March 25, 2008

"What is Yours is Mine, and What is Mine is Mine"--He is a Wicked Man: Haredim and Organ Donation

Israel finally, after many years of trying passed an organ donation law late yesterday. This is no small achievement. Why?

Haredim.

Ha'aretz reports:

The Knesset approved a law yesterday intended to regulate organ donations in compliance with Jewish law. The bill was passed with the support of the ultra-Orthodox Shas party.

The new law on brain and respiratory death was introduced by MK Otniel Schneller (Kadima), and it was accompanied by an exceptional process of discussion between rabbis and doctors. The bill enjoyed the support of senior rabbis from the Sephardic ultra-Orthodox community as well as from the National Religious camp, including the Shas spiritual leader Rabbi Ovadia Yosef and Sephardi Chief Rabbi Shlomo Amar. Ashkenazi interpreters of halakah, however, were in disagreement on the bill.

Politicians say the real test of the new law will be the publication of calls by rabbis for organ donation, defining it as a religious obligation. Ultimately, success will be determined by the rabbis' ability to convince the religious and traditional public to support organ donations.

The law determines, among other things, that brokering sales of organs, whether in Israel or overseas, is a criminal offense punishable by up to three years in prison.

According to Tamar Ashkenazi, who heads the National Transplant Center, 55 percent of the families asked to donate the organs of a family member refuse, and the number of potential donors is quite small to begin with. Donors are mostly accident victims, rather than those who die of disease. Such potential donors must have organs in good condition and must still be alive when they arrive at the hospital.

Out of the 145 families asked to permit organ donations in 2007, only 61 agreed. The organs from these 61 donors were transplanted into 231 people. This means every donor saved about four others.

According to Ashkenazi, half of those families that refused said they did so for religious reasons, with some saying they wanted to preserve the wholeness of the body. In practice, it is very difficult to differentiate between the two explanations.

The new law is expected to add dozens of donors a year, and could save the lives of another 100 to 200 people every year.

Why do Ashkenazi haredi rabbis disagree with the law? Confusion about what constitutes death:

Brain death usually precedes cardiac death. Most of the internal organs used for transplants - hearts, lungs and livers - need to be removed during the brain-death stage, since once the heart stops beating, they will no longer be fit for transplantation.

The Orthodox and ultra-Orthodox publics have almost completely refrained from donating organs until now. In the case of the ultra-Orthodox, their rabbis had not recognized the status of brain death, and therefore viewed the extraction of such organs as equivalent to murder.

Before going on it is important to realize that brain stem dead patients do not recover. Without a respirator they will die within a few minutes, because the brain does not have the ability to tell the body to breathe at a level to support life.

To understand the problem, let's go back 100 years or so and see how death was defined by halakha.

When a person was thought to have passed away, a member of the Chevra Kadisha or the town's rabbi placed a feather near the nose of the body and watched intently to see if their was any breathing. If there was not, the person was declared dead.

Rarely, this method failed and an unconscious  person whose breathing was very shallow and sporadic was misdiagnosed as dead. This accounts for the rare cases of "dead" bodies who "woke up alive" in their coffins.

Modern medical technology is far more advanced than the feather.

The halakha always was cessation of breathing determined death.

Today, because of respirators and other medical equipment, a person unable to breathe on his own can be kept alive. So how should halakha view this?

In two ways.

First, if the patient can breathe on his own, although that breathing is not really adequate to support life and the patient will eventually in a few hours or days die from lack of oxygen-profused blood and its related problems, that person should most always be kept alive. (There may be exceptions due to other serious issues like end stage cancer or the like.)

If a person cannot spontaneously breathe, and this is due to an irreversible brain injury that has caused brain stem death, that person may be disconnected from life support (carefully, under controlled circumstances and rabbinic direction). His organs may be taken for transplant.

This is the view of Rabbi Moshe Feinstein, of the RCA's committee, of most National Religious and Modern Orthodox rabbis, and, it now seems, of Rabbi Ovadia Yosef and other leading Sefardic rabbis. (Here is a video of Rabbi Moshe Dovid Tendler explaining brain stem death. He also explains the process for determining brain stem death and the difference between brain stem death and a deep coma.)

Despite overwhelming medical and halakic proof that brain death is halakhic death, Israeli haredi rabbis like Rabbi Yosef Shalom Elyahiv disagree. They view the harvesting of organs as possible murder. It may be interfering with a gosses, a person in his death throes. And halakha, they are quick to point out, forbids us to touch a gosses or to hasten his death. They do, however, accept the possibility brain death is death.

Confused by the issues of life support and artificial respiration, they want to use cardiac death as the gold standard for halakhic death, even though cardiac death was never the halakhic standard.

To clear this up, years ago Rabbi Moshe Dovid Tendler, Rabbi Steinberg and and others arranged and experiment. Rabbi Tendler had told Rabbi Shlomo Zalman Auerbach about a brain dead woman who was kept alive for almost two months until her child was developed enough to be born by c-section. Rabbi Auerbach argued based on a Gemara, that a fetus will die before its mother, because the fetus is weaker. He refused to believe the woman was brain dead. So here is what Rabbi Tendler, Rabbi Steinberg and others did.

A sheep was put on a ventilator and then decapitated. Its heart was kept beating for four hours afterward. (it could have been kept beating for days, but the cost of doing so was astronomical.) Rabbi Tendler showed that brain stem death was not much different than decapitation remove the respirator and the patient will not spontaneously breathe. Even so, his heart will continue to beat while the respirator is attached.. (Rabbi Tendler explains this experiment toward the end of this video.)

Rabbi Tendler says Rabbi Auerubach accepted this as proof that brain stem death is halakhic death. But Rabbi Auerbach did not publish a responsa on this before his death.

Other Israeli haredi rabbis rejected this argument, first on the grounds of touching a gosses to determine brain death. Rabbi Tendler and others made short shrift of the argument by simply pointing out the dye needed to measure brain function would be injected into the patients I.V. line following their protocol, the patient would not be directly touched.

Israeli haredi rabbis then shifted the argument, claiming cardiac death, not cessation of breathing, was the halakic standard for determining death.

And so things sat for more than 20 years.

It should therefore follow that haredim who are followers of Rabbi Elyashiv, the Gerrer Rebbe, Rabbi Steinman, other hasidic rebbes, etc., would consider organ donation to be possible murder would refrain from taking donated organs. After all, what right would these Jews have to benefit from "murder"?

Further, because haredim do not donate organs, one would think they should not ethically benefit from the scarce organs that are available. Other Jews who do donate should get first crack, right?

Wrong.

Haredim, while they will not donate organs, will take organs others donate, "murder" or not. Further, they often take places in line ahead of other Jews who are registered organ donors.

While Rabbi Elyashiv and other may see this a leniency, a kula, allowing haredim to have a chance for life where otherwise they would die.

The problem is, that chance at life comes at the expense of others who are denied that chance by Rabbi Elyashiv's actions.

Pirke Avot 5:13 notes:

There are four types among men:

He who says, "What is mine is mine and what is yours is yours"--this is the common type, though some say that this is the type of Sodom.

He who says, "What is mine is yours and what is yours is mine"--he is an ignorant man.

He who says, "What is mine is yours and what is yours is thine own"--he is a saintly man.

And he who says, "What is yours is mine, and what is mine is mine"--he is a wicked man.

Ha'aretz continues:

Within the national religious community, there was a serious crisis of faith vis-a-vis the medical establishment, which led to a lack of agreement on determining the moment of death.

Schneller led a process intended to overcome this problem. According to the bill that was passed, a committee will be established to follow the situation and reach agreement. The committee will include rabbis, doctors and ethicists. It will also authorize doctors who will be responsible for determining brain death.

The doctors will determine brain death by using a series of different tests that will verify complete cessation of [spontaneous] breathing and brain activity. The family can object to organ transplantation, even if a patient is brain dead. [All this was the practice before the law was passed, although there were problems sensitizing doctors to the needs of Orthodox families, largely because the state had not passed a law to do so and had no real apparatus in place to set standards. And it lacked this for several reasons, one of which was haredi opposition.]

MK Chaim Amsellem (Shas) explained yesterday that the great advances in medical instrumentation of recent years are what enabled yesterday's breakthrough. "For the first time, there is a clear and final statement of rabbis that the end of brain activity is death. The minute a person is declared dead, it is clear that the donation is life-saving and a religious commandment," explained Amsellem. [This same "first time" happened in America more than 20 years ago, based on basically the same medical technology.]

Haredi Opposition

The United Torah Judaism (UTJ) party objected to the law. Its leaders, led by Rabbi Yosef Shalom Elyashiv, insist that religious law does not recognize brain death as death. MK Moshe Gafni (UTJ) told the Knesset plenum yesterday: "A brain-dead person is a living being." Such opinions are expected to make the promotion of organ donations difficult.

The law passed yesterday by a vote of 38 to 17.

Until now, the rules governing transplants were ordinances set by the director general of the Health Ministry. The courts have ruled a number of times that there was a need to legislate the matter in law. One of the results of a lack of a legal basis was the inability to prosecute organ brokers, said Ashkenazi. Instead, such cases usually were prosecuted on the basis of peripheral issues, such as tax evasion.

What was controversial was the acceptance of two amendments proposed by Finance Minister Roni Bar-On, which cancelled budgets intended to encourage donations. The main funding was to be for educational and promotional activites, at a cost of NIS 5 million a year.

Israeli take far more organs worldwide than they donate, so much so that Israelis have been banned from international transplant waiting lists everywhere but the United States.

As Rabbi Moshe Dovid Tendler noted years ago, Jews cannot be seen as people who take donated organs (thereby excluding others from receiving them) but who themselves do not donate. (Video.)

Soon, Rabbi Tendler said, all Orthodox Jews will be banned from receiving donated organs because of the actions of these rabbis.

Israel was forced to act.Still, beacuse of haredi opposition, that action took years.

This new bill may stave off the crisis for a time. But if secular Israelis and their black-robed counterparts don't start giving if, God forbid, they are put into a position to do so, the day may really come when Jews die because transplant lists are closed to them.

And you'll be able to thank Rabbi Yosef Shalom Elyashiv, the Gerrer Rebbe and many other so-called gedolim for that.

Halachic Organ Donor Society.

Halakhic issues (videos). Halakich issues (articles). Documents.

Medical issues.

Brain death from a secular perspective (warning - very dated) (video).

UPDATE: Part 2.

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seraphya

So if an animal is "alive" after shechita, as it appears they would say because the heart is still beating, isn't that a gross violation of tzar baale chayim?

Shmarya

There is a halakhic understanding that, after shechita the animal needs a few seconds to bleed out, lose consciousness and die.

Yet, many haredim view the animal as dead immediately after the shechita cut, even if the animal is trying to get up and run away.

Many of these same rabbis seem to hold like Rabbi Elyashiv when it comes to brain death, which seems to be a bit of a contradiction.

But this is not and should not be a discussion of shechita. We can do that elsewhere on this blog.

Kathy

Wow good thing I was in the USA at a time when I was able to receive a heart transplant and live! I think HaShem was watching over me. Rabbi Elyashiv would deny many a chance at life! It's too bad people are so afraid of him and his power that they will not stand up to him and let him know how wrong he is on many issues. By the same token more Jews should go ahead and donate organs and consider it a Mitzvah because they would be saving a person's life or sometimes many people's lives who would otherwise die. Isn't it a greater good to save life? One should not stand idly by and watch another person die either! I think they should take to heart the old saying, "He who saves the life of one [Jew] is as if he saved the whole world".

seraphya

I know, just was pointing out that its a complete contradiction

Ariel Sokolovsky http://www.BostonChabad.com

B"H
A video lecture that makes interesting points about time of death, shifting definitions in "medical ethics" and organ donation:

Intro to Medical Ethics rtsp://yeshivalive.net/tiferesorg/video/tbts64/bb060904a.rm

Yochanan Lavie

Didn't Rav Moshe Feinstein okay organ donation after brain death?

Shmarya writes: Many of these same rabbis seem to hold like Rabbi Elyashiv when it comes to brain death, which seems to be a bit of a contradiction.

It's not a contradiction. Perhaps brain death is not the end of life after all. Look at all those followers of flesh and blood idols...

MalachHamovies

Shmayra,

You have to start posting about the kid that was shipped to a jamaican concentration camp under the auspices of the rosh yeshiva of chaim berlin. Check out jewish survivors and UOJ for more details.

Garnel Ironheart

Brain death and brain stem death are not the same thing. Brain death means loss of function of the cerebrum, the higher portions of the brain. However, respiration and much of the homeostasis of the body is controlled from the brain stem which sits below the cerebellum and at the top of the spinal cord. A person can be brain dead but if his brain stem is functioning, he can continue living as long as iv fluid is provided to prevent dehydration.

Secondly, the reason cardiac death, which was never considered in older sources, is so important now is because we now have ways of measuring it. Indeed, there are times when one, using ECHO ultrasounds and invasive monitoring, can pick up faint heart beats in the absence of a palpable pulse. Now, usually a heart this bad off is about to die anyway but that's not the point. The point is that at that moment it's still moving. So those authorities who are concerned for cardiac activity base their opinions on this phenomenon.

Finally, excellent articles on this can be found in books by both Rav J David Bleich and Dr. Fred Rosner. Both make absolutely clear that brain-sterm death = death. The only question is how to determine if a person on a respirator is brain-stem dead, but once determined to be, only an idiot (hence the position of UTJ) would say the person is still alive.

Archie Bunker

It would be refreshing to see some honesty from Shmarya for a change. Instead, we see the same old routine where he leaves out numerous facts that would make it more difficult for him to demonize Rabbi Elyashev.

Rabbi Tendler has been accused of distorting Rabbi Moshe Feinstein's rulings on death and elsewhere. There is another HODS video where they ask Rabbi Dovid Feinstein if he believes Tendler is distorting his father's ruling. RDF dances around the question without answering.

Shmarya is arrogant and not nearly as learned as most people he quotes. It's not up to him to decide whether the Mishna in Avoth applies here. How about this? A person who donates his organs has given up any claim to them upon dying - no matter how they died. No one is "taking" from the deceased. Organ distribution is decided by govt authority from what is "hefker".

Shmarya also conveniently omits Rabbi ELyashev's ruling that it is forbidden to take organs from China where able bodied political prisoners are murdered to profit from organ harvesting.

ploni

http://ca.news.yahoo.com/s/capress/080324/health/health_not_dead

Archie Bunker

SHmarya claimed in the name of the Gra on Shulchan Aruch OC 2:6 that one need not wear a yarmulka even when reciting a blessing.

I tracked down the Biur HaGra on Orach Chaim siman 2. The Gra is entirely unclear in that short comment and one cannot deduce what his position is without examining his commentary elsewhere.

The Gra in siman 91 as a matter of fact cites a ruling in tractate Sofrim that it is REQUIRED to wear a yarmulka.

Perhaps Shmarya confused the Gra in 91 with Rabbi Akiva Eiger there who cites a Terumas Hadeshen that one cannot explicity prohibit not wearing a yarmulka. Even still, I am not aware of any halachic authority that rules like the Terumas Hadeshen and custom overrules any previous halachic rulings to become de facto halacha. This itself is a halacha which SHmarya seems intent to deny at all cost.

More to come on the Yarmulka issue now that I again have access to the library in my shul.

shmuel

Archie,
Forget your library. Just read "Yarmulke: A Historic Cover-up?" by Dan Rabinowitz in Hakira-The Flatbush Journal of Jewish Law and Thought, Vol. 4, Winter 2007, pp. 221-238. Maybe Shmarya meant the Gra's comment on O.C. 8:6, not 2:6.

gross

Shmarya,

I am curious about a separate, rather ubiquitous issue of burying an intact-since-time-of-death body. I would imagine that most poskim hold that living donation of a "non-vital" organ like a kidney is permissible so long as the donor has the other kidney intact and functioning (rendering the donated kidney non-vital.) But even if respiratory cessation might be considered death, is there a separate issue of not touching any of the organs now that death has ensued?

Noclue

Of course, there is the widely reported recent case of a brain dead patient whose organs were about to be harvested but who woke up in time to prevent it.

Nobody has offered any good explanation for this. Perhaps you can.

Yosef Ben Matitya

the biggest problem is, a haredi rabbi will never allow donating organs for gentiles.
otherwise, i can't see them refusing to donate to omygad- a felloejew! with organs taken from felloejew or fellowgoy!

Archie Bunker

"there is the widely reported recent case of a brain dead patient whose organs were about to be harvested but who woke up in time to prevent it."

Please don't confuse Shmarya with facts. He might get unsettled and question your intelligence.

Archie Bunker

"Dan Rabinowitz in Hakira-The Flatbush Journal of Jewish Law and Thought, Vol. 4, Winter 2007"

Is that available anywhere online?

gross

Archie,

Found it. Copy and paste:

http://www.hakirah.org/Vol%204%20Rabinowitz.pdf


If you want a less optimized (not formatted and sans photos) but easier web version, try here: http://72.14.205.104/search?q=cache:Fh7Dg6t4Nn4J:www.hakirah.org/Vol%25204%2520Rabinowitz.pdf+http://www.hakirah.org/Vol%25204%2520Rabinowitz.pdf&hl=en&ct=clnk&cd=1&gl=us

Yoel B

Ah, yes. Scientific certainty.* Impeccable physicians. Note that AP ran these 2 stories the same week Now mix the Israeli Rabbinate in.

*Man Declared Dead Feels 'Pretty Good'

OKLAHOMA CITY (AP) Four months after he was declared brain dead and doctors were about to remove his organs for transplant, Zach Dunlap says he feels "pretty good."
Dunlap was pronounced dead Nov. 19 at United Regional Healthcare System in Wichita Falls, Texas, after he was injured in an all-terrain vehicle accident. His family approved having his organs harvested.
As family members were paying their last respects, he moved his foot and hand. He reacted to a pocketknife scraped across his foot and to pressure applied under a fingernail. After 48 days in the hospital, he was allowed to return home, where he continues to work on his recovery.
On Monday, he and his family were in New York, appearing on NBC's "Today."
"I feel pretty good. but it's just hard ... just ain't got the patience," Dunlap told NBC.
Dunlap, 21, of Frederick, said he has no recollection of the crash.
"I remember a little bit that was about an hour before the accident happened. But then about six hours before that, I remember," he said.
Dunlap said one thing he does remember is hearing the doctors pronounce him dead.
"I'm glad I couldn't get up and do what I wanted to do," he said.

http://ap.google.com/article/ALeqM5iaSD7rm6dRosapRR9aKKcWQXpHLwD8VJRDM81

Calif Transplant Doctor Ordered to Trial
By LINDA DEUTSCH, AP Special Correspondent
Thursday, March 20, 2008

(03-20) 21:30 PDT Los Angeles (AP) --
A transplant surgeon accused of hastening the death of a man so his organs could be harvested has been ordered to trial on one count of felony dependent adult abuse, but two other felony charges involving administration of drugs to the dying man were dismissed.
The criminal case against Dr. Hootan Roozrokh of San Francisco is the first such action against a transplant doctor in the United States.
After a preliminary hearing in San Luis Obispo County, Superior Court Judge Martin J. Tangeman issued a ruling Wednesday describing an uncoordinated scene surrounding the 2006 death of Ruben Navarro at Sierra Vista Regional Medical Center, which had never handled a "Donation After Cardiac Death (DCD)" case.
Navarro, 26, had a debilitating neurological disease and was in a coma when he was admitted to the hospital after a heart attack.
His mother had authorized harvesting of his organs but because he was not brain dead, the judge said, it was determined that the transplant procedure to be used would be DCD, which requires withdrawal of life support leading to death prior to recovery of organs...

http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2008/03/20/state/n174849D69.DTL&hw=transplant&sn=002&sc=735

Anon

--Israel was forced to act.Still, beacuse of haredi opposition, that action took years.--

Wrong. It took so long to work things out with the non-haredi orthodox groups. No one ever believed that they would work things out with the haredi groups so that was never the hold up, but the other groups were prepared to negotiate and compromise. Make no mistake about this, the end result is not what the other orthodox groups viewed as the optimal result, but is the result of estensive negotiations and compromise. As I pointed out last time Shmarya addressed organ transplant, his understanding of this issue is (intentionally or untinentionally) overly simplistic, even infantile. Virtually everyone, including virtually all haredi halachic authorities agree that full brain death is death. The issue is how thoroughly this needs to be diagnosed and how certain we need to be. There is no question that requiring absolute certainty will result in signficantly less organs being available for donation and result in loss of life so this is a major moral dillemma for halachic jews. I'm not in a position to determine whether the compromises accepted by the orthodox factions that supported this legislation is appropriate or not from a halachic perspective. Neither is Shmarya in a position to do so - particularly when he seems to have all his facts wrong. The refusal of the haredi groups to support this is not because they would never accept brain death, but rather because they refused to accept any material uncertainty in the diagnosis. However, that would be a non-starter for the (non-religous) medical community. For the record, I am not taking the position that the compromises agreed to by the non-haredi orthodox groups are inappropriate. Organ transplants save lives so I believe that this warrants making halachically permissible compromises (i.e. this is not the place to adopt extensive chumrot). This is a tough issue which probably none of us are (certainly not Shmarya who either doesn't have his facts right or intentionally distorts them) are qualified to resolve. I am just trying to correct certain inaccuracies in Shmaryas post.

Anon

--Of course, there is the widely reported recent case of a brain dead patient whose organs were about to be harvested but who woke up in time to prevent it.--

Assuming this case does exist, could someone post a link to this. The medical community is advanced enough today that I would find such a case quite suprising. As I noted above and more extensively last time Shmarya posted about this topic, the push to advance the diagnosis of death is not because doctors are bad but because they are trying to save lives. It is a major moral dilemma that is treated differently in different jurisdictions and sometimes even between hospitals within the some jurisdiction. The problem is from a halachic perspective we can't weigh the benefit of one life against another - we need a definitive diagnosis of death. Of course what is "definitive" from a halachic perspective is subject to debate.

rabbidw

There are plenty of brain dead people that function. Many of them are Shul Presidents. Some are running for US President. Being brain dead can be an asset.

shmuel

Archie,
How about a thank you to me and gross? A bissel hakaras hatoiv? Think of all the work we saved you.
Well done, gross.

Shmarya

>>>SHmarya claimed in the name of the Gra on Shulchan Aruch OC 2:6 that one need not wear a yarmulka even when reciting a blessing.<<<

Archie,
Forget your library. Just read "Yarmulke: A Historic Cover-up?" by Dan Rabinowitz in Hakira-The Flatbush Journal of Jewish Law and Thought, Vol. 4, Winter 2007, pp. 221-238. Maybe Shmarya meant the Gra's comment on O.C. 8:6, not 2:6.

Posted by: shmuel | March 25, 2008 at 08:42 AM


Of course, that is exactly what I told Archie:

http://failedmessiah.typepad.com/failed_messiahcom/2008/03/senior-member-o.html#comment-106467006
Gra on Orach Chaim 8:6

Shmarya

As for brain dead patients who recover, this is extremely rare.

It happens when a patient is not brain dead but is, instead, in a deep coma and the physicians did not do the final test necessary to finalize brain death.

People who cite these extremely rare occurrences do not seem to cite the much more common incidents of "dead" bodies who "revived" in the coffin, even though the feather test had been used as halakha demands.

We don't paskin from the unusual to the usual.

Mistakes will always, God forbid, be made, no matter what system is used, no matter if organ transplantation is involved or not.

If halakha were forced to rule from the very rare mistake, nothing would ever get done, medically or otherwise.

Hundreds of thousands of people have been declared brain dead in the US. You can cite perhaps 10 or so cases of supposedly brain dead people "reviving."

Yet some supporters of Rabbi Elyashiv, et al, would have you believe this is a frequent occurrence. It is not.

As for Archie's 'defense' of RYSE, and his slur against me, I would point out I linked directly to the HODS page that has RYSE video.

Like much else of what Archie does, his case is overstated and based on false information.

gross

Shumel,

Forget Archie. I thank you for the fascinating article. Oh the lies we have been fed...

Archie Bunker

SHmuel please. Give me a chance to come back to this post so that I can thank you & Gross. I plan on taking a look soon.

Thanks

Archie Bunker

So even if it's only 10 people who were misdiagnosed as dead, Shmarya would rather sacrifice them in the name of harvesting their organs & demonizing Rabbi ELyashev.

My only comment about the videos is that one of them gets into the accusations that Tendler distorts Rabbi Feinstein's ruling.

"his case is overstated and based on false information."

It would be beneficial if SHmarya took a good hard look in the mirror.

Archie Bunker

WHen I finally got my hands on a Shulchan Aruch, I had not seen SHmarya's post for some time. I wasn't sure if he wrote 6:8 or 8:6. I checked both and did not find anything to support his claim. After following the flow in the Beit Yoseph, I found a cryptic passage in 2:6 and a clearer statement in 91. I later saw the Damesek ELiezer commentary on the Biur Hagra by Rabbi Shmuel Landau of Vilna says the intention of the Gra in 91 is that a yarmulka is required as I thought he meant.

I mentioned earlier that custom overrides earlier halachic arbiters. Rabbi Yitzchak Yosef in Yalkut Yosef says he was told by his father Rabbi Ovadya that even according to the more lenient Sephardic opinion, it has become binding custom to wear a yarmulka at all times.

Neo-Conservaguy

Shmuel, Gross: toda raba for the great article on the history of head covering. I'm no longer shocked when I see proof of manipulated/edited text in rabbinic writing; I've seen RaMBaM's statements tweaked to support certain views as well (Pesach kashruth).

I see Archie still can't admit he's wrong.

As for his remark:

So even if it's only 10 people who were misdiagnosed as dead, Shmarya would rather sacrifice them in the name of harvesting their organs & demonizing Rabbi ELyashev.

This proves Archie's inability to admit th etruth. It also shows his grasp of the halakhic process is quite weak.

Perhaps you could do us all a favor, Archie. Go away. Your pomposity and your ignorance are tiring.

Anon

--It happens when a patient is not brain dead but is, instead, in a deep coma and the physicians did not do the final test necessary to finalize brain death.--

Do tell us oh great one, what is the final test? The absolute "final" test is usually not peformed because it takes too long and you would loose organs. Perhaps that is still the appropriate way to go pursuant to halacha, but these errors are built into the system and it is misleading to say that these are because the doctor in question screwed up. The question is how much of a margin of error is okay.

--People who cite these extremely rare occurrences do not seem to cite the much more common incidents of "dead" bodies who "revived" in the coffin, even though the feather test had been used as halakha demands.--

This is rediculous. The much more common margin of error under the feather test was because medical technology was primitive at that time. It has no bearing on what we should do today when the relevant technology is widely available.

--Mistakes will always, God forbid, be made, no matter what system is used, no matter if organ transplantation is involved or not.--

Again, you are conflating two issues and you need to differentiate between human error and systematic error (i.e. errors that will be made even if all procedures are followed). Human error will always exist, though we need to monitor that doctors, even with good intentions, don't try to short cut the required controls and procedures. At issue here is what kind of systematic error should be acceptable. Having said that, the story mentioned about someone waking up to stop his organs from being harvested, if true and recent, is likely the result of human error, or even more likely the result of human short cuts, and not systematic error.

Archie Bunker

What's your problem Mr. No-Name Phantom? I said even if. I think there have been more than 10 people. I know one of them personally.

Noclue

The question is whether the person who woke up met the criteria for brain death and was still alive or whether there was human error involved.

To date, no doctor has asserted that human error or mechanical failure was the cause of the misdiagnosis. It is possible the hospital fears litigation; but it does not sound to me like anybody is suing.

It amy be that brain dead is not as absolute as doctors would like us to believe. Where that leaves us halchically I will leave to those who are experts in Halacha.

P.S. Did Rav Moshe Feinstein, Z'tzal, ever write a tshuva approving brain death criteria or transplants. In the absence of a written tshuva (preferably not in the more recent volumes which are not his writing)it is virtually impossible to tell what his views were).

Anon

--I know one of them personally.--

Are you at liberty to disclose the relevant facts?

Archie Bunker

"Are you at liberty to disclose the relevant facts?"

He was discharged by a hospital to a morgue for burial. Before the chevra kadisha could prepare his body, he snapped out of whatever suspended state he was in and actually just stood up and walked away.

This type of scenario is obviously much more uncommon than the others who are not dead yet still quite ill.

Shmarya

P.S. Did Rav Moshe Feinstein, Z'tzal, ever write a tshuva approving brain death criteria or transplants. In the absence of a written tshuva (preferably not in the more recent volumes which are not his writing)it is virtually impossible to tell what his views were).


Some linked here:
http://www.hods.org/English/h-issues/articlesE.asp

Yossi

A lot of the questions about halachic organ donation are answered here:

http://www.hods.org/index.shtml

Shmarya

Do tell us oh great one, what is the final test? The absolute "final" test is usually not peformed because it takes too long and you would loose organs.

Injecting radioctive dye takes a few minutes.

--Injecting radioctive dye takes a few minutes.--

Is injecting radiactive dye required under the guidelines adopted by Israel? It is not, to my limited knoweledge, SOP here in the US and mostly used only when the other less perfect test are inconclusive. btw, testing with a radioactive dye is not perfect either but I would agree that it is a more accurate test.

btw, did you know that certain studies found that one in one thousand people who are diagnosed as brain dead survived when the machines are switched off. Not that they got up and walked away, but they didn't die.

--Other Israeli haredi rabbis rejected this argument, first on the grounds of touching a gosses to determine brain death.--

btw, while this is a nice attempt at making this a haredi/MO disagreement, you get an A for effort but an F for accuracy. Rabbi Tendler's position on brain death is in fact opposed by many current and former MO leaders, including Rabbis Shachter, Wagner, Willig and Bleich and, when he was alive, Rav Aron Soloveitchik.

Anon

Talking of the devil, just saw this on CNN. and this happen even though the diagnosis was made with the help of a brain scan!

http://www.cnn.com/2008/US/03/24/NotDead.ap/index.html

Shmarya

Good. Thank God.

Now what do we do?

Paskin from the most extreme case possible?

If you answer yes to that question, would you approve the same for administration of blood transfusions, antibiotics, and the like? Angioplasty? Bypass surgery?

Because, if you answer yes, all these treatments are out the window.

Anon

--Now what do we do?--

Have no clue - that is for the doctors and rabbis to decide. But for those with at least a shred of integrity, what we do is recognize that your characterization of the halachic issues relating to organ donation was a gross oversimplification.

Shmarya

what we do is recognize that your characterization of the halachic issues relating to organ donation was a gross oversimplification

Not at all. The only "gross oversimplification" here is yours.

Anyone who paskins from a one in a billion occurrence is a fool.