The kindling and extingushhing of light
THE KINDLING AND EXTINGUISHING OF LIGHT
106. Light should be left on throughout the Sabbath in a room adjacent to that of a patient so that he may receive treatment as necessary, including during the night.
The seriously ill patient
107. It is permitted to turn on a light in order to attend to a seriously ill patient. This is also permitted if the seriously ill patient is afraid to lie in the dark or feels that if the room is dark his needs will not be noticed; this feeling of neglect may lead to a possible decrease in his well-being.
108. If light is needed it should be turned on in an unusual manner, such as with the elbow, the back of the hand or the back of the finger. See also paragraph 5 above. For a patient that requires immediate life saving treatment, an electric bell may be used to call for help even if a light is also automatically turned on (regarding a non-seriously ill patient, see paragraph 118).
109. Even if the patient is blind, light is turned on in his room (where possible in an unusual manner – see paragraph 108 above) if he is afraid, or so that he should feel he is under continuous observation. This is not permissible for an unconscious patient.
110. If light is needed for a seriously ill patient and there is light in another room, he should, if possible, be moved there rather than a light be turned on in his room. If however the light is not sufficiently strong, or if time is of the essence, light should be turned on where the patient is (where possible in an unusual fashion – see paragraph 108 above; but see paragraph 5 above).
111. If there are two switches, one for one light bulb and the other for two, and the one light is sufficient, that should be turned on. If the electricity has to be turned on via a main switch (such as a Sabbath clock), one should first turn off the switches in the other rooms and only then turn on the main switch (where possible all this should be done in an unusual fashion – see paragraph 108 above), so that lights are not lit unnecessarily. However if time is of the essence, the main switch should be turned on immediately.
112. If a non-Jew has been asked to turn on a light for a seriously ill patient and does so via a main switch, there is no need for him to first turn off the switches in the other rooms. If, as a result, light also comes on in another room, or the electric stove is switched on thus heating food or water, a healthy person may make use of the light or the heated food or water.
113. One should preferably light the smaller of two available lights, if it sufficient for the treatment of the seriously ill patient.
114. Light that has been lit on the Sabbath for the needs of a seriously ill patient may be used by anyone else. This includes light in another room that was lit automatically when the main switch was used in order to provide immediate light for the patient, and there was no time to first turn off the switch in this other room.
115. It is permitted to extinguish light (where possible in an unusual fashion – see paragraph 108 above) to enable the seriously ill patient to sleep, unless he or the light (if on a long cord) can easily be moved to another room, or the light can be safely covered, or the Sabbath clock which is already switched on adjusted so that the lights will shortly be extinguished. It is preferable (where possible) to dim the light via a dimmer switch rather than switch it off. When the patient awakens, if light is needed for his treatment, it may be switched on again. Where a non-Jew is available, he should be asked to switch the light on and off as required.
116. A refrigerator may be opened in order to take out what is needed for the seriously ill patient (at the same time food for others may also be taken out), even if an inside light (which was not inactivated before the Sabbath) goes on when the door is opened. However the door may not now be closed since this will result in the light being switched off. If however it is possible that more food or medication etc requiring refrigeration may be needed that Sabbath, or immediately after for this patient, the door may be closed, provided that there is nowhere else where it can be kept (such as in a neighbor's refrigerator where there is no inside light). However, if the food will not spoil as a result of the door being left open or, even if it did, it can be replaced in time, the door must not be closed. If the door is to be closed, the inside light should first be inactivated, even if it is only probable that the refrigerator will be needed again that Sabbath for the patient, since by doing so only one act of extinguishing is done rather than a number of acts of kindling and extinguishing each time the door is opened and closed for the patient's needs.
The non-seriously ill patient
117. A light may not be turned on for a non-seriously ill patient even if done in an unusual manner. On the other hand, where necessary for his well-being, it is permissible to turn off a light if done in an unusual manner. It is permissible to ask a non-Jew to turn on a light to care for the patient and then later to turn it off so that the patient can sleep.
118. A bedridden non-seriously ill patient may use a non-electric bell to call for assistance. He may only use an electric bell if it is certain that no light is kindled at the same time and immediate help is required (regarding a seriously ill patient see paragraph 108). A patient, even if non-seriously ill. who requires to use a bedpan should attempt to find someone who can ask for help. If a non-Jewish patient is in the next bed he may be asked to ring the electric bell. However if there is no alternative and he cannot wait, he may use the electric bell, activating it in an unusual fashion (such as with the back of a finger or the back of the hand), even if a light is also automatically turned on.
 Shemirat Shabbat Kehilchata 32:63 in note.
 Shemirat Shabbat Kehilchata 32:63.
 Shemirat Shabbat Kehilchata 32:64.
 Orach Chayyim 330:1.
 Written communication from R. Y.Y. Neuwirth.
 Shemirat Shabbat Kehilchata 32:68.
 Shemirat Shabbat Kehilchata 32:66.
 Oral communication from R. Sh.Z. Auerbach because there is no prohibition of pesik reishah (inevitable, consequential results) with respect to the actions of a non-Jew (see Shemirat Shabbat Kehilchata 31, note 1). Further, since this is a case of two distinct objects, we do not prohibit the water because the non-Jew might increase the amount he heats for us. See Shemirat Shabbat Kehilchata 32, note 174.
 Shemirat Shabbat Kehilchata 32:16.
 Shemirat Shabbat Kehilchata 32:69.
 Shemirat Shabbat Kehilchata 32:70.
 Oral communication from R. Sh.Z. Auerbach because use of the dimmer leaves a glowing filiment in the bulb. When the current is increased, the filiment glows brighter. Conversely, when the current is decreased, it glows less. This is therefore not a violation of causing a flame even according to the Chazon Ish.
 Mishnah Berurah 278:2 and 328:12 in note.
 Shemirat Shabbat Kehilchata 32:71.
 Orach Chayyim 328:17.
 Because it is permitted to violate a second-degree rabbinic prohibition (shevut de-shevut) for the benefit of a non-seriously ill patient; Mishnah Berurah 328:57. See R. Sh.Z. Auerbach, Me'orei Eish, page 84a, quoted in Nishmat Avraham Pt. 1, Orach Chayyim 278 (page 118).
 Because of the weight of personal dignity; Shemirat Shabbat Kehilchata 40:19. See Sha'ar ha-Tsiyyun, Orach Chayyim 322:12; oral communication from R. Y.Y. Neuwirth.