The famous Halacha of "Piku’ah Nefesh" establishes that the concern for a Jew’s life overrides the prohibitions of Shabbat. The laws of Shabbat may, and in fact must, be violated when this is necessary to save the life of a seriously ill patient. It is critically important for people to acquaint themselves with the detailed Halachot of "Piku’ah Nefesh," as when such situations arise, people do not normally have the opportunity to begin searching through books to find the Halacha. These Halachot must be learned so that when one finds himself in a situation of a critically ill patient in need of urgent care, Heaven forbid, he will know exactly what should be done.
The custom of the Sepharadim, following the ruling of the Shulhan Aruch, is to have specifically an adult, Jewish male violate Shabbat in situations of "Piku’ah Nefesh." If the job is assigned to a gentile, people might mistakenly conclude that a Jew may not violate Shabbat to save a life. Similarly, if the job is assigned a woman, people might think that men should not violate Shabbat in situations of "Piku’ah Nefesh." The same concern arises if a child is given the task, which might give the impression that adults may not transgress Shabbat for "Piku’ah Nefesh." Therefore, according to Sephardic practice, specifically an adult Jewish male should be called upon to violate Shabbat for the sake of helping a critically ill patient. (It should also be noted that a Jew would presumably exert himself more fully to help a fellow Jew than a gentile would, and for this reason, too, it is preferable for a Jew to tend to the patient’s needs.)
Interestingly enough, the Rambam (Rabbi Moshe Maimonides, Spain-Egypt, 1135-1204) goes even further, claiming that the most righteous man available should be the one chosen for the purpose. In order to impress upon people the importance of saving a Jewish life, according to the Rambam, the greatest Rabbi available should be called upon to violate Shabbat to tend to a critically ill patient.
Hacham Ben Sion Abba Shaul, in one of his published responsa, qualified the Shulhan Aruch’s ruling requiring an adult Jewish male to violate Shabbat in cases of "Piku’ah Nefesh." He writes that this applies only to the actual administering of medical treatment, such as turning on machines, preparing the intravenous feeding system, and the like. When it comes to needs that are not directly related to administering treatment, however, then it is preferable to either ask a gentile to perform the action in question, or for a Jew to perform the action with a "Shinui" (in an unusual manner). For example, if a heater or light needs to be turned on in the patient’s room, then a gentile should be asked to turn the switch, or a Jew should do so in some unusual manner, such as with his elbow. By the same token, if a prescription must be written, this should be done by a gentile, or by a Jew in an unusual manner.
Summary: If a critically ill patient requires emergency medical care on Shabbat which entails violating the Shabbat prohibitions, an adult, Jewish male should be called upon to perform the acts in question, to emphasize the point that the concern for human life overrides the Shabbat prohibitions. This applies, however, only to the actual administering of medical care. When it comes to secondary needs such as turning on a heater or writing a prescription, it is preferable to either ask a gentile or for a Jew to perform the act in an unusual manner.
