Rabbi Gedaliah Rabinowitz
Rabinowitz: As I recall, the Gemura Yodea is discussing a case where somebody, something fell upon a person and it’s a question if he’s considered alive or not, do we think he’s alive or do we not think he’s alive. If there’s any chance that he’s alive, then we desecrate the Shabbos to save his life. If we are sure that he’s not alive, then we’re under conclusion that we have to draw, then we might as well postpone it until after Shabbos. You’re not saving a life; it’s a question of just bringing him to burial, that can wait until after Shabbos.
What do we check for, that is the issue that the Gemura deals with. What do we check for? The Gemura Yudea makes a distinction between if you are working from, depends, what end are you finding, there are you starting from the head down or are you working from the feet up? If you’re working from the head down, there’s no question that when you get to the nostrils and you see that he’s breathing, he’s alive. If he is not breathing, then we can assume that he’s not alive.
Interviewer: “including that he looks dead and he’s not moving.”
Rabinowitz: Yea. In other words, if you see no movement, then it’s cessation of breath. On the other hand, if you are checking him, if you find, if what you uncover, the feet, that part of the body, you keep on moving and clearing away the debris, there we run into two versions of the text of the Gemura. There is one version, which is found in our text of the Gemura, which is Rashi’s version, you work your way up to the heart. And when you work your way up to the heart, there is one opinion that says, when you get to the heart, there you can tell if they’re heartbeat or not. And there’s another one that says you can’t rely upon it, you still have to continue up to his head to see if he’s breathing or not.
Interviewer: “The other opinion says if you come to the heart and you do not find a heartbeat…”
Rabinowitz: So you continue. You don’t rely… one opinion says you can rely upon that, the other one says, look, you may not notice heartbeat, so therefore you have to continue to see if he’s breathing or not. That’s one opinion. There’s another opinion that is found in the text of the Rif, and other poskim, another version, not an opinion. That version states, it’s not when you get to the heart, when you get to the abdomen, then you check to see if he’s alive or not. In one opinion you can rely upon that, in another opinion you cannot rely upon that.
What does it mean, the abdomen? We came to the conclusion then that it means the diaphragm, because the diaphragm is a major respiratory muscle, so again we’re referring to breathing. According to this opinion, heartbeat is not even mentioned whatsoever, according to this version, is not mentioned whatsoever in the Gemura. So it’s one opinion, according to one version, heartbeat. According to the other opinion, and according to another version, there’s no mention of heartbeat altogether. That’s what, in conclusion, we arrived at in our analysis of the Gemura.
Interviewer: “And so in your analysis of the Gemura, your conclusion was that if a person can’t breathe, he’s dead. If he looks dead, doesn’t move, can’t breathe, he’s dead and nothing to do with a heartbeat.
Rabinowitz: I would not say, totally, that we ignore heartbeat. The Gemara there… what the Gemura is referring to there is when I’m confronted with a situation where I have to remove debris and investigate if a person is alive or not, so I have to just check and see. I rely upon breathing. That’s clearly so in the Gemura. If I do find heartbeat, there’s no question that I will still consider him alive. Because if there’s heartbeat, why should I assume that he’s not – and there’s a question, he may still be alive. What the Gemura is saying there, is can I rely upon the fact if there’s a lack of heartbeat, can I assume that he’s dead. But the Gemura is not saying, the Gemura is no way saying, that if I do find a heartbeat, this was, look, until 30, 40 or 50 years ago, nobody would say that if somebody is breathing that he was dead. There’s no reason to think that way. I mean, when his heart beats, you assume the person to be alive, why not?
Interviewer: “But in the case today now when you have a ventilator…”
Rabinowitz: That’s something else. We are talking about naturally speaking, even though this was a known fact, even hundreds of years ago, that the heart can continue to beat after the person dies, you can take the heart out of the body and it will continue to beat. It’s a pump that can work… it works by itself, it’s autonomous, for a certain amount of time, it can continue to beat. It’s not absolute proof of life, but from a practical standpoint, if I see a heartbeat I assume the person is alive, unless they have enough evidence to the contrary.
Interviewer: “such as?”
Rabinowitz: And that brings in the whole concept of brain death. If I can prove that there’s brain stem death, that there’s no functioning in the brain, then I can, then I believe, and those that follow this opinion, can say, I can ignore heartbeat. But as long as I can’t prove brain death, there’s no question that I’m concerned about the heartbeat. Nobody is discarding the issue of heartbeat.
Interviewer: “But where do you see that in the Halachic sources. Halacha doesn’t mention brain. Maybe in Ohalot, but not in Yuma.
Rabinowitz: The Gemura in Ohalot, see, the Gemura deals with cases, the Gemura is not dealing with… the Gemura doesn’t set up a theoretical thing, ‘how am I going to define life or death?’. The Gemura is dealing with a practical question: what happens when you find it says “nafla alav mapolet” (??), if debris or if a wall caved in on the top of, or fell on a person. Well it’s Shabbos, obviously I have to do everything to try to save his life, as long as I have any chance, any remote possibility, that the person’s alive, I have to do everything to save his life. That is what the Gemura is dealing with. If I will see a heartbeat, there’s no question that I have to be concerned that maybe he’s alive. I don’t think anybody even today, if you find somebody lying there and his heart is beating, even if you don’t see him breathing, you’re not going to declare him dead. I don’t think anyone will say that.
Interviewer: “So now apply it to a person in a hospital whose brain stem is dead who is being ventilated… you see a heartbeat.”
Rabinowitz: That’s something else. I cannot prove, all I can say is that the Gemura Yuma that is being referred to, is a question, is it proof to the contrary but it doesn’t prove brain death. I don’t think it runs counter to brain death, but you cannot prove brain death from there. The source, the main source, for the concept of brain death, is the Mishnan Ohalos. The Mishnan Ohalos states clearly that if you find a human being, or an animal, whose head has been chopped off, automatically, that human or animal is considered dead for all purposes, even though we see movement in the body. And the example they give, it’s like if you chop off the head of a lizard, the tail of the lizard will still continue to wag, will still move around. Well, this is anytime anybody has seen a slaughtering of a chicken, you chop off the head of a chicken, the chicken will still run after the head after the head is chopped off, but nobody is going to say the chicken is alive, the chicken is dead. That’s what the Mishna says there.