Crafting Your Comfort: Adjustable Electric Beds on Shabbos

Adjustable electric beds are commonly used in homes for comfort and in healthcare settings for patient care. For healthy individuals, adjusting the bed would be Chilul Shabbos and it should be set to the desired position before Shabbos.  Conversely, a Choleh – even a Choleh she’Ein Bo Sakana – may adjust it on Shabbos under certain circumstances.

It is essential to emphasize that if manual adjustment is feasible, there is no justification for using the electrical controls on Shabbos. However, there are scenarios where this is not practical. For instance, an elderly or frail individual may lack the physical strength to adjust the bed himself and may not always have others available to assist. Additionally, adjusting the bed of a bedridden patient may be challenging due to his weight and/or limited mobility.

What conditions permit the electrical adjustment of a bed on Shabbos?

The Gemara (Shabbos 129a) states:

…R’ Ulla, son of R’ Ilai, said: All the needs of a Choleh may be performed by an Aramean on Shabbos… R’ Hamnuna said: When there is no Sakana, one should instruct a Nachri to act.

The Gemara is discussing a Choleh she’Ein Bo Sakana. The Chachamim permitted asking a Nachri to perform Issurim d’Oraisa on Shabbos if they are “Tzarchei Choleh”.

How are Tzarchei Choleh defined? The Rishonim argue which actions are permissible for a Choleh sheYesh Bo Sakana. In straightforward terms, only actions necessary to preserve life (“l’Fake’ach Nefesh”) are permitted. However, the Magid Mishna asserts that any Tzarchei Choleh are permitted, even those not needed to save his life.^[1]

            Based on this definition, haGaon Rav Asher Weiss Shlit”a maintains that Tzarchei Choleh for a Choleh she’Ein Bo Sakana similarly include general patient needs, even if they are not directly related to his Refua.

R’ Raziel Friedman Shlit”a, a member of our Beis haMedrash, pointed out that the Tehila l’Dovid^[2] (328: 4) appears to disagree:

According to the Magid Mishna (2:14), one may desecrate Shabbos for all the needs of a Choleh sheYesh Bo Sakana, even if neglecting them would not endanger him. However, for a Choleh she’Ein Bo Sakana, whose needs may be tended to by a Nachri, we specifically require that refraining from those acts would impede his treatment. For example, heating water for a Choleh sheYesh Bo Sakana may be performed by a Jew, even if it is possible to warm him with clothing [or blankets]. But for a Choleh she’Ein Bo Sakana, it is forbidden since he can be warmed with clothing [or blankets]. However, according to Rashi even for a Choleh sheYesh Bo Sakana, if refraining from the act would not pose a direct danger to his life, Shabbos should not be desecrated [by a Jew] but should be performed by a Nachri (see Magen Avraham 328:17).”

Nonetheless, according to Rav Asher’s ruling, acts essential for the patient’s well-being – in other words, refraining from performing them would cause distress – may be performed by a Nachri on Shabbos. Therefore, if a patient’s bed position is causing discomfort – particularly if he cannot sleep, eat, or drink in that position – one may ask a Nachri to adjust the bed.

This leniency applies only when the adjustment is performed by a Nachri. Allowing a Jew to adjust the bed, even with a Shinui, is more problematic due to the debate among the Poskim (328:17) regarding whether only Issurim d’Rabbanan may be violated with a Shinui for a Choleh she’Ein Bo Sakana, or if Issurim d’Oraisa may also be permitted. The Mishnah Berura consistently rules that this leniency only applies to Issurim d’Rabbanan, whereas the Shulchan Aruch haRav permits even Issurim d’Oraisa. Contemporary Poskim rule that in a case of dire need (Sha’as haD’chak Gadol), one may rely on the Shulchan Aruch haRav, but the prevailing practice follows the Mishnah Berura.

This discussion only concerns cases where the bed position is not a matter of Sakana. However, Professor Moshe Sonnenblick and Nurse Netanel Fuxbrumer identified several cases in which a Sakana is present:

1. A patient fed via a gastrostomy tube (PEG) or nasogastric tube whose position may need to be altered to prevent aspiration.
2. A patient in respiratory distress or difficulty breathing in that position.
3. A patient who needs to change position to prevent pressure sores.

As stated, if a manual adjustment is easily possible, it should be done that way. However, if manual adjustment is impractical or inaccessible, the issue becomes a matter of Pikuach Nefesh, and the bed may be adjusted as follows:

1. If a Nachri is available without delay, he should be asked to perform the adjustment. The Poskim maintain that even according to the Shulchan Aruch’s opinion that a Jew should perform the necessary actions, if it is non-urgent or indirect medical care, one can enlist a Nachri if there will not be a delay.
2. If no Nachri is available, the action should be performed with a Shinui, such as pressing the button with the back of the hand or using a non-Muktza object.

If the adjustment is not necessary for the Refua of the Choleh sheYesh Bo Sakana (as in the above examples), but it will help him to sleep, it is still permissible. According to the Mishna Berura, non-Pikuach Nefesh needs do not permit a Jew to violate Issurim d’Oraisa, but in this case, sleep itself is considered essential for Refua (Biur Halacha, 328 s.v. “Bishvil sheYishan”). The Shevet haLevi (6:30:2) adds that relieving a patient’s suffering, even if it does not directly treat their illness, is considered a component of medical care according to all opinions. Thus, even the Mishna Berura would agree that relieving severe pain caused by the bed’s position is permissible. Nevertheless, since adjustments can easily be performed with a Shinui, one should certainly be utilized, but if a Nachri is available, it is ideal to enlist him to make the adjustments.

[1] The Bi’ur Halacha (O.C. 328) rules that one should not rely on the Magid Mishna‘s position for Issurim d’Oraisa even for a Choleh sheYesh Bo Sakana. Further discussion is beyond the scope of this essay.

[2] R’ Dovid b. Yisrael Tzvi Ortenberg zt”l (d. 1910) was a Rav and Posek in Berditchev.