Going the Distance: A Clinician’s Guide to Commuting and Shabbos
Summary
Traveling to and from the hospital is a significant halachik impediment to working or taking an assigned call on Shabbos. While the sanctity of life is an overriding moral principle in Hilchot Shabbos, traveling to and from prescheduled shifts or knowable on-call responsibilities is not directly related to patient care as, unlike first responders, clinicians working in a hospital setting could ostensibly remain in the hospital over the entirety of Shabbos avoiding whatever Melachot commuting would require. We will examine the halachic status of different methods of travel on Shabbos, summarize the relevant halachic opinions regarding which situations would allow for which corresponding mode of travel, and conclude with a proposed practical algorithm for physicians and healthcare workers who find themselves commuting to save lives in the hospital environment on Shabbos.
Halachik status of different modes of travel
Commuting to the hospital for an emergent case
Commuting to the hospital for a scheduled shift
Returning home from an emergent case
Returning home from a scheduled shift
Halachik Status of Different Modes of Travel
The different modes of travel vary in the Melachaot that they violate. Even when Shabbos violations for traveling are permitted, efforts to minimize the Issurim involved are required. With this in mind, it is important to preface this conversation by analyzing the types and relative severities of the prohibitions associated with different methods of travel.
Biking: Riding a bicycle on Shabbos in an area surrounded by an eruv is generally prohibited because it is an act of "Uvdin Dechol" (not in the spirit of Shabbos, a lesser violation than a normal Derabanan). In an area not surrounded by an Eruv, it is additionally a form of "carrying" violating the melacha of Hotza. In a modern context, however, this would only be considered an Issur d'Rabbanan as many modern poskim argue that most modern cities do not count as a biblical Reshus Ha’rabbim, making carrying only rabbinically prohibited (Rav Poalim 1:25, Minchas Asher 2:42). It is important to note however, whether or not local city streets constitute a biblical “Reshus Harabim” is an honest question for local authorities better informed of “on the ground realities.”
Electric Vehicles: The halachic status of an electric scooter, moped, or car on Shabbos would be a question of how we model the usage of electronic devices on Shabbos. Poskim from the previous generation wrestled with this matter extensively. Depending on the posek, the use of electricity on Shabbos can be categorized as a violation of an Issur D'oraysa or a D'rabbanan. According to Rav Shlomo Zalman Auerbach Zt" l (1:9), clinicians may be lenient concerning the use of electricity on Shabbos and rely on the opinion that it is only an Issur D'rabbanan when necessary, a view that is widely accepted amongst modern poskim.
Rav Asher Weiss, who typically posits that using electricity on Shabbos is a biblical prohibition (Minchat asher 1:30), considers it acceptable to rely on lenient opinions in the interest of patient care. With this in mind, the use of an electric vehicle should be looked at similarly to that of using a bicycle in an area with no eruv, i.e., it would violate a rabbinic prohibition though not be biblically prohibited.
Public Transportation: The use of public transportation like a bus or a train in a nonjewish majority country is prohibited because it is an act of "Uvdin Dechol” (Tzitz Eliezer 1:21, Chatom Sofer 6:97) Provided that the driver and most passengers are not Jewish, even the general rabbinic prohibition against "amira lenachri" would not apply. However, practically using public transportation entails carrying some form of payment and performing monetary transactions, adding two rabbinic prohibitions in an area with no eruv. It is recommended to wear a garment that signifies why one is commuting on Shabbos, such as scrubs or a white coat, to avoid “Maarat Ayin”.
Taxi/Uber: The halachic issues surrounding ordering a non-Jewish Uber or taxi on Shabbat would be the rabbinic prohibition of "Amira L'nochri," i.e., the giving of commands or directions to a non-Jew on Shabbat to violate Shabbos practice for a Jew.
Driving: Using an internal combustion vehicle is the most problematic form of transportation we have discussed, as lighting a fire is biblically prohibited due to the melacha of "Havara" (lighting a fire). When driving a car, the engine burns gas as you drive, making each gas pedal usage an additional forbidden activity.
Techum Shabbos: "Techum Shabbat" refers to the limit of how far one is allowed to travel on the Jewish Sabbath, which is traditionally defined as 2000 Ammah (approximately 3/4 of a mile or 1.2 kilometers) from the last dwelling in one's town's periphery. Most opinions hold that the issue of traveling further than 2000 Amma is rabbinic while venturing a distance over 12 mil is potentially Biblically forbidden. The Minshna Breura and Rabbi Chayim Noeh rule that an ama equals 48 centimeters. Therefore, 2000 Amos equals 960 meters (0.59651 miles).
Igros Moshe (Yore Deah, volume 3, chapter 66) states that the ama is 21.25 inches long – 53.975 centimeters. According to this opinion, 2000 Amos is 1079.50 meters (⅔ of a mile). It is important to note that there are many nuances and exceptions to the rule of Techum Shabbat. It is best to consult with a Rabbi or Halachic authority for guidance regarding a specific situation and commute. However, it is worth noting that this is rarely an issue in metropolitan areas.
Commuting to the Hospital for an Emergent Case
The Halachic principle of "pikuach nefesh," or the preservation of life, overrides the laws of Shabbat. Therefore, the Shulchan Aruch (O.C. 328:2) rules that it is a Mitzva to desecrate the Sabbath for a life-threatening illness, including traveling on Shabbat to treat a patient whose life is in danger. For this reason, emergency responders who have no way of knowing if there will be an emergency or where an emergency will occur may do any melachot necessary to respond as quickly as possible, including driving to the responding site. On the other hand, a physician has far greater certainty regarding where they will be called to preserve life, i.e., the hospital. Additionally, unlike the emergency responder, there is greater confidence about "whether" they will be called in, as it is easy to gauge how many weekend calls come in in a particular clinical practice. For this reason, unlike other community organizations like Hatzolo or even private doulas, there is an honest halachic question as to whether a clinician on call must remain in the hospital from the start of Shabbos to respond to hospital calls. If the call is infrequent enough and there is a real possibility that a physician will not be called in for Shabbos, this matter would be more akin to emergency responders.
Commuting to the Hospital for a Scheduled Shift or a Frequent Knowable Call
Halachic authorities differ in opinion on how physicians should deal with commuting to a scheduled shift or a near certain call requirement. Rav Moshe Feinstein, in Igros Moshe O.C 1:131, holds that a physician traveling to shift must live within walking distance of the hospital, even if this means that they will be forced to rent a shabbos residence and/or be away from their family and community and unable to perform the positive mitzvot of shabbos observance such as kiddush and the seudah.
Rav Shlomo Zalman Auerbach, in his work Shulchan Shlomo O.C 248:7, Minchas Shlomo 1:7, argues that there is no halachic requirement per se to avoid Melachot (Sabbath prohibitions) that are required for the sake of pikuach nefesh. He considers responding to pikuach nefesh on shabbos as a tremendous mitzvah and posits that one is never obligated to avoid a mitzvah in other contexts. He, therefore, rules that a physician may stay home every Friday night and, when required to be involved in the mitzvah of "pikuach nefesh," they may commute to their shift. However, he rules that it would be appropriate and respectful of the spirit of Shabbos to use a non-Jewish driver for the commute and avoid prohibitions, or if this situation is only infrequent on those rare Shabbosim, make efforts to be within walking distance of the hospital (Nishmat Avraham of 329:7:2 p 505-506).
Returning Home From an Emergent Case
The question of returning from an emergent case or call on Shabbos is more nuanced. Returning home is not a matter of Pikuach Nefesh – medical staff could remain in the hospital until after Shabbos. However, if that were required, there would be a genuine concern that people would refrain from being as diligent in responding to emergencies as, at least subconsciously, we are concerned about the presence of bias against responding to emergencies due to the tremendous inconvenience of being stranded in the hospital for the remainder of Shabbos. The Shulchan Aruch (329:9) brings similar reasoning when discussing a case of a militia responding to aggressors stating "that people who go out to save lives on Shabbos may return with their weapons on Shabbos" the Mishneh Berura adds the reasoning "for, if not, they would not consider doing so again in the future" (based on the Rambam, Hilchos Shabbos 2:23, see the Mishna Berura ibid. 20). The scope of this permissiveness, however, is a matter of deep disagreement amongst the Rishonim and Achronim, and this controversy can still be found in the rulings of modern rabbinic authorities.
Rav Shlomo Zalman Auerbach Zt" l (Minchas Shlomo 2:60:18) and the Tzitz Eliezer (8:15) both broaden the scope of the ruling and apply it to clinicians returning from emergencies, this ruling is in accordance with the Magen Avraham (497:18) who would permit Issurei d'Rabbanan in returning from the hospital. According to this reasoning, driving home or enlisting a Jewish driver, whereby biblical prohibitions would be violated, would be strictly forbidden. However, a mode of travel that would only violate rabbinic prohibitions, such as enlisting the services of a non-Jew to drive him home or biking or using an electric vehicle, would be permitted (as discussed in the earlier paragraph).
Rav Moshe Feinstein (Igros Moshe, O.C. 4:80), in a novel responsa, permits even the violation of Issurei d'Oraisa in returning from the hospital, echoing the ruling of the Chatam Sofer (O.C. 203), holds that those returning from life-threatening emergencies may even violate Issurei d'Oraisa 1.
Returning Home from the Hospital from a Scheduled Shift
The responsa literature raises two reservations about using the exact legal mechanism for clinicians returning home on Shabbat from scheduled shifts. Firstly, since these shifts are paid or at least necessary for clinicians to retain their appointments, there is less concern for patient safety as residents and medical staff will likely make their shifts. Therefore, the concern for bias against being present in the hospital does not apply in this context. Secondly, even if it were feasible for all Shabbat-observant clinicians to avoid Shabbat shifts, the likelihood that it would endanger patient care is less prominent, especially in countries that do not have a Jewish majority.
Notwithstanding this hesitation, many poskim ultimately conclude that Issurei d’Rabbanan could be waived to allow medical staff to return home after their shifts. This is in line with what is, at this point, the ruling and practice of generations of Rabonim and physicians 2.
Conclusion
The different modes of travel vary in the melachaot that they potentially violate. The types of situations and contexts largely dictate what methods of travel are permitted for clinicians to use on Shabbos. However, it is important to note that even when shabbos violations are allowed, efforts are required to minimize the Issurim involved. Performing biblical melachot for unforeseeable medical emergencies, such as driving, would be permitted. Commuting to a foreseeable emergency or a scheduled shift is a matter of disagreement between Rav Moshe and Rav Shlomo Zalman Auerbach. The latter is more lenient, allowing even biblical melachot such as driving. Returning from an emergency as well as returning from scheduled shifts, most authorities allow the usage of methods of travel that violate rabbinic prohibitions, such as using public transportation, electric vehicles, or taxis that employ amira lenachri.
The poskim of the previous generation argue about whether the following leniencies should or should not be used routinely and to be sure there is a large and sensitive Hashkafic component that any new physician should discuss with their personal Rav and spiritual mentor. Additionally, many of these rulings were issued in Israel, where the majority of clinicians and patients are themselves Shabbos observant, a consideration relevant to the generalizability of these rulings to other clinical positions that should be best discussed on a case-by-case basis with one's trusted rabbinical authority.
Note: In this summary table is organized with the most lenient types of travel at the top, "Not permitted" means that the mode of travel is not halachically allowed under the specified circumstances; permitted means that the mode of travel is allowed but with certain halachic considerations and limitations that should be discussed with one's personal rov. Based on the clinical situation and Rabbinic authority, some of these positions may change; for convenience, consider the blank table below a conversation starter
It is worth mentioning that a third more stringent opinion amongst the desicors of the previous century. Rav Tzvi Pesach Frank (Har Tzvi O.C. 2:10) cautions against extrapolating from the Shulchan Aruch's ruling to other scenarios, such as healthcare workers being that Chaza"l did not discuss it explicitly. Therefore, we may only permit people returning from saving lives with their weapons to violate Issurim on Shabbos, not those returning from the hospital.
(Rav Nuebort Shemiras Shabbos Kehilchasa 40:81). Minchas asher 2:42, Rabbi Sprung https://medicalhalacha.org/2021/01/07/traveling-to-and-from-the-hospital-on-shabbos/, Rav Shlomo zalman is also recorded as agreeing with this psak in the above link.
Rabbi Apfel is also recorded with this psak: Audio/Video Version