What is pikuach nefesh?

Response

Pikuach nefesh, which means “saving a life” in Hebrew, stems from the rabbinical concept of pikkuah nefesh doheh Shabbat—”prioritizing saving a life in danger over observing the Sabbath.” This principle originates from a rabbinical interpretation of Leviticus 18:5, which states, “Keep my decrees and laws, for the person who obeys them will live by them. I am the LORD.” The Babylonian Talmud highlights that God intends for His people to “live by” the Law rather than “die by” it. Therefore, the Law aims to foster life, making the preservation of human life a greater concern than upholding the Law.

In the Mosaic Law, God instructed Israel not to work on the Sabbath, with the penalty for doing so being death “And while the children of Israel were in the wilderness, they found a man that gathered sticks upon the sabbath day.” (Numbers 15:32ff). However, pikuach nefesh dictates that if someone’s life is at risk, it is permissible to violate the Sabbath by working to save that individual. For instance, Jewish ambulance drivers may work and carry loads on the Sabbath, and Jewish nurses may provide medical care to their patients on that day. Pikuach nefesh goes beyond merely allowing the breach of the Law; it mandates such transgression when a life is in jeopardy. In matters of life and death, it is our duty to take action, even if that means contravening the literal interpretation of the Law.

Jesus exemplified the principle of pikuach nefesh by healing individuals on the Sabbath (Luke 13:10-13). When a synagogue leader objected, Jesus justified His actions with a question: “Doesn’t each of you on the Sabbath untie your ox or donkey from the stall and lead it out to give it water?” “The Lord then answered him, and said, Thou hypocrite, do…”

Doth not each one of you on the Sabbath loose his ox or his ass from the stall, and lead him away to watering? », (Luke 13:15). If one may violate the Sabbath for the sake of animals, how much more for the sake of human beings, created in the image of God? As Jesus pointed out, the Sabbath was made for man, not man for the Sabbath «And he said unto them, The Sabbath was made for man, and not man for the Sabbath: », (Mark 2:27).

Of course, believers in Jesus are no longer required to keep the Sabbath. We are under a new law—the Law of Christ, in which we “carry each other’s burdens” (Galatians 6:2; see also Colossians 2:16). Since Christians are not bound by the Mosaic Law, the rule of pikuach nefesh is not really applicable to them. However, under the Old Covenant, Jesus gave pikuach nefesh His stamp of approval as a principle that reflected God’s mercy and compassion.