Whether you’re a patient staying in a hospital over Shabbat, or you’re a visitor, there are common issues that arise. Here are some pointers for keeping Shabbat in a hospital.

Defining the Terms

Before getting into specific scenarios, it’s important to point out that in Jewish law, there are different categories of sick people, and each has their own specific rules about what is permitted or prohibited. (Spoiler: the more serious the condition, the more room for leniency).

The following is a brief overview of the different categories and what is generally permitted for the care of each one:

Life-threatening illness (choleh sheyesh bo sakanah)

The highest priority is saving a life, so one can perform virtually any action needed to treat people with life-threatening illnesses.

Patients need not be medically classified as “critical” to fall into this category; it includes anyone whose condition could become life-threatening if not treated immediately. Even if there is uncertainty about whether the condition is life-threatening, the patient is included in this category.1

For example, a woman in active labor (and within the first three days postpartum) falls in this category.2

In danger of having a limb lost or damaged (sakanat eiver)

If a patient's condition risks the loss or damage of a limb, a non-Jew may be asked to perform any action needed to treat the patient immediately on Shabbat.

Jews can also take necessary actions, as long as they are done with a shinui, i.e., in an unusual manner. Actions that are ordinarily forbidden by rabbinic decree may be done even without a shinui.3

If there is concern that this condition may worsen and become life-threatening or lead to blindness, the patient would fall into the first category, life-threatening illness.

Non-life-threatening illness (choleh she'ein bo sakanah)

This category includes those who are so sick that their whole body is affected, or who are bedridden or can’t function—but aren’t in danger.

In this case, a non-Jew may be asked to perform any action needed to treat the patient immediately on Shabbat (no hinting necessary).

A Jew may do any necessary rabbinically prohibited action with a shinui. In cases of great need, any action is permitted with a shinui.4

(There are additional categories of illness, such as minor ailments that cause discomfort but do not significantly affect overall health [miktzat choli], or general discomfort [meichush].5 However, we can assume that no one goes to the hospital over such minor issues.)

OK, so now that we’ve outlined the various halachic categories of illness, we can address the common issues that arise in hospitals.

Automatic Doors

Ideally, use manual doors on Shabbat. However, many hospitals have automatic doors (either with an electronic eye or a button), so wait until a non-Jew opens the door.6

If you legitimately need to fulfill a mitzvah (e.g., you need to tend to the patient) or you’re in need of the restroom, you may directly ask a non-Jew to open the door.7 If a non-Jew is not readily available to help you, the next best option is to activate the sensor in an irregular manner, such as by walking backward.

Of course, if you’ve just arrived with the patient on Shabbat (for example, if your wife is in labor), don’t wait for a non-Jew to open the door.

Stairs and Elevators

The use of elevators on Shabbat (even “Shabbat elevators”) raises various halachic issues, so it’s best to use the stairs.

But stairwells come with their own issues. Doors may have electronic alarms or electromagnetic locks, and pressing these may trigger an alarm or use electricity. So if you need to use the stairs, you can ask a non-Jew to open the door. This is preferable to using an elevator.8 However, if the stairways have motion-activated lights, the elevator may be preferable to the stairs (unless a non-Jew is walking ahead of you to your floor).9

Since you’re involved in the mitzvah of caring for the sick, you can be lenient and use the elevator if necessary. The guidelines are as follows:10

  • If the elevator stops at all floors automatically (also known as a Shabbat elevator), enter and exit the elevator as soon as the door opens, and avoid blocking the doorway to prevent activating the electric eye mechanism.
  • If it does not automatically stop, and your presence at the hospital bed is not required immediately, enter the elevator when a non-Jew pushes the button in order to ride the elevator themselves. However, you may only get off at the floor where the non-Jew stops and may not ask them to press a button for your floor. Additionally, you must enter the elevator while the door is already open and hasn't started closing (your presence can keep the door open, but not cause the door to open). It’s best to enter in an irregular manner (walking on your heels, etc.). You may not ride the elevator if you know that the person pushing the button is Jewish.

Automatic Lights in Restroom

If the lights turn on automatically as you enter the restroom, it’s best to find another restroom without that issue. If no other restrooms are available, ask a non-Jew to walk in first to trigger the light switch. If no non-Jew is readily available, you can enter in an irregular fashion (e.g., walk backward or on your heels, etc.). When the light is triggered by simply opening the door, open the door in an irregular fashion, and then enter regularly. You can leave the restroom in an ordinary fashion.11

Motion-Activated Toilets

The issue here is that when you get up to leave the toilet, you’ll trigger the sensor and cause the toilet to flush. If there are no other options, then, to preserve basic human dignity, you can get up and walk away in an unusual manner, such as on your heels or on the sides of your feet.12

Alternatively, place a tissue or paper towel over the sensor before walking away. Even though it’ll eventually fall off by itself, your movement will not have directly activated the flush.13

Motion-Activated Sink

This is an issue. Ideally, use a bottle of water or another cleanser for washing your hands.

If this isn’t possible, then:14

After using the bathroom, you may rub your hands with a cloth or other material.

Before prayer (but not after using the bathroom or touching parts of your body normally covered), you should simply rub your hands together. If you did use the bathroom or touch normally covered parts of the body and now wish to pray, you may ask a non-Jew to fill a cup with water for you.

Washing before bread or upon awakening is a mitzvah, so you may ask a non-Jew to fill up water for you.15 If no non-Jew is available to help obtain water for washing before bread, you should cover your hands with gloves or something similar while eating.16

Note: If the patient has a compromised immune system and is under "contact precautions” and you need to come in contact with the patient, you can wash normally if there are no alternatives.

Security Cameras and Sensors

Metal Detectors: It’s permitted to pass through a metal detector on Shabbat as long as you’re not carrying any metal items that would trigger it.

Security Cameras: Generally, it’s best to avoid being recorded by video cameras on Shabbat. However, in places such as a hospital where it’s challenging to avoid this, it’s permissible to walk past the cameras.17

Call Button

If it’s difficult to find a nurse in person and there is a pressing need (for example, the use of the bathroom, or something for the patient's recovery), one can use the call button in an irregular fashion (e.g., using the back of your hand or elbow).18

Warming Food on Shabbat

It’s permitted for a non-Jew to heat food on Shabbat for ill patients,19 but not for visitors. If a hot meal is brought for a visitor, wait until the food has cooled to room temperature before eating it.20 Even if the hot meal was initially intended for the patient, visitors should refrain from eating it until it has cooled down.21

Carrying

As long as one does not go outside, one is generally permitted to carry within the confines of the entire hospital building. If the hospital is surrounded by a perimeter wall, carrying within those grounds is also permitted.

Shabbat Candles and Kiddush

Lighting Shabbat candles is an obligation that applies even to someone who is in the hospital. Since hospital regulations generally forbid the actual lighting of candles in the room, one should light an electric incandescent lamp or flashlight in the hospital room.22

If wine or grape juice is not available on Friday night, you may wash your hands and recite Kiddush over challah (or even a slice of bread), substituting the blessing of Hamotzi instead of Borei Pri Hagafen. If bread is also unavailable and you’ll be returning home extremely late and can’t wait to eat, you may eat without making Kiddush.23

Discharged on Shabbat

Thank G‑d, things are on the mend and the patient has been discharged from the hospital. One problem, it's still Shabbat!

If possible, arrange for the patient to remain in the hospital until the end of Shabbat (hospitals are often willing to accommodate). If staying in the hospital is very difficult or there is a great need to return home on Shabbat, the patient may be transported home by a non-Jew. This is also permissible if the patient needs assistance only available at home, is especially vulnerable, requires a conducive environment to recuperate, can only receive necessary follow-up healthcare at home, or if there are small children at home who would otherwise be unattended or not cared for properly.24

Family members or caregivers may accompany the patient only if the patient’s needs cannot be met without their assistance—there is no carte blanche to hitch a ride. The patient’s condition that led to the hospital stay is irrelevant; all that’s relevant is the patient’s needs upon discharge.25

Let us hope and pray that our hospital visits are only for joyous occasions, and may all those who are ill be blessed with a speedy recovery!