Rabbi Shabtai Rappaport
Chacham Tzvi & Chatam Sofer
[5 minutes 29 seconds]
Chacham Tzvi writes that the definition of life or death is the heart. If the heart is absent, you have death. The Chacham Tzvi was contradicted 150 years ago by many poskim. And the chief among them was Rav Yehoshua Mi Kutna, that proved that in halacha an animal that a heart was removed is not dead. And the proof that an animal that the heart was taken out it was part of pagan ceremony, to remove the heart while the animal was alive and offer it to the pagan god. The Gemara says that the animal, you cannot use it anymore, it’s considered to be ke kurban leAvoda Zara, a sacrifice for Avodah Zara [pagan worship].
Now, you remove the heart and then you present it to the god, so if I considered the removal of the heart as the death of the animal then the presentation to the god was after the death. So this is not sacrifice for Avodah Zara, because anything that happens after the death of the animal is not called “sacrifice”. So Rabbi Yehoshua proved before the whole thing started before the organ transplants started, before more than 100 years ago, he proved that the Chacham Tzvi was wrong because the heart is not the determination of an animal, of a human being also, is not the main factor of the life. This is the Chacham Tzvi.
Chatam Sofer was a different issue, he didn’t think that the heart is the issue, he just writes that the death is the, he said that death can only be determined 72 hours after the physician says that the person died. But Sofer writes, no, when the heart, when the breathing and the heartbeat stop this shows that a person is dead. It’s no different at all, the classical definition that was in halacha. But Chatam Sofer says that if a person stops breathing but his heart is still functioning he’s still alive, there’s no doubt about it, of course it’s true, why? Because the breathing is not life. I talk – so I don’t breathe. I don’t inhale, doesn’t mean that I am dead. If I was dead I’d have to leave the place because I’m a cohain [priest]. So the thing is you’re alive not when you breathe, you’re alive as long as the breath affects you. As you still enjoy the effects of the aspirating. Which means if we are really interested in considering the exact moment of death, for example for inheritance. Who died first? So the last breath is not the death, it’s the last breath and the effect of the last breath. What is the major effect of the last breath? The heart function. When the heart stops beating so we see that the last breath – you finished, you used up what was stored by the last breath.
Hence, of course, when a person breathes autonomously then the termination of death is not the cessation of the breath but the cessation of the heart function, this is true. But it has nothing to do to a person who is ventilated, since the ventilator is not living function as Rav Moshe says, so the heartbeat is a result of artificial ventilation, he is not considered to be alive. So if enough time passed, and we know from experience that no stores of oxygen remain from the last natural breath, the last autonomous breath that a person is breathing, and still his major living functions because of this last breath, he’s still considered to be alive until the major living functions will cease, this is what we call the cessation of breathing, the effect of the breathing stop.
When a person is ventilated, since Rav Moshe said that the ventilation is not considered to be a living function, because it’s a mechanic function not living function. The effect of the ventilator cannot be considered living function. If enough time passed from the last natural breath, that we know that no effect could have lingered 2 hours, 3 hours, 24 hours passed from the last natural breath, so no effect of the last natural breath was lingered, is lingering. And we know that without the ventilator they would have been definitely dead. So the living function of the organs definitely attributed to the ventilator, and ventilator is not life. So it has nothing to do with Chatam Sofer, so what changed the picture was the life support system.
The life support system, the mechanical breathing, changed the whole picture. A person could be dead when his organs are alive. But without life support system, the Chatam Sofer is 100% right. As long as the heart is beating, the person should be considered to be alive.
Until now, if in a hospital they’ll have to determine death of a person who is not on life support but he’s in the hospital on a normal bed. Of course they’ll have to wait until the cessation of the heartbeat in order to determine his death like the Chatam Sofer said and Rav Moshe doesn’t argue against that.
So many tshuvas that Rav Moshe wrote in the 60s, that as long as the ECG, electrocardiogram is functioning the person is still alive, of course it’s all true, when there is no life support system. The life support system changes the picture.
The life support system started mid-70s, so every tshuva of any posek [decisor] that discusses life or death should be said that before 76 it’s one story and after 76 it’s another story. And heartbeat is not a sign, a heartbeat does not show life only after 75, 76, only for a person who was on life support system.