March 26, 2008
Haredim and Organ Donation, part 2
Just when you thought the debate between the rabbis who support organ
donation (including Rabbis Ovadia Yosef
and Shlomo Amar) and those who
oppose it (Rabbi Yosef Shalom Elyashiv)
couldn't get stranger, this happens:
A hand picked representative of haredi
leader Rabbi Yosef Shalom Elyashiv
explained
Rabbi Elyashiv's halakhic
position:
…MK Moshe Gafni (United Torah
Judaism), speaking on behalf of Lithuanian rabbi Yosef
Sholom Eliashiv, Tuesday
urged all Jewish people to “ask doctors to keep treating a brain-dead relative
until he either recovers or his heart stops beating.”…
…"[Brain stem death] in essence means that someone who
has suffered a stroke or aneurysm can in essence be declared dead.”MK Gafni, in keeping with Eliashiv's views, objected to this law at every stage of
the legislative process.
…“Death should only be declared with the cessation of
cardiac activity,” he said. “From the Torah’s point of view a brain-dead
individual is still alive. Today, with all the recent advances in medical
science, a person who is brain-dead can be saved by doctors.”
You can read a detailed
post on the halakhot of organ donation here,
along with links to teshuvot, videos and papers on
the issue, most in English.
The basic mistakes in Gafni's position are as
follows:
- "[Brain
stem death] in essence means that someone who has suffered a stroke or
aneurysm can in essence be declared dead.”
This only true if the patient has no gag reflex, if
his cornea can be touched and the patient does not blink or respond, if he can
be pricked with needles and not respond, and if a scan done with radioactive
dye shows no blood circulation to the brain stem. And then, when disconnected
from the ventilator, the patient must have no spontaneous breathing.
What Gafni said is also
true of a patient who had a massive heart attack or who was struck in the head
by a large stone or who was injured in dozens of other ways.
It isn't like a person has a stroke, God forbid,
and the doctors say, "Hey we need a kidney and a couple of corneas – let's
declare this guy dead."
- “From
the Torah’s point of view a brain-dead individual is still alive."
This is false. Hundreds of Orthodox rabbis hold
brain stem death is death. Rabbi Elyashiv, however,
thinks differently.
It would be correct to say that, from one position,
this is true. It is, however, completely false to claim that position as the
position of the Torah in exclusion to all others.
- “Death
should only be declared with the cessation of cardiac activity.”
Again, this is false. Historically, Jews have
always determined death by cessation of respiration. Halakha
does not call for special tests to make sure the heart has stopped beating. But
it does call for a special test – the use of a feather – to determine if
respiration has truly ceased. If it has, the patient is, unfortunately, dead.
If a body is artificially ventilated, the heart
will continue to beat for days, sometimes weeks or months. Rabbis Tendler and Steinberg proved this years
ago by surgically decapitating a sheep. The sheep was vented before
decapitation and remained vented after. The heart continued to beat
for 4 hours, even though there was no brain. (It could have
continued to beat for days, but the cost of maintaining the sheep on life
support was so high – $7,000 at that point – the experiment was ended.)
Rabbi Elyashiv would view
that headless sheep (if it were a headless man) as alive and would mandate full
treatment indefinitely to 'preserve' his 'life.'
- "Today, with all the recent advances in medical science, a
person who is brain-dead can be saved by doctors.”
This statement is foolish beyond belief. Like
everything else Gafni says here, it shows a complete
lack of knowledge of science. If doctors could save the life of brain stem dead
people, they'd do it. But they can't, because we lack a way to rejuvenate a
dead brain.
Cardiac death has never been the determining factor for halakhic
death. It has always been cessation of respiration.
When a heart can be kept beating for days even though the head has literally
been decapitated, judging death by cessation of cardiac function is both
foolish and bizarre. We have no way to fix a dead brain. If and when that fact
changes, then our definition of death should change to accommodate it.
But, sadly, that time has not yet come, and Rabbi Elyashiv's
position only brings more death.
His brain stem dead patients will never walk, speak, react, or live again.
They will simply remain attached to a machine that keeps their lungs pumping
and, therefore, their heats beating. And this will continue until, one by one,
all their organs fail.
All this is even more obscene when you realize Rabbi Elyashiv
considers
organ donation to be murder, yet he allows his followers to receive cadaver
organ donations. His followers profit from a system they do not support, and do
not donate organs to.
This has in led every country in the western world, save the
So even more Jews die unnecessarily, waiting in vain for
transplants that never come.
Previous post including links to primary sources.
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What about the story that broke two days
ago with Zach Dunlop who awoke after being pronounced brain dead, and his
organs just about to be removed?
1. We don't really know what happened
there.
Was there a malfunction of the scanning equipment or a mistake made with the
dye injection?
Is someone lying or mistaken about tests done or test results?
Is it simply a one in a billion freak occurrence?
2. We don't make law based on freak occurrences.
3. We also do not make law based on the rare medical error or technological
failure.
I want to follow up on one point. Why do Poskim, when they take a position, demonize those who take
a different position? Why is there no one who says this is how I see the halachah, others might see it differently? I spent Purim
with a cousin of mine who is a
If you read Moshe Tendler's translation of Rav Moshe's teshuvot on medical
questions, you see how much time Rav Moshe spent
studying with DOCTORS, (including someone that I knew very well) as to why
medicine moved to brain death and what it was. Once he understood the scienctific facts, he was able to make the psak. It is ridiculous that people who have no idea of the
facts feel free to come up with halachic rulings.
First the facts must be established and understood. Only then can the law be
applied. If the facts are wrong the halachic decision
is meaningless.
I think one reason for the high emotions
in this particular issue is that we are potentially dealing with murder. If Rav Eliashiv is right, then those
who disagree are agreeing to murder helpless patients. If he's wrong, then
those who follow him are agreeing to deny other patients a chance for a longer
life. Very high stakes lead to high emotions.
But beyond that, there is now a trend towards consolidation in Chareidi thought. Multiple ideas, points of view, or
approaches are being considered anathema. There is only "strict" and
"stricter" and any deviation from that, no matter how minor, is
treated with fury and hatred. It's a sign of intellectual contraction, if you
ask me.
--Again, this is false. Historically, Jews
have always determined death by cessation of respiration. Halakha
does not call for special tests to make sure the heart has stopped beating.--
I suspect Gafni doesn't really understand what he
is talking about or Rabbi Elyashiv's psak. Unlike respiration, the heart beat is an independent
function that is not dependent on the brain. Under normal circumstances where
respiration ceases for some reason or another, the heart can continue beating
for ten minutes or more. The heart would then fail due to lack of oxygen, not
because it is dependent on any other bodily function.
--Is it simply a one in a billion freak occurrence?--
It may be one in a billion where the guy got up and walked away, but
approximately one in a thousand brain death diagnosis turn out to be faulty
(i.e. when they shut down all life support the person continues to live and
breath on his own).
--Again, this is false. Historically,
Jews have always determined death by cessation of respiration. Halakha does not call for special tests to make sure the
heart has stopped beating.--
I suspect Gafni doesn't really understand what he
is talking about or Rabbi Elyashiv's psak. Unlike respiration, the heart beat is an independent
function that is not dependent on the brain. Under normal circumstances where
respiration ceases for some reason or another, the heart can continue beating
for ten minutes or more. The heart would then fail due to lack of oxygen, not
because it is dependent on any other bodily function.
--Is it simply a one in a billion freak occurrence?--
It may be one in a billion where the guy got up and walked away, but
approximately one in a thousand brain death diagnosis turn out to be faulty
(i.e. when they shut down all life support the person continues to live and
breath on his own).
approximately
one in a thousand brain death diagnosis turn out to be faulty (i.e. when they
shut down all life support the person continues to live and breath on his own).
Source?
If what you mean to say is 1 in 1000 fail the apnea test, then say that.
Zach Dunlap
http://www.abc.net.au/worldtoday/content/2008/s2198491.htm
Shmarya,
If it's a technological or assesment failur with the Zach Dunlop story thenperhaps
you are right. But if it's a fact he was brain dead and got up, then there
cannot be a discussion of %%%%%. it makes no
difference if it's a 1 in a million or in 10 million that wakes up from this
condition.
We won't kill a person just in order to save another 50 people's lives. Even if sick and frail.
--Source?--
Don't recall off-the-cuff. Will try to look it up later if
I have a chance. Please note that the results are geographic specific as
the practice of diagnosing brain death differs.
--If what you mean to say is 1 in 1000 fail the apnea test, then say that.--
No. What I mean is that the person is diagnosed as brain dead and when they
disconnect the life support equipment they find that there is spontaneous
respiration. Which continues for some time, though most often
even the one in a thousand with spontaneous respiration will die within a day
or two.
Multiple ideas, points of view, or
approaches are being considered anathema.
Similarly, the town rav is losing his influence
because of this attitude. A papacy for Orthodox Judaism is on the horizon.
it
makes no difference if it's a 1 in a million or in 10 million that wakes up
from this condition.
Really?
That is not how halakha works.
There is a greater chance that you will run over and kill a person on the
way to shul than there is an event laike the Zach Dunlop case will recur.
Does that mean you cannot drive to shul?
Please.
Can a cow be hooked up heart and brain
monitors to see how long it takes to die, medically, after shkhita?
Or was this already done?
It was done with a decapitated sheep. The
poor beast was kept "alive" (heart beating) for some time.
I mean to do nothing but monitor how long
it takes for the anumal to die. To see how long after
severing the two major arteries the animal is dead.
And then to measure that against say a retractable bolt to
the head.
Anyone want to talk about the diagnosis
of " presistent vegatative state" ?
I mean to do nothing but monitor how
long it takes for the anumal to die. To see how long
after severing the two major arteries the animal is dead.
Had to do on an animal that large. It could be
done, I suppose, if it were sedated first.
B"H
Shmaryah
Arik Sharon remember the famous "surgeon"
who cut the Jews out of Gush Katif is laying in
persistent vegetative state
to quote Wikipedia:
Medical experts have indicated that Sharon's cognitive abilities were destroyed
by the massive stroke, and that he is in a persistent vegetative state with
extremely slim chances of regaining consciousness.
http://en.wikipedia.org/wiki/Illnesses_of_Ariel_Sharon
Would you like to find a posek who would allow to
start donating his organs now
(which would also surely free up some money to help some of the Jewish families
still screwed by his "surgery" on Gush Katif.
see:
http://video.google.com/
&esrc=sr1&ev=v&len=699&q=never%2Bagain
2Bgush%2Bkatif%26total%3D9%26start%3D0%26
num%3D10%26so%3D0%26type%3Dsearch%26plindex%3D0&usg=AL29H22x-KY
or would you like to be more stringent in this case
and rule according to R. Eliyashiv?:-)
PS.
By the way SamsonBlinded blog
reports that:
New law: Kidneys for tax breaks
Posted By admin On March 25, 2008 @ 8:24 pm In
feature, society | No Comments
Israeli Knesset approved the law which bans organ sales, and empowered
doctors to devour patients’ bodies while their heart is still beating (though a
lower brain becomes inoperative).
Family members will receive financial benefits for complacence, as will the
living donors of kidneys.
http://samsonblinded.org/
news/new-law-kidneys-for-tax-breaks-1942
So this seems to be one more reason to cut up the former hero/rosh ha'memshalah/ethnic cleanser
of Gush Katif in pieces to squeeze at least some good
out of him while it is still possible.
What do you think about this wonderful idea?:-)
With all the talking about brain death
and cardiac death, first of all does Eliyashiv have
the same standard for humans and cows?
And second of all, can't the quickest and most painless death to a cow be
scientifically determined? How quickly does the brain die from Shkhita? When does the monitor flatline?
Sedate it if necessary, and then send the carcass to a non-kosher butcher, and
shoot one in the head, and use a retractable bolt (No Country for Old Men) on
another and see what causes the poor cow to die fastest. 1,000s are slaughtered
a day. Maybe a smooth blade was most humane 3,000 years ago, but now a
retractable bolt actually causes less pain, causes death faster.
Bolted and Salted instead of Bosser Kosher.
Ariel –
You are truly disgusting.
Now spend some of your copious free time boning up on the difference between
a PVS and brain stem death,
"Does that mean you cannot drive to shul,"
Shmarya, Halacha does
not work with statistics. And if you ever studied the "bavos"
you would learned the concept of what a "chazaka"
really is.
IF someone is on his deathbed, and 99.99% die, you cannot pull the plug on
them even if there is that 0.000000001% that he will live.
On the contrary, your analogy of drving to shul is just way out of whack.
Actually, I've learned quite a bit,
including a lot of medical halakha.
I'll phrase the question differently for you:
There is a bad snow storm.
You're sitting with a brain stem dead patient and the ventilator fails. The
patient does not breathe spontaneously.
You give him mouth to mouth resuscitation. His lungs inflate only when you
do this. The minute you stop, the brain stem dead patient ceases to 'breathe.'
You call Hatzalah for help.
Should that ambulance driver and his crew of EMTs
drive to 'save the life' of that brain stem dead person who is not breathing
spontaneously and who never will?
After all, there is a far greater likelihood that a Hatzalah
driver or EMTs will die in a vehicle accident then
there is that a brain stem dead individual will miraculously return to life.
What confuses you is the definition of life.
According to halakha, life means the ability to
spontaneously breathe.
A brain stem dead patient cannot spontaneously breathe, because the part of
his brain that controls breathing has been destroyed.
That is why he is dead.
Just because we can artificially breathe for a brain stem dead patient does
not make that patient alive.
Indeed, we can do the exact same thing for a headless body.
In your mind, would that 'breathing' headless body be alive?
Your mistake is paskining from the miraculous.
What happened to that guy in
Yet you want us to pasken as if it were normal.
And you want this no matter how many other people it hurts or kills.
Ariel,
Thanks for giving us that personal and sickening display showing us what
brain death is even when the heart is still beating although your heart also
doesn't seem to do what it's supposed to.
Phil
B"H
Ariel –
You are truly disgusting.
Now spend some of your copious free time boning up on the difference
between a PVS and brain stem death,
Posted by: Shmarya | March 27, 2008 at 04:50 AM
Shmaryah
I do know there is a difference.
The reason I wrote the above comment is to mock your
"ultra-utilitarian" Socialist approach to halacha by taking it to its logical extreme.
As you may remember Terry Schiavo also was in PVS not
brain death.
This is so rich of SHmarya
to criticize rabbis for what he deems to be not respecting other opinions when
he has never subscribed to the concept of Eilu veEilu divrei Elokim
chaim when HE doesn't like another opinion.
It's besides the fact that SHmarya does not even
reach the ankles in learning of these rabbis nor in
medical knowledge of the experts.
Shmarya calls some of his readers
"blowhards" when he is not qualified to offer an opinion in these matters,
yet he promotes himself as if he is a peer of all the experts or even greater
than them.
Rabbi DW, perhaps your
One of the problems with Rackman is that he
illegally nullifies marriages thus producing mamzerim.
Shmarya
calls some of his readers "blowhards"
Just one or two, Bunker. You,
primarily.
Name calling aside SHmarya,
you come up very short on substance here and should leave this topic to the
real experts who are qualified to argue over it.
Name calling aside SHmarya,
you come up very short on substance here and should leave this topic to the
real experts who are qualified to argue over it.
I guess that would leave you out, Bunker.
That's correct Shmarya.
I have not inserted myself as a "bar plugta"
here because unlike you, I don't put on shoes that are bigger than my feet.
All I have done is pointed out that Tendler has
been accused of distorting Rabbi Feinstein's ruling.
You are not even a rabbi yet you think you are an authority on life &
death matters.
I am a rabbi (although I don't advertise my ordination) as well as having a
legal and a