Tuesday, July 8, 2008

Smoking prohibited! status of Brain Death & Preventative Tests

Jerusalem Post reports:

Jews are not allowed to smoke, and they are required to observe a healthful way of life, said Rabbi Moshe Shaul Klein, rabbi of Bnei Brak's Ma'ayanei Hayeshuva Medical Center and representative of the halacha committee of one of the city's leading rabbinical arbiters, Rabbi Shmuel Wosner.

Klein was addressing a conference of rabbis and hospital staffers on the subject of Medical Ethics and Halacha over the weekend.

"Let's take the example of tobacco smoking. Anyone who is intelligent and offered a certain drink that just one out of 10 doctors says is poisonous would not drink it," said Klein, implying that smoking - which has incontrovertibly been proven deadly - is forbidden by Jewish law.

A handful of rabbinical arbiters had previously stated publicly that it was forbidden to smoke; many others have ruled that it was forbidden to start smoking, but have stopped short of requiring those who already smoke give up the habit, while others say this only privately.

Klein said at the hospital conference that the requirement to live a healthful life includes undergoing preventive tests for early diagnosis of disease, as survival rates are much higher when diseases are detected early.

He endorsed mammographs for women and colonoscopies for both men and women who were over 50.

Another leading rabbinical arbiter, Rabbi Yitzhak Zilberstein, took the conservative haredi view (contrary to that of national religious rabbis and some haredi rabbis abroad) that death - after which one may halachically take organs for transplant - means the cessation of heartbeat, and not lower-brain death in which the heart can continue to beat. He also attacked the phenomenon in some hospitals of demented kidney-failure patients being denied dialysis and other medical treatments. "There is no difference in giving medical treatment to a demented patient and one with a wise and acute brain," he said.


  1. Jews are not allowed to smoke, and they are required to observe a healthful way of life
    any communal action plan?
    Joel Rich

  2. I find it interesting that, although the conclusion is that it is forbidden to smoke, he still did not come out and openly state it.

    Also, in terms of brain death, I wonder how much of the Chareidi position on heart beats is based on the old assumption that the heart is the organ of respiration?

  3. WADR, some of our Rabbeim might want to follow up on more recent research implicating mammograms as a leading CAUSE of breast cancer:

    70% of mammogram detected tumors are not tumors at all. 25% of cancers are missed by mammograms (1 in 4 false negatives)

    One Canadian study found a 52 percent increase in breast cancer mortality in young women given annual mammograms, a procedure whose stated purpose is to prevent cancer. Despite evidence of the link between cancer and radiation exposure to women from mammography, the American Cancer Society has promoted the practice without reservation. Five radiologists have served as ACS presidents.
    (When Healing Becomes A Crime by Kenny Ausubel, page 233)

    each time the breasts are exposed to an x-ray, the risk of breast cancer increases by 2 percent.
    The Hope of Living Cancer Free by Francisco Contreras MD, page 104

    numerous studies to date have shown that among the under-50s, more women die from breast cancer among screened groups than among those not given mammograms. The results of the Canadian National Breast Cancer Screening Trial published in 1993, after a screen of 50,000 women between 40-49, showed that more tumors were detected in the screened group, but not only were no lives saved but 36 percent more women died

    John W. Gofman, M.D., Ph.D., an authority on the health effects of ionizing radiation, spent 30 years studying the effects of low-dose radiation on humans. He estimates that 75% of breast cancer could be prevented by avoiding or minimizing exposure to the ionizing radiation from mammography, X rays, and other medical sources. Other research has shown that, since mammographic screening was introduced in 1983, the incidence of a form of breast cancer called ductal carcinoma in situ (DCIS), which represents 12% of all breast cancer cases, has increased by 328%, and 200% of this increase is due to the use of mammography.
    Alternative Medicine by Burton Goldberg, page 588

    see also:

    The Politics Of Cancer by Samuel S Epstein MD,
    Under The Influence Modern Medicine by Terry A Rondberg DC,
    The Cancer Industry by Ralph W Moss
    Dr Isadore Rosenfeld's Breakthrough Health By Isadore Rosenfeld MD,
    The Cancer Handbook by Lynne McTaggart,

  4. WADR to anonymous, please go and read actual studies instead of faux ones by people with agendas and axes to grind. Anyone who is trying to sell you the conspiracy theory about how medicine is trying to ruin people's lives is selling you a bill of goods. However, if you insist on believing all that, I own a bridge in New York city I'm willing to part with for a reasonable price. Contact me at...

  5. I would be inclined to be stringent when regarding the moment of death for a few reasons.

    One reason is that he have come nowhere close to understanding the human brain. The field of neurology is one area where sacred cows are constantly being shechted because of new research discoveries.

    Another reason is that the technologies being deployed are not exactly the Star Trek solutions that people think that they are.

    A partial and practical reason is who is the doctor on call deturmaning death. Does he have the top reputation. Even with top specialists, there are many stories abound in which people come out of a vegetative state. Some people may call such instances miracles. It also might be partially because science has not yet plumbed the debths of the brain function.

    I would say that barring decapitation or the like the whole situation is a suffek. How can halachic authorities pasken on issues that the doctors themselves do not fully understand.

    I believe that Rav Moshe had a psak regarding infertile couples. The question being if they need to divorce. Rav Moshe said that with the rapid changes of medical knowledge and technology, who is to say that a solution will not come about any day for any specific problem. He should only how things have advanced in fertility issues since his time. The same with neurology. They are learning new things every day. Not just extra bits of information but facts that change the whole perspective on how we view the body, particularley the brain.

    I would say that it is not good to rely on what doctors see as lower brain death.

  6. One bright spark on another website, reading the same story in the JP, has asked why the same rabbonim who now condemn smoking are not urging everyone to jog and get rectal exams since they are just as important to one's health as staying away from smoking, and can't wait for UOJ to latch onto this and ask how come the rabbonim worry about the effects of smoking and not about the presence of sexual predators in their midst who are causing much harm to frum kids in yeshivas..?

  7. Regarding brain death see


  8. Dear Garnel Ironheart:

    I have not been able to find even ONE study that conclusively shows that mammograms save lives; to the contrary:

    Myth 1: Mammograms are safe.

    Fact: Mammograms may actually prompt an existing cancer to spread.

    The breast is compressed between two flat surfaces so that the tissue will be sparse enough to allow tumors to be revealed. At the very least this is uncomfortable and often painful. At worst, however, it may actually break down cancer tissue and rupture small blood vessels that support the cancer, causing it to spread.

    William Campbell Douglass, M.D., wrote about what he calls the "compression contradiction." Dr. Douglass says, "I find it maddeningly contradictory that medical students are taught to examine breasts gently to keep any possible cancer from spreading, yet radiologists are allowed to manhandle them for a mammogram."

    And then there's the radiation question.The radiation exposure is about one RAD, or radiation absorbed dose. That's approximately 1,000 times more radiation than you receive from a chest x-ray.

    Pre-menopausal women in particular have been shown to be sensitive to this radiation exposure that can cause cancer. And yet the American Cancer Society recommends that all women over the age of 40 receive yearly mammograms.

    Myth 2: When breast cancer is caught at an early stage by a mammogram, the need for surgery is reduced because tumors can be treated in other ways.

    Fact: If a tumor is large enough to be detected with a mammogram, it's already in an advanced state. Furthermore, the typical alternatives to surgery can do more harm than good.

    Three years ago, scientists at the Nordic Cochrane Center in Copenhagen, Denmark, reviewed seven of the largest mammography studies yet conducted. They found that women who underwent regular screening had about 30 percent more mastectomies and lumpectomies than women who weren't screened. They also found that tumors detected by mammograms are likely to be treated with radiation, which carries a high risk of cardiovascular damage. The authors wrote, "As screening primarily seems to identify slow-growing tumors, the adverse effects of treatment could potentially reduce or even neutralize any possible benefits."

    The rate of false positive results from mammograms is also very high, leading to unnecessary biopsies, radiation, mastectomies and lymph node removal. A National Cancer Institute study showed that over the course of nine mammograms for women between the ages of 40 and 69, the risk of a false positive was well over 40 percent.

    Myth 3: Mammograms save lives.

    Fact: Mammograms do not save lives.

    There are certainly cases where a mammogram has detected a life-threatening cancer and the patient's life was saved by the follow up treatment. But overall, the statistics simply don't support the argument that mammograms save lives.

    The Nordic Cochrane researchers cited two definitive studies in their report. The first, conducted in Malmo, Sweden, compared the experience of 21,088 women who had regular mammograms to 21,095 women who did not. After nearly nine years, 63 women in the mammogram group and 66 women in the control group had died of breast cancer. The second study, performed in Canada, tracked almost 90,000 women for 13 years. Approximately half of the women had mammograms, and half did not. Deaths due to breast cancer numbered 120 in the mammogram group, and 111 in the control group.

    These are just two of many studies that have come to the same conclusion: mammograms do not save lives.

    The ACS continues to recommend routine annual mammograms for women aged 40-49 even while acknowledging the Danish study on their website:

    "The many American women who routinely have a mammogram were probably quite surprised to hear a recent report concluding that mammograms do not save lives."

    "Two Danish researchers certainly started a debate with their analysis of the value of mammography, published in the British medical journal Lancet.

    The researchers analyzed seven large studies of mammography often used as evidence of the test's ability to save lives. They decided that most of the studies weren't designed well enough to give reliable answers and the two that were didn’t show any benefit"


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