Pikuach nefesh
(ה) וּשְׁמַרְתֶּ֤ם אֶת־חֻקֹּתַי֙ וְאֶת־מִשְׁפָּטַ֔י אֲשֶׁ֨ר יַעֲשֶׂ֥ה אֹתָ֛ם הָאָדָ֖ם וָחַ֣י בָּהֶ֑ם אֲנִ֖י יְהֹוָֽה׃ {ס}
(5) You shall keep My laws and My rules, by the pursuit of which human beings shall live: I am יהוה.
רַבִּי שִׁמְעוֹן בֶּן מְנַסְיָא אוֹמֵר: ״וְשָׁמְרוּ בְנֵי יִשְׂרָאֵל אֶת הַשַּׁבָּת״, אָמְרָה תּוֹרָה: חַלֵּל עָלָיו שַׁבָּת אַחַת כְּדֵי שֶׁיִּשְׁמוֹר שַׁבָּתוֹת הַרְבֵּה. אָמַר רַב יְהוּדָה אָמַר שְׁמוּאֵל: אִי הֲוַאי הָתָם, הֲוָה אָמֵינָא דִּידִי עֲדִיפָא מִדִּידְהוּ: ״וְחַי בָּהֶם״ — וְלֹא שֶׁיָּמוּת בָּהֶם.
Rabbi Shimon ben Menasya said: It is stated: “And the children of Israel shall keep Shabbat, to observe Shabbat” (Exodus 31:16). The Torah said: Desecrate one Shabbat on his behalf so he will observe many Shabbatot. 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” (Leviticus 18:5), and not that he should die by them. In all circumstances, one must take care not to die as a result of fulfilling the mitzvot.
א"ר יוחנן משום ר"ש בן יהוצדק נימנו וגמרו בעליית בית נתזה בלוד כל עבירות שבתורה אם אומרין לאדם עבור ואל תהרג יעבור ואל יהרג חוץ מעבודת כוכבים וגילוי עריות ושפיכות דמים ועבודת כוכבים לא והא תניא א"ר ישמעאל מנין שאם אמרו לו לאדם עבוד עבודת כוכבים ואל תהרג מנין שיעבוד ואל יהרג ת"ל (ויקרא יח, ה) וחי בהם ולא שימות בהם יכול אפילו בפרהסיא תלמוד לומר (ויקרא כב, לב) ולא תחללו את שם קדשי ונקדשתי
§ The Gemara now considers which prohibitions are permitted in times of mortal danger. Rabbi Yoḥanan says in the name of Rabbi Shimon ben Yehotzadak: The Sages who discussed this issue counted the votes of those assembled and concluded in the upper story of the house of Nitza in the city of Lod: With regard to all other transgressions in the Torah, if a person is told: Transgress this prohibition and you will not be killed, he may transgress that prohibition and not be killed, because the preserving of his own life overrides all of the Torah’s prohibitions. This is the halakha concerning all prohibitions except for those of idol worship, forbidden sexual relations, and bloodshed. Concerning those prohibitions, one must allow himself to be killed rather than transgress them. The Gemara asks: And should one not transgress the prohibition of idol worship to save his life? But isn’t it taught in a baraita: Rabbi Yishmael said: From where is it derived that if a person is told: Worship idols and you will not be killed, from where is it derived that he should worship the idol and not be killed? The verse states: “You shall keep My statutes and My judgments, which a person shall do, and he shall live by them” (Leviticus 18:5), thereby teaching that the mitzvot were given to provide life, but they were not given so that one will die due to their observance. The baraita continues: One might have thought that it is permitted to worship the idol in this circumstance even in public, i.e., in the presence of many people. Therefore, the verse states: “Neither shall you profane My holy name; but I will be hallowed among the children of Israel: I am the Lord Who sanctifies you” (Leviticus 22:32). Evidently, one is not required to allow himself to be killed so as not to transgress the prohibition of idol worship when in private; but in public he must allow himself to be killed rather than transgress.

(ה) עֻבָּרָה שֶׁהֵרִיחָה, מַאֲכִילִין אוֹתָהּ עַד שֶׁתָּשִׁיב נַפְשָׁהּ. חוֹלֶה מַאֲכִילִין אוֹתוֹ עַל פִּי בְקִיאִין. וְאִם אֵין שָׁם בְּקִיאִין, מַאֲכִילִין אוֹתוֹ עַל פִּי עַצְמוֹ, עַד שֶׁיֹּאמַר דָּי:

(5) We feed a pregnant woman who smells [and craves food], even unkosher [food] until she recovers. We feed a sick person on the advice of an expert [doctor]. And if there is not an expert there, we feed him on his own word, until he says enough.

(ו) מִי שֶׁאֲחָזוֹ בֻלְמוּס, מַאֲכִילִין אוֹתוֹ אֲפִלּוּ דְבָרִים טְמֵאִים, עַד שֶׁיֵּאוֹרוּ עֵינָיו. מִי שֶׁנְּשָׁכוֹ כֶלֶב שׁוֹטֶה, אֵין מַאֲכִילִין אוֹתוֹ מֵחֲצַר כָּבֵד שֶׁלוֹ, וְרַבִּי מַתְיָא בֶן חָרָשׁ מַתִּיר. וְעוֹד אָמַר רַבִּי מַתְיָא בֶן חָרָשׁ, הַחוֹשֵׁשׁ בִּגְרוֹנוֹ, מַטִּילִין לוֹ סַם בְּתוֹךְ פִּיו בְּשַׁבָּת, מִפְּנֵי שֶׁהוּא סְפֵק נְפָשׁוֹת, וְכָל סְפֵק נְפָשׁוֹת דּוֹחֶה אֶת הַשַּׁבָּת:

(6) If one is seized with a pathological craving [for food], he is to be fed even with unkosher food, until he recovers. A person who is bitten by a mad dog must not be fed any of the dog's liver, but Rabbi Matya ben Charash permits it. Moreover, Rabbi Matya ben Charash said, If a person has a sore throat, it is permitted to put medicines into his mouth on the Sabbath, because of possible danger to his life, and whatever threatens to endanger life supersedes [the observance of] the Sabbath.

(ז) מִי שֶׁנָּפְלָה עָלָיו מַפֹּלֶת, סָפֵק הוּא שָׁם סָפֵק אֵינוֹ שָׁם, סָפֵק חַי סָפֵק מֵת, סָפֵק נָכְרִי סָפֵק יִשְׂרָאֵל, מְפַקְּחִין עָלָיו אֶת הַגַּל. מְצָאוּהוּ חַי, מְפַקְּחִין עָלָיו. וְאִם מֵת, יַנִּיחוּהוּ:

(7) If debris falls and it is unknown whether any person is buried [under it] or not; or whether he is dead or alive, or whether he is a gentile or a Jew, we remove the debris from him on the Sabbath; if he be found alive, we extricate him, but if he is dead, we leave him.

ת"ר מפקחין פקוח נפש בשבת והזריז ה"ז משובח ואין צריך ליטול רשות מב"ד הא כיצד ראה תינוק שנפל לים פורש מצודה ומעלהו והזריז ה"ז משובח ואין צריך ליטול רשות מב"ד ואע"ג דקא צייד כוורי ראה תינוק שנפל לבור עוקר חוליא ומעלהו והזריז ה"ז משובח ואין צריך ליטול רשות מב"ד אע"ג דמתקן דרגא ראה שננעלה דלת בפני תינוק שוברה ומוציאו והזריז ה"ז משובח ואין צריך ליטול רשות מב"ד ואע"ג דקא מיכוין למיתבר בשיפי מכבין ומפסיקין מפני הדליקה בשבת והזריז ה"ז משובח ואין צריך ליטול רשות מב"ד ואע"ג דקא ממכיך מכוכי וצריכא דאי אשמועינן ים משום דאדהכי והכי אזל ליה אבל בור דקא יתיב אימא לא צריכא ואי אשמועינן בור משום דקא מיבעית אבל ננעלה דלת אפשר דיתיב בהאי גיסא ומשביש ליה באמגוזי צריכא
§ The Sages taught in a baraita: One engages in saving a life on Shabbat, and one who is vigilant to do so is praiseworthy. And one need not take permission from a court but hurries to act on his own. How so? If one sees a child who fell into the sea, he spreads a fisherman’s net and raises him from the water. And one who is vigilant and acts quickly is praiseworthy, and one need not seek permission from a court, although in doing so he catches fish in the net as well. Similarly, if one sees a child fall into a pit and the child cannot get out, he digs part of the ground out around the edge of the pit to create a makeshift step and raises him out. And one who is vigilant and acts quickly is praiseworthy, and one need not seek permission from a court, although in doing so he fashions a step. Similarly, if one sees that a door is locked before a child and the child is scared and crying, he breaks the door and takes the child out. And one who is vigilant and acts quickly is praiseworthy, and one need not seek permission from a court, although he intends to break it into boards to be used later. Similarly, one may extinguish a fire by placing a barrier of metal or clay vessels filled with water in front of it on Shabbat when life is endangered. And one who is vigilant and acts quickly is praiseworthy, and one need not seek permission from a court, although he leaves the coals, which can be used for cooking after Shabbat. The Gemara comments: And it is necessary to teach these examples, since each one suggests an original idea. As, had it taught us the halakha of the child who fell into the sea, we would have said: He must act quickly in that case because in the meantime, if he delays, the child will be swept away by the waves and disappear, and therefore the rescuer need not seek permission; but in the case of a child who fell into a pit, who remains there and is in no further danger, one might say the rescuer need not hurry but should request permission from the court first. Therefore, the baraita explains: No, it is necessary to tell us that case, too. And if it had taught us the case of the pit, one might have thought it is because the child is scared at being trapped; but when a door is locked before a child, it is possible to sit on the other side of the door and amuse him with the sound of nuts until Shabbat is over. Therefore, it is necessary to teach that in this case, too, one does not delay but acts immediately because a life is possibly in danger.