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:

1. "[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."

2. “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.

3. “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.'

4. "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 US, to bar Israelis from receiving organs. (Please see the details here.)

So even more Jews die unnecessarily, waiting in vain for transplants that never come.

Previous post including links to primary sources.