The Gemara explains the rationale for this leniency: The gentile thinks to himself that the Jew is asking him for his opinion, and just as he is asking him, he will also ask other people. And the gentile further reasons that if the Jew understands that the gentile provided him with bad advice, that man, i.e., the gentile, will bring harm to himself by damaging his own reputation. It is therefore assumed that the gentile will provide good advice in order to avoid sullying his reputation.

§ The Gemara analyzes a situation in which one may receive medical attention from gentiles. Rava says that Rabbi Yoḥanan says, and some say that it was Rav Ḥisda who says that Rabbi Yoḥanan says: If there is uncertainty as to whether a patient will live through his ailment or die from it, the patient may not be treated by gentile doctors, due to the concern that a gentile doctor may kill him. But if it is certain that he will die from his affliction if he does not receive medical attention, the patient is treated by them, as it is possible that a gentile physician will save him.

The Gemara challenges: Even if it is certain that the patient will die if he is not treated, nevertheless, there is value in temporal life, i.e., it is preferable for the Jew to live as long as his ailment permits rather than risking a premature death at the hands of a gentile physician. The Gemara explains: We are not concerned with the value of temporal life when there is a possibility of permanent recovery, and therefore it is preferable to receive medical attention from a gentile despite the risk involved.

The Gemara asks: And from where do you say that we are not concerned with the value of temporal life? As it is written with regard to the discussion held by four lepers left outside a besieged city: “If we say: We will enter into the city, then the famine is in the city, and we shall die there; and if we sit still here, we also die. Now therefore come, and let us fall unto the host of the Arameans; if they save us alive, we shall live; and if they kill us, we shall but die” (II Kings 7:4). The starving lepers decided to risk premature death rather than waiting to die of starvation. The Gemara asks rhetorically: But isn’t there temporal life to be lost, in which case it would be preferable for the lepers to remain in their current location? Rather, is it not apparent that we are not concerned with the value of temporal life?

The Gemara raises an objection from a baraita: A person may not engage in dealings with heretics, and one may not be treated by them even in a case where it is clear that without medical attention one will experience only temporal life.

The baraita relates an incident illustrating this point. There was an incident involving ben Dama, son of Rabbi Yishmael’s sister, in which a snake bit him. And following the attack, Ya’akov of the village of Sekhanya, who was a heretic, a disciple of Jesus the Nazarene, came to treat him, but Rabbi Yishmael did not let him do so. And ben Dama said to him: Rabbi Yishmael, my brother, let him treat me, and I will be healed by him. And I will cite a verse from the Torah to prove that accepting medical treatment from a heretic is permitted in this situation. But ben Dama did not manage to complete the statement before his soul departed from his body and he died.

Rabbi Yishmael recited with regard to him: Fortunate are you, ben Dama, as your body is pure and your soul departed in purity, and you did not transgress the statement of your colleagues, who would state the verse: “And who breaks through a fence, a snake shall bite him” (Ecclesiastes 10:8), i.e., one is punished for ignoring an ordinance of the Sages. This incident indicates that it is not permitted for one to accept medical treatment from a heretic even if it is clear that without it he will live only a short while.

The Gemara explains: Heresy is different, as it is enticing. In other words, it is prohibited to accept medical treatment from a heretic, as one might come to be drawn after his heresy. By contrast, receiving medical attention from a gentile is permitted if it is certain that one will die if he is not treated.

The Master said above: You did not transgress the statement of your colleagues, who would state the verse: “And who breaks through a fence, a snake shall bite him.” The Gemara asks: But ben Dama was also bitten by a snake, even before this declaration of Rabbi Yishmael, so how can he be considered fortunate? The Gemara explains: The snake mentioned in the curse of the Sages is different, as it has no remedy whatsoever. Although ben Dama was bitten by a snake, he could have been healed.

The Gemara asks: And what would ben Dama have said? What verse did he intend to cite as proof that it was permitted for him to be healed by a heretic? The verse: “You shall therefore keep My statutes, and My ordinances, which if a man do, he shall live by them” (Leviticus 18:5). This teaches that one should live by God’s mitzvot, and not that he should die by them. This verse serves as a source for the halakha that one may violate a prohibition in order to save a life.

And why does Rabbi Yishmael disagree with ben Dama? He maintains that this matter applies only in private, but in public one may not transgress a prohibition even to save a life. As it is taught in a baraita that Rabbi Yishmael would say: From where is it derived that if oppressors say to a person: Worship an idol and you will not be killed, that one should worship the idol and not be killed? The verse states: “He shall live by them,” and not that he should die by them. One might have thought that this applies even in public. Therefore, the verse states: “And you shall not profane My holy name” (Leviticus 22:32).

§ The Gemara examines various circumstances in which one is permitted to receive treatment from a gentile. Rabba bar bar Ḥana says that Rabbi Yoḥanan says: With regard to any injury for which Shabbat is desecrated, one may not be treated by gentiles. And there are those who say that Rabba bar bar Ḥana says that Rabbi Yoḥanan says: With regard to any