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Professor of Surgery Cleveland Clinic & NYU

Dr. Frank Veith

Professor of Surgery

Cleveland Clinic & NYU

[9 minutes  20 seconds]

TRANSCRIPTION OF VIDEO

Interviewer:   

Do you remember meeting with a Rabbi Moshe Feinstein?

Veith:       

I do.

Interviewer:   

Can you tell me what you recall about that, who initiated it and where it was?

Veith:       

Well, we, we decided, I guess that we were going to try to substantiate in a somewhat scientific, philosophical, legal, and ethical manner the basis for brain death. And I can’t remember if we decided to write the article, or if we did some of the background work and then decided to write the article, but there was a group of, of six of us that were interested in this problem from various aspects. I obviously was the driving force for this because I was very active in lung transplantation and kidney transplantation. I think at the time, I was the Director of the Organ Sharing Unit in New York City, and, … the I was the Chairman of that organization at that time. And we were having, of course, and are still  having, some difficulty in procuring organs. And even though I’m not Jewish, I was working in a Jewish hospital and many of our patients were Jewish. And so the idea of getting some Orthodox Jewish religious, support for the concept of brain death, was one that we thought about.

At that time, I think I was working with several religious leaders, some in the Protestant religions, some in the Catholic religion, some in the Jewish religion. And Rabbi Tendler was my representative who subsequently became a friend, represented the Orthodox Jewish group … and he arranged for a meeting with… Rabbi Feinstein who was the most authoritative Orthodox Jewish scholar, certainly in the New York City area, and perhaps in the whole United States, or even recognized throughout the world.

Interviewer:   

And this was in 1976-77?

Veith:       

Probably 1976 because the article was published in ‘77, and it took a long time to write and, and, get through the process of everybody who was interested in it signing off on it as it were.

Interviewer:   

What do you recall about the meeting with Rabbi Feinstein where it was, how many people were there?

Veith:       

It was a long time ago, so my recollection may not be perfect. But he had an apartment  somewhere down on the Lower East Side, uh, on the Hudson River, and I believe we, we went to see him in his apartment. … Rabbi Tendler, I, I believe Rabbi Feinstein’s wife was also there, and I can’t remember if there were any other individuals. It’s possible there were.  I think they gave us some refreshments, maybe some tea and coffee, rolls or something like that. Then we sat down with … the Rabbi, and discussed the matter, and subsequently, he came up with a written document which, was basically supportive of brain death, and which, or the the concept of brain death, and the fact that it could be used in organ donation. And that, … written statement I quoted … in the article. I’d be happy to read it, if you would like.

OK, the article is an article entitled “Brain Death.” It was in two parts. The first part was “A Status Report of Medical and Ethical Considerations”  and the second part was, …  “A Status Report of Legal Considerations.” The article was published in the Journal of the American Medical Association on October 10, 1977. And I was the lead author. There were a number of co-authors: Jack Fein, who was a neurosurgeon who I had worked with Rabbi Moses Tendler, …there was a philosopher named Robert Veach; and there were two lawyers who worked for the Health and Hospitals Corporation, and we’d been involved together in some cases, one was Mark Kleiman and the other was George Kalkanis.

Obviously I can’t read the whole article relating to the Orthodox-Jewish position; it’s quite lengthy. But I will just read the paragraph relating to Rabbi Feinstein’s … comments and …, written statement. And that reads:

“Since the distinction between cellular and organysmal death is valid, once death of the person has occurred and can be determined, there is no biblical obligation to maintain treatment or artificial support of the corpse. Thus, according to M. Feinstein, there is no religious imperative to continue to use a respirator to inflate and deflate the lungs and thus maintain the cellular viability of other organs in an otherwise dead patient. “

And that’s cited as a written communication, uh, dated May 5, 1976.

Interviewer:   

And this you understood to mean that Rabbi Feinstein did not view the necessity of maintaining support of the heart for a person that is already dead?

Veith:       

That’s precisely right. And, and, the way the brain death concept is used, it can be used in one of two ways. Once a patient is declared brain dead, the organs can be harvested with the heart continuing to beat. Or, in some communities, the respirator is turned off, the heart is allowed to stop, and then the …organs are harvested.

Interviewer:   

But here, in this ruling by Rabbi Feinstein, you understood it to mean that he was saying that a beating heart is not a sign of life?

Veith:       

That is correct. That, that brain death, and the whole article goes into the medical basis for this as well as the philosophical and religious basis, as well as the Orthodox-Jewish position on this. There is a whole page devoted to the Orthodox Jewish position. … The concept is that once the brain is dead, the person is dead. And the organs or other accompaniment of the body, accompaniments of the body that are still presumably functional can be taken and used in another to maintain and sustain the life of another human being.

Here’s one other quote in the article: “In the situation of decapitation, death can be defined or determined by the decapitated state itself as recognized in the Talmud and the Code of Laws. So that even though the heart continues to beat after the head’s cut off, the patient’s death is the time when head is cut off.  So, in effect, brain death is analogous to physiologic decapitation.”

Interviewer:   

And that was your understanding based on the conversation with Rabbi Feinstein?

Veith:

I believe that that was discussed with him, and I believe that he accepted that. The statement about the Talmud and the Code of Laws, about the decapitated man, I’m sure it was discussed by Rabbi Feinstein and Rabbi Tendler.

… In summary, my recollection was that Rabbi Feinstein supported the concept of brain death, and the analogy that a person or a patient who is brain dead is analogous to someone that’s been physiologically decapitated. In other words there’s no function of the brain, that patient is dead just as a person who is decapitated is dead even though his heart beats on for some time even after decapitation.

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