Transgress Torah prohibition because of Aiva?

 Igros Moshe (Orech Chaim 4:79): Concerning the case where a Jewish doctor must be on duty in a hospital or he is an established doctor – even if his office is closed on Shabbos and yet a dangerously ill non‑Jew comes to him – he is forced to treat the non‑Jew even if it involves a Torah level violation of Shabbos. And surely it is required  if there is some accident that happens close to his house where they call the closest doctor. That is because the excuse that Abaye gave in the gemora is not accepted in our country. Therefore his refusal to treat the ill person creates an actual physical danger to him from the relatives of the sick person. And even if the doctor is certain that there is no danger to him personally by not treating the non‑Jew on Shabbos, nevertheless there is a real concern that great danger will be caused by the reaction of other  non‑Jews in that country and perhaps also from the government itself. Thus one has to be concerned with the great likelihood that physical danger will result to Jews as the result of his refusal to treat a non‑Jew on Shabbos. Even though Tosfos expresses surprise that it is possible to permit the violation of a Torah prohibition because of aiva – however the reality of our country in modern times presents the real concern for great danger even when the government permits every Jew to conduct themselves according to the laws of the Torah – but it won’t tolerate a refusal to save another person’s life. Thus  the words of the Chofetz Chaim (Mishna Berura 330:8) are astounding. He writes that this that even the most observant doctors travel distances on Shabbos to treat non‑Jews and to prepare medicines by themselves and he concludes that these doctors are complete Shabbos violators who transgress willingly even though there is aiva produced if they don’t comply. The fact is that in Russia in the small villages where there is only a single doctor for the entire area it is quite obvious that if the doctor doesn’t treat the non‑Jews there is no question that he would be killed because he caused their family member to die etc. It is obvious that if the doctor were killed under these circumstances that the judge would at most provide a light punishment. Besides they might kill the doctor secretly. It is obvious that the Chofetz Chaim was well aware of this physical danger because he put a note in the Mishna Berura that his ruling in this case was only applicable to idolaters in India. If there wasn’t great danger to  the Jewish people then he would not have had to write  this. Even if this concern was only a distant possibility – but we are lenient in the life threatening cases even for low probabilities. Thus is also the view of the Chasam Sofer (Y.D. 131). The Divre Chaim (O.H. 25) after he writes that aiva is not a reason to transgress Torah prohibitions on Shabbos concludes that the practice of doctors is to be lenient and he heard that it was an official rabbinic decree to permit it. But this seems problematic – how can there be a rabbinic decree against a Torah prohibition  - so therefore he must mean that even if someone doesn’t think that danger result from not treating a non‑Jew on Shabbos nevertheless one should not protest against the doctors who are lenient because it is really not clear that there is no danger. Even if in the immediate area there is truly no danger but it simply adds greater hatred towards Jews, but you should know that there was a decree not to protest against  doctors who were lenient so that no one will err and be stringent in places where there is genuine danger… In fact we find many times in the gemora that an action is prescribed now to prevent a problem later. So surely in this case where there is also an immediate problem since it is fairly common to find sick non‑Jew so the decree that the Divrei Chaim mentioned is not a rabbinic decree but it is simply the halacha in this case…Especially today where there is widespread publicity through the newspapers so that events immediately become a problem in the entire world and this can readily lead to incitement to increase hatred until it can produce a great massacre. Therefore it is obvious that in modern times it should be treated as a definite danger if the doctors doesn’t treat the non‑Jew and it is permitted when this situation occurs.