Sunday, October 31, 2010

The Halacha is Moral Principal and a Wrap-up of the Time of Death Issue

The fifth principle of rationalist medical halacha is the Moral principle.  Similar to the fourth principle of Common-sense, this principle is not meant to prove anything.  However, it does challenge us to view Halacha as  moral guide that is meant to teach us how to properly act in the complicated situations that confront us in our daily lives.  Certainly, the idea of what is moral and what is not is something which changes over time in different societies.  Clearly, a Jew who claims to adhere to halacha should be looking to halacha to decide right and wrong, and not to the whims of society and what the general public thinks is moral.  However, when the two conflict, it certainly warrants a clear review if the halacha to decide if indeed there is a conflict, or maybe the understanding derived from halacha may not have been correct.

The moral arguments in favor of brain death have been made by others, and I will not go into too much detail.  But I owe it to the readers of this blog to review the basics.

1) Using brain death as a criteria for death allows us to harvest organs from a dead body to save lives
2) Halachic Jews generally allow the receipt of organs from brain dead donors, therefore, to prohibit the converse, i.e. Jews can get organs but not donate, leads to a situation that causes understandable animosity from people outside halachic circles.
3)  Is it moral to use very considerable and very limited resources to maintain the “life” of a person who is completely brain dead, with no chance of ever regaining any consciousness or functioning?

I know that this topic has been discussed and debated in so many forums over the past 20-30 years, and that the “lines in the sand” have already been drawn on this issue.  I don’t pretend to think that I will be changing any minds with this blog, nor will I delude myself into thinking that I have anything to say that will change the fundamental nature of this argument.

However, what I DO claim is as follows.  That if you are willing to concede that a good moral case could be made for using brain death as a criteria for death, then at least can we review the halachic literature to make sure that we got it right when we declare this person to be halachically alive when his/her brain is completely dead?

That is all the fifth principle of rationalist medical halacha demands.  That if something seems to be morally right, that we seriously examine the halacha to make sure we are learning the right lessons.

Let me take the opportunity to thank all of you who bothered to read and think about this first topic in our new blog.  I do believe that we are beginning a new adventure together, a new way to look at medical/halachic topics.  In our first discussion regarding the halachic time of death we used the five principles to suggest the following:

1. The Historical Principle when applied to this topic leads us to the conclusion that the gemara only declared that cardio respiratory death was halachic death because of the understanding that chazal had of physiology.  This would lead us to conclude that with a new understanding of physiology that we should develop a new understanding of when death occurs

2. By applying the historical corruption principle we found that even the brain death advocates were guilty of trying to inject into the gemara modern ideas that could not have been the true intent of the gemara

3. Applying the mixed up principle taught us that trying to consistently apply the gemara’s understanding of death which is based on an understanding of physiology dramatically different from what we know today leads us to conclusions that are not logical.  This forces us to try to amend and change and reinvent what the gemara meant in order to avoid decisions that are uncomfortable or clearly wrong.

4. The Common Sense principle forces us to reconsider the halachic time of death as common sense would have us conclude that brain death is death

5. The Halacha is Moral principle forces us to reconsider the halachic time of death as using cardiovascular death as the criteria for death can lead us to conclusions that seem to be immoral.

I am looking forward to hearing what you have to say, and I am getting material ready for my next topic, “Treating a non-Jew on Shabbos”

1 comment:

  1. Isn't also true that a brain-stem-dead person on a respirator can maintain his own blood pressure, body temperature, and sugar/insulin levels and grow from being a child to an adult or carry a fetus to term? That's quite impressive for a cadaver. Is it so obvious that such a person should be cut open to remove his heart and liver for transplant?