pikuach nefesh. The p’shat is though that on a weekday one would not feed the patient treif meat when kosher meat is available and therefore when the pikuach nefesh falls on Shabbos, it is Shabbos that is preventing us from feeding him kosher meat and therefore one may violate the Shabbos and feed him kosher meat.] [2]

The Rosh concludes that when it is an emergency and there is no time to slaughter and skin the animal and cook it, we obviously feed him the treif meat. ^[3]

MaHaram of Rottenburg - R’ Meir Of Rottenburg, cited in the Rosh in Yumah, learns that Shabbos is äåúøä (totally permitted) with regards to pikuach nefesh and therefore one treats the ill on Shabbos exactly as one would during the week. He compares cooking food for the ill on Shabbos to cooking food on Yom Tov, which is totally permitted.

Rabeinu Nissim – The Ran learns that the reason we would want to feed him the non-kosher meat is because it is less a violation than slaughtering and cooking on Shabbos. However, the Ran says that ultimately eating treif meat is worse because one is chayav for every k’zayis (olive size), ^[4] which turns out to be many more violations than slaughtering which is only one issur and cooking, which is another (even though the punishment for deliberately violating the Shabbos is stoning and for eating treif meat only malkos - lashes).

Rosh - The Rosh adds another reason and says that the ill person might be disgusted from the treif meat and will refuse to eat it, thereby endangering himself. (Would one be permitted to present him with treif meat without telling him that it is treif, or may one lie to that effect?).

For a synopsis of these opinions, see the Mishna Berura simon 328:39.

Halacha – The Shulchan Aruch [5] rules in accordance with these Rishonim who hold that one may “violate” the Shabbos for the sake of pikuach nefesh even though there is adequate treif food available that would not require chillul Shabbos. Accordingly one may travel in a car to fetch kosher food, cross the reshus harabim with kosher food etc. Nevertheless one should try and limit the chillul Shabbos as much as possible because one is not dealing with the actual life-saving, but rather one is bringing food for pikuach nefesh and that can be done b’shinui etc.