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דְּחוּיָה הִיא שַׁבָּת אֵצֶל סַכָּנַת נְפָשׁוֹת, כְּמוֹ שְׁאָר כָּל הַמִצְוֹת שֶׁבַּתּוֹרָה. לָכֵן חוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה וְהוּא אָדָם כָּשֵׁר, וְאַף עַל פִּי שֶׁלִּפְעָמִים עוֹשֶׂה עֲבֵרָה לְתֵאָבוֹן (עַיֵּן יו"ד סִימָן קנ"ח וחו"מ סִימָן תכ"ה). וַאֲפִלּוּ הוּא תִּינוֹק בֶּן יוֹמוֹ, מִצְוָה לְחַלֵּל עָלָיו אֶת הַשַׁבָּת. וְאִם הַחוֹלֶה אֵינוֹ רוֹצֶה, כּוֹפִין אוֹתוֹ עַל כָּךְ. וְעָוֹן גָּדוֹל הוּא בְּיָדוֹ לִהְיוֹת חָסִיד שׁוֹטֶה, שֶׁלֹּא לְהִתְרַפֵּא בִּשְׁבִיל אֵיזֶה אִסּוּר, וְעָלָיו נֶאֱמַר וְאַךְ אֶת דִּמְכֶם לְנַפְשׁוֹתֵיכֶם אֶדְרֹשׁ. וְהַזָּרִיז לְחַלֵּל ; בִּשְׁבִיל חוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה, הֲרֵי זֶה מְשֻׁבָּח. וַאֲפִלּוּ יֵשׁ אֵינוֹ יְהוּדִי לְפָנֵינוּ, מִשְׁתַּדְּלִין לַעֲשׂוֹת עַל יְדֵי יִשְֹרָאֵל. וְכָל מִי שֶׁחִלֵּל שַׁבָּת בִּשְׁבִיל חוֹלֶה שֶׁיֵּשׁ בּוֹ סַכָּנָה, אַף עַל פִּי שֶׁלֹּא הֻצְרַךְ לוֹ, הֲרֵי זֶה יֵשׁ לוֹ שָׂכָר, כְּגוֹן שֶׁאָמַר הָרוֹפֵא, חוֹלֶה זֶה צָרִיךְ גְּרוֹגֶרֶת אַחַת, וְרָצוּ תִּשְׁעָה אֲנָשִׁים וְתָלַשׁ כָּל אֶחָד גְּרוֹגֶרֶת וְהֵבִיא, כֻּלָּם יֵשׁ לָהֶם שָׂכָר טוֹב מֵאֵת ה' יִתְבָּרַךְ שְׁמוֹ, אֲפִלּוּ הִבְרִיא הַחוֹלֶה בָּרִאשׁוֹנָה. וְכֵן בִּשְׁבִיל כָּל פִּקּוּחַנֶפֶשׁ, וַאֲפִלּוּ סְפֵק פִּקּוּחַ נֶפֶשׁ, מִצְוָה לְחַלֵּל עָלָיו אֶת הַשַׁבָּת, וְלַעֲשׂוֹת בִּשְׁבִילוֹ כָּל אִסּוּרֵי דְּאוֹרַיְתָא, שֶׁאֵין לְךָ דָּבָר שֶׁעוֹמֵד בִּפְנֵי פִּקּוּחַ נֶפֶשׁ, כִּי לֹא נִתְּנָה הַתּוֹרָה אֶלָּא לְמַעַן הַחַיִּים, שֶׁנֶּאֱמַר אֲשֶׁר יַעֲשֶׂה אוֹתָם הָאָדָם וָחַי בָּהֶם, וְלֹא שֶׁיָּמוּת בָּהֶם, חוּץ מֵעֲבוֹדָה זָרָה גִלּוּי עֲרָיוֹת וּשְׁפִיכַת דָּמִים, שֶׁהֵם בְּיֵהָרֵג וְאַל יַעֲבֹר (סִימָן שכח שכט, וביו"ד סִימָן קנז).
[The laws of] Shabbos are suspended1דְחוּיָה = suspended. More literally the word דְחוּיָה means “pushed aside,” as opposed to הוּתְּרָה —“made permissible.” There is great controversy among the poskim as to the attitude we take in permitting the transgression of Shabbos to save a life, whether it is דְחוּיָה or הוּתְּרָה. Shulchan Aruch Harav 328: 13 and this author maintain that it is דְחוּיָה and, therefore, if a method can possibly be found to minimize the transgression, such as doing the melachah with a שִׁינוּי, i.e. in an unusual manner, then that is preferable (see Sho’el U’maishiv 41, 42). Tzemach Tzedek (o.c. 38), Tashbatz (III: 37), Magein Avraham (328: 17) etc. hold הוּתְּרָה and there is no need to seek ways of minimizing the transgression. Chelkas Yoav (o.c. 14) writes that where a definite danger exists it is הוּתְּרָה, but where there is doubt as to whether the situation is life-threatening, it is דְחוּיָה. [See also Kovetz Shiurim, Kesubos paragraph 13; Biur Halacha 278: 1] where there is a life-threatening situation, as are all mitzvos in the Torah. Therefore, one who is dangerously ill and he is an observant person, though he occasionally transgresses a law because of temptation,2Either due to lack of self-control or to inconveniences. This is as opposed to one who transgresses spitefully, who, having done so twice, may not be saved if desecrating the Shabbos is necessary. and even for a day-old child,3Desecrating the Shabbos is permitted to save an unborn fetus. [Ritva, Maseches Niddah 44; B’hag; Tur 617; see also Rosh, Maseches Yoma 8: 13; Peri Megadim 328: 1; Biur Halacha 330] it is a mitzvah to violate the Shabbos to save him. [Even] if the patient refuses, we force him to accept help. It is a grave sin to carry piety to the point of idiocy, and refuse treatment because it would violate a law. About such a person is it said:4Genesis 9: 5. "Only of the blood of your lives will I demand an account." One who is quick to desecrate the Shabbos for the sake of a critically ill person, deserves praise. Even if a non-Jew is present, [every] effort should be made that a Jew do [what is necessary].5This is a matter of controversy among the poskim. Rosh, Shulchan Aruch (328: 12), Taz (ibid.) and Mishnah Berurah rule that a Jew is preferable. Rema and Shulchan Aruch Harav prefer that it be done by a non-Jew if one is available. The author agrees with the former. Any person that desecrates Shabbos for the sake of a critically ill person, even if it was found later to be unnecessary, will be rewarded. For example, if the doctor said: "This patient requires one dried fig [for cure]" and ten people ran and plucked one fig each and brought it, they all will be well rewarded by Hashem, blessed be His Name, even if the patient was cured [as a result of] the first [fig]. Similarly, in any life-threatening situation, even when the threat to life is uncertain,6V. paragraph 3. it is a mitzvah to desecrate Shabbos for him, and to do any and all d'oraisa prohibitions for him, because there is not a thing that stands in the way of a life-threatening situation. The Torah was given only for the purpose of [bringing] life, as it is said: "That man shall do them and live through them," and [the Sages] inferred: "Live through them but not to die on account of them." This holds true except for the laws concerning idolatry, illicit sexual relations and murder, where one must die rather than transgress.7V. Yoreh Dei’ah 157.
תנא דבי אליהו כל השונה הלכות בכל יום מובטח לו שהוא בן העולם הבא שנאמר הליכות עולם לו אל תקרי הליכות אלא הלכות (נדה ע"ג.)