“Question: If a patient is defined a choleh sheyesh bo sakono, is it permitted to perform melochos for the non-essential needs of the patient, or are only essential melochos permitted?
Discussion: We find a major dispute among the Rishonim about this very point:
• The Maggid Mishna (Perek 2 Hilchos Shabbos Halocho 14) infers that it is permissible to perform all necessary melochos for a choleh sheyesh bo sakono; including those which are non-essential for the choleh [i.e. it would be beneficial for the choleh to have something, but there is no possibility of danger to life by withholding this]. It appears from the wording of the Maggid Mishna that he infers this from the Rambam (Perek 2 Hilchos Shabbos Halocho 1) and the Brisker Rav (Chidushei HaGriz Hilchos Shevisas Asor) also understands that the Maggid Mishna infers this from the Rambam. However, from the Bi’ur Halocho (Siman 328 se’if 4 d.h. “kol”) it appears that the source of the Maggid Mishna is actually the Ramban in Toras Ho’odom.
[The Mishna Berura (Siman 328 s.k. 14) defines “necessary melochos” as those that there is a minor need for, and it is regular to perform the melocho in question on a weekday.]
• It appears from Rashi (Shabbos 129a d.h. “dovor”) however, learns that only that which is essential may be done for a choleh sheyesh bo sakono; i.e. that without this action the choleh’s life is threatened.
The Beis Yosef (Siman 328 se’if 4) quotes the aforementioned opinions; and although he does not clearly rule like either opinion, the Magen Avraham (Siman 328 s.k. 4) and Mishna Berura (Siman 328 s.k. 14) infer that the Shulchan Aruch sides with the Maggid Mishna (the Magen Avraham infers this from the wording of the Shulchan Aruch “… we perform for him [i.e. the choleh sheyesh bo sakono] all that we regularly perform for him on a weekday” which sounds like non-essential activities as well).
(The Graz Siman 328 s.k. 4 quotes both opinions and writes that ideally these non-essential activities should be performed by a non-Jew, and if this is not possible then one can rely on the lenient view; however, a G-d fearing person should be cautious regarding a melocho d’orayso.)
The Mishna Berura (Siman 328 s.k. 14) continues and says that that many Rishonim maintain that it is only permitted to be mechalel Shabbos for a choleh sheyesh bo sakono for essential needs; i.e. that without this specific action his life may be endangered. The conclusion of the Mishna Berura is that regarding melochos min hatorah it is correct to be stringent [and only perform tasks that are critical or essential for the choleh]. All other tasks should only be performed by a non-Jew.
The Mishna Berura (in the Bi’ur Halocho) concludes that this only pertains to an action where there is no concern that withholding this action will cause deterioration to the choleh. However, if there is any possibility that withholding this action will cause deterioration then one should be mechalel Shabbos.
Additionally, the Mishna Berura quotes the Me’iri who writes that if the desired action will strengthen the general constitution of the choleh one should not refrain from performing the melocho in question.
Conclusion: Although it appears from the wording of the Shulchan Aruch that he sides with the lenient opinions and permits performing even non-essential melochos for a choleh sheyesh bo sakono, the conclusion of the Mishna Berura is that one should be stringent regarding melochos min hatorah, where there is no concern that withholding will cause the condition of the choleh to deteriorate (and nor will they result in strengthening the constitution of the choleh).
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