What may one ask a gentile to do for an ill person on Shabbos? 

Up until now we have dealt with many of the halachos relating to the critically ill (pikuach nefesh) on Shabbos. We will now attempt to clarify certain halachos that relate to ill people who are not in critical danger.

Asking a gentile to do a melacha for one on Shabbos is an issur d’rabanan and as such, the Rambam [1] writes “one may ask a gentile to attend to all the needs of an ill person. How is this done? One asks the gentile to cook, bake, fetch medication from a different domain etc.” The reason for this heter is because Chazal did not implement their restrictions when illness is involved.

The Maggid Mishne explains that the type of illness referred to is one which sends the patient to bed or a person whose entire body is in pain from an illness. It does not apply to slight ailments, as one is not permitted to ask a gentile to violate an issur d’oraisso under such circumstances.

The Shulchan Aruch [2] concurs with the Rambam, and the Mishna Berura adding [3] that one may only ask a gentile to violate a melacha when the medication or food is necessary on Shabbos. Rav Shlomo Zalman Auerbach ztz”l added [4] that it is permitted to have a gentile prepare medication on Shabbos if it will alleviate the patient’s condition after Shabbos earlier than if it was only prepared after Shabbos. One may not request attention to weekday needs when these tasks can be performed after Shabbos. In other words, asking a gentile to perform deeds using the illness as the basis does not grant blanket permission to do whatever one needs. 

Are there limitations with respect to making requests of a gentile? 

One may not request a gentile to violate an issur d’oraisso for the sake of a person who is only slightly ill. For example, someone with a slight pain, which is not defined as an illness, may not ask a gentile to bring him food from a reshus harabim. However, one may request that food be brought via a karmelis, which involves carrying through a domain normally forbidden mid’rabanan.

The logic of this halacha is that asking a gentile to violate an issur is defined as an issur d’rabanan – a sh’vus, and when the nature of the prohibition is an issur d’rabanan it is called a sh’vus dishvus – a double d’rabanan, which via a gentile, may be performed for the sake of someone slightly ill.

What if one is even less ill than that, such as having a slight headache etc? 

The Shulchan Aruch says [5] one with a very minor pain etc. may not have anything done for him on Shabbos, and the Mishna Berura explains [6] that one may not even request a gentile to violate an issur d’rabanan.

To summarize the rules:

• Ill person  - one may request a gentile to violate even an issur d’oraisso. This would include turning on lights and heating, cooking, heating water, writing prescriptions, bringing medication or food via a reshus harabim (a public domain) and operating necessary medical equipment.
• Slightly ill person – one may request a gentile to violate an issur d’rabanan. This would include bringing necessary items via a karmelis.
• Slight aches and pains – one may not request a gentile to violate any issurim on Shabbos.

What melachos may a Jew perform for an ill person whose life is not in danger? 

Since we are not dealing with pikuach nefesh, the general rule is that one may not perform a melacha for the sake of an ill person in Shabbos. [7] The reason is that Shabbos may only violated with an issur d’oraisso for the sake of saving a life and not for any other reason. 

What if the person is in danger of losing a limb (Heaven forbid)? 

The Shulchan Aruch goes so far as to say that even when there is danger of losing a limb one may not violate an issur d’oraisso. However, doctors are of the opinion that in many cases where a loss of limb is an issue it almost always involves pikuach nefesh, which permits the violation of an issur d’oraisso.

For example, a severed finger requires stitching and disinfection otherwise infection can set in, which would ultimately endanger the entire body. A broken leg could easily lead to poisoning of the blood-stream which again involves pikuach nefesh. Therefore (this be”H should never happen) but if it does, one must ask a competent rav whether one may violate Shabbos in order to save a limb.