Igros Moshe (YD III #132) The definition of when a person is dead is stated explicitly in the gemora (Yoma 85a) in the case where a person is buried under a pile of rubble. It says he can be dug out even on Shabbos and then his nostrils are examined to determine if he is still breathing. Rambam and Shulchan Aruch rule that if breathing is not detected he is considered dead. Thus we determine death by the absence of breathing. Even if the breathing is very slight he is considered alive. This can readily be determined with the aid of a feather placed near the nostrils. If the feather or a small piece of paper doesn’t move at all, he is presumed dead. Nevertheless he should be examined a number of times as I have explained previously to ensure he hasn’t just fainted because it is impossible to live without breathing. This test is valid only if the person is under constant watching. However since this is not realistic and it is possible he regained his strength a bit and was able to briefly get a few weak breathes it is impossible to properly determine death except by repeated testing. If these tests reveal there is no breathing at all than that is a sign the person is dead. This is more fully discussed by the Chasam Sofer. This is also relevant with the typical sick person who is close to dying, but is not dependent on a respirator. However there are many sick people who can not breathe without a respirator. Thus it is possible with a respirator to continue breathing even after death and these people are not considered alive. If it is not clear that he is alive from other indicators e.,g. he doesn’t respond even if stabbed with a needle such as being in a state known as a coma. Then as long as the respirator is working it is prohibited to remove it from his mouth because he might be alive and by the removal he is being killed. However when the respirator stops working for example when the oxygen tanks are depleted, it is not required to put him back on the respirator when it starts working for a period of 15 minutes. If he is no longer alive as seen by the absence of breathing then it means he has died. IKn contrast if he is living as can be seen from the fact that he is breathing even without the respirator even if it is with difficulty and interruptions then he should be returned to the respirator immediately. This should be done a number of times until his condition improves or it is apparent that he can’t breathe on his own and is dead.
You say that now there is a test that allows the great doctors to determine by the injection of a special fluid into the veins that can show whether the connection of the body to the brain has been stopped If this fluid does not go to the brain it is clear that the brain is no longer attached to the body and it also indicates the brain is already completely rotted and the patient is considered functionally decapitated. If this is true then we should be strict with those, especially if they don’t feel anything anymore and don’t respond if stuck with a needle and they no longer can breathe independently .to not declare them dead without doing this test. . That means if we see that the brain is still connected to the body even though they can’t breathe without a respirator to keep them on the respirator even for a long time. Thus we should say that the test of independent breathing should be done in conjunction with this test to determine death. This might be relevant also for those who have taken an overdose of sleeping pills or other medication. Until all the medication gets out of the body they can not breathe. In such cases the respirator needs to be connected for longer periods in order to clarify if they are dead since death can not be determined readily as long as the drugs remain in the body.
So he's accepting his son in law's research on brain stem death
ReplyDeleteNo he is simply noting what he claims.
DeleteI have heard that what he was told is not correct
Of course they will try saying that.
DeleteIt was not something that was raised in the various articles by opponents.
The current understanding of anatomy and physiology strongly suggest that brain death is due to loss of either a heart beat or the destruction of the automatic respiratory centre in the brain stem. This is completely consistent with the Gemara in Yuma which sets respiratory cessation as the criteria for death. If the heart stops beating, then no blood goes to the brain stem and it stops working. If the brain stem dies, then the person stops breathing. The introduction of a ventilator doesn't change this - the brain stem is still dead.
ReplyDeleteWhen Rav Tendler was learning about the brain stem death , he did 2 years shimush with neurologist specialists
DeleteThat's a professor of biology.
So when he was debating with great poskim, they had no inkling of what he was saying.
So rumours by askanim who hate modern orthodoxy, and science, are worthless
I was at a HOD (now Ematai) talk once and as the speaker brought up Rav Moshe's teshuvah, the local Lubavitcher raised his hand and repeated the story that since the teshuvah was post-humous and reflected Rav Tendler's position, it probably wasn't authentic. And the speaker looked straight at him and said "Are you calling Rav Tendler, a major Talmid Chacham and dedicted talmid of Rav Moshe, zt"l, a liar?"
Delete"Well, um, it's not like that..."
Garnel in fact he was considered by many to be a liar,
DeleteIt is not strange that at a group that depends on his testimoney that there is hostility to those who disagree!
But not by Reb Dovid, by Rappaport..
DeleteYou are introducing a next level smear btw, that he was even lying about the medical science he presented to Rav Moshe.
There was an interesting anomaly on another subject.
Rsza was forced to rollback his teshuva on insemination during niddah.
But you recently provided a translation where Rav Moshe allows it!
Any thoughts?
Wow Rav Rappaport was his son in law.
DeleteI spoke to others including major poskim who stated clearly that the Tendlers were not regarded as reliable sourcers of Rav Moshe's views and in fact were declaring their personal views as being that of Rav Moshe. There is an entire volume of the Igros that was known in yeshiva circles as the Igros Mordechai. See also my interview wirh Rav Greenblatt. Rav Rappaport told me that Rav Eliashiv had wanted to ban the eighth volume of the Igros which appeared after Rav Moshe was niftar because he suspected it wasn't authenti views of Rav Moshe.
Before I indexed the 8th volum I asked Rav Meir Zlatowitz because of widespread belief that it wasn't authentic. He yold me that my job was to make an index and it was the decision of the Feinstein family whether it should be published
Similae=rly a posek told me that the issue was that most of the material was not from Rav Moshe's written teshuvos but was from what was recalled by others and some felt that they did not accurately reflect Rav Moshe's aqxtual views
There's a difference between Moshe Tendler and his son Mordy. Shouldn't just bunch them together as the tendlers.
DeleteWow, Ephraim was nota Greenblatt's uncle..
DeleteAnyone who doesn't like Rav Moshe's view, writes some sort of maaneh l'igrot.
DeleteSatmar didn't like his AI D psak, so Yom tov Schwartz wrote the big book
Rav Hutner didn't like the height of the mechitza, so he blamed reb Yaakov for giving him authority.
Rav Elyashiv didn't like the annulment of marriages, do he limited them to the ones Rav Moshe cancelled himself.
Agudah didn't like brain stem death definition, so they said Rav Tendler made up the teshuva. Tendler provided further evidence, so the argument now is that he lied about the medical evidence.
One argument is that posthumous teshuvot are not acceptable. There's some validity to this claim if there is no corroborating evidence.
But the Noda b'yehuda used this logic to cast doubt on the authorship of a famous book published by Moses de Leon, 1000 years after the attribbuted author was niftar.
Chakham Zvi (based on Rashi) understands Yoma 85a to be saying “it’s not enough to check the upside-down avalanche victim until the heart; you even have to check the victim until the nose.” This Chakham Zvi has become a source of considerable controversy, as correctly reflected in the comments on the present post, and as further explained in the first five sections of http://www.scribd.com/document/375175373/Halakhic-Bioethic
ReplyDeleteThe famous Chacham Zvi is actually a backhanded support for the respiratory definition of death since the CZ thought that the heart was the organ of respiration and the lungs merely served to keep it from overheating. So again, respiratory death.
DeleteYes, but R. Moshe Feinstein, writing in 1970 [when the true physiological nature of the heart as a circulatory organ (and not a respiratory organ) was appreciated by the scientists of his era] writes that CZ might [or might not] possibly still be correct. See https://www.hebrewbooks.org/pdfpager.aspx?req=919&st=&pgnum=247 , 12 lines from bottom of left-hand column, where Rabbi Feinstein writes:
Deleteואף שאין הכרח לזה, אפשר שהוא כן
The problem is about understanding Torah in the light of current science. The Torah is always true which means that if science contradicts it, we have to look again at the Torah and see how it is still reflecting reality. That means changing our understanding of it. Some people can't do that.
DeleteThe paradigm example is the Lubavitch approach to the solar system. A simple reading of Tanach tells us that the Sun revolves around the Earth. Reality tells us it's the other way around. The proper thing to do is look at the p'sukim that gave us this impression and understand them from this new position. The Lubavitch approach is to declare science a fraud and insist on the original position.
The CZ's anatomical understanding was wrong. Period. One can accept that or continue to say "Well, you know, it's from tradition and scientists are always changing their minds..."