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On Organ Donation Aspects of This Issue time to read and comment upon my Tendler, as well as a committee of the votes are less than fifty percent of the Counterpoint article. He is a forceful, energetic Israeli Chief Rabbinate, do interpret total membership since approximately advocate for the encouragement of Rav Moshe’s pesakim as supporting half of the membership claims to have organ donation within the Orthodox BSD, but certainly none of us can dis- no informed opinion on the matter.) community, and HODS’ web site is a miss out of hand the contrary interpre- III. Views of other posekim: Brain-death treasure-trove of valuable information tation of Rav Auerbach, Rav Elyashiv criteria have been rejected by a whole on both the medical and halachic and Rav Soloveichik. For further eluci- spate of posekim including Rav Auerbach, On Organ Donation aspects of this issue. Indeed, I cited dation, I refer the reader to my earlier Rav Elyashiv, Rav Waldenberg, Rav this source several times in my article. article, “The Brain Death Controversy Yitzchok Weiss, Rav Nissan Karelitz, Rav I realize, as well, that he and his orga- in Jewish Law,” Jewish Action (spring Yitzchok Kolitz, Rav Shmuel Wozner, Rav nization are motivated solely out of 1992): 61 (available at the HODS web Ahron Soloveichik, Rav Hershel Schachter I commend Rabbi Breitowitz’s and documents from these rabbis may sides of the BSD debate, and therefore concern for those persons who desper- site) and especially the addendum in and Rabbi J. David Bleich. Some of these attempt to expound upon the complicat- be found at the web site of the we offer a unique organ donor card ately need organs to stay alive. the summer 1992 issue (p. 78). See posekim reject BSD in principle; others are ed issue of organ donation and halachah Halachic Organ Donor Society that allows members to indicate their Nevertheless, his letter may create the also the voluminous discussions in Dr. concerned with the accuracy of the diag- (“What Does Halachah Say About Organ (HODS) (www.hods.org). desire to donate organs after BSD or misleading impression that acceptance Abraham’s Nishmat Avraham YD 339:1 nostic test; still others acknowledge that Donation,” fall 2003). I would, however, Regarding the Rabbinical Council of alternatively after cessation of heartbeat. of BSD is well-nigh universal, both (2), pp. 241-244 and in J. David while BSD may be death, it is at best a like to clarify a number of points. America (RCA), Rabbi Breitowitz Rabbi Breitowitz mentions a num- halachically and medically. Neither Bleich’s “Of Cerebral, Respiratory and safek (doubtful situation), and as such, one Rabbi Breitowitz casts doubt on the claims that even though the organiza- ber of reasons why Jews would proposition is true. Cardiac Death,” Contemporary would be prohibited to remove organs as acceptance by the medical establish- tion has officially accepted BSD as halachically be able to donate organs I. Rav Moshe’s position: Rav Moshe Halakhic Problems IV (New Jersey, it is possibly murder. Again, I refer the ment of the criteria of brain-stem halachic death, “many rabbanim who to non-Jews. I would like to suggest addressed issues of brain death in sever- 1995), 343-350. Again, I am well reader to the following: Nishmat Avraham death (BSD) by stating that, “the are members of the RCA, however, do three more. In many instances where al teshuvot: YD 2:174 (5728); YD 3:132 aware of the controversy surrounding YD 339:2, pp. 241-244; Nishmat brain-stem death standard itself has not follow this position.” HODS the Talmud discriminates between the (5736); Choshen Mishpat 2:72 (5738). Rav Moshe’s position. I take no sides Avraham V, pp. 92-98 and J. David recently been questioned by some neu- recently sponsored a random sampling lives of Jews and non-Jews, the non- While a number of statements seem to in this matter other than to note that it Bleich, Time of Death in Jewish Law (New rologists.” Tens of thousands of neu- survey by an independent researcher of Jews are specifically idol worshippers. I indicate support for a BSD definition, is indeed a controversy. York, 1991), 144-145. It is true that Rav rologists throughout the Western the RCA membership. The results show would like to suggest the possibility Rav Shlomo Zalman Auerbach z”l, Rav II. The RCA position: The RCA has Auerbach’s final pronouncement comes world understand BSD to mean death. that approximately half of the RCA that since Muslims are not idol wor- Ahron Soloveichik z”l and, yibadel endorsed BSD as halachically suffi- much closer to a standard that would Rabbi Breitowitz’s comment, and his rabbis claim not to have an informed shipers, and according to some lechaim, Rav Yosef Sholom Elyashiv cient following the pesakim of Rabbi legitimate organ removal but, as noted, it note that lists one paper written by opinion about BSD, and of those that posekim neither are Christians, the dis- interpreted Rav Moshe as permitting Tendler and the Israeli Chief would require that the BSD donor be off two physicians, implies dissent large do have an opinion, the majority of tinctions made in Talmudic times the utilization of the brain-death crite- Rabbinate. As chairman of the RCA’s of the respirator for five to six minutes enough to note. It is not. them accept BSD as halachic death. would not be applicable today. ria only after cessation of heartbeat. It Biomedical Ethics Committee, Rabbi before the heart could be removed. Concerning Rav Moshe Feinstein’s Rabbi Breitowitz, when discussing Second, donating organs only to must be emphasized that these gedolim Tendler spearheaded the preparation of IV. Medical Definitions: Mr. Berman position confirming BSD as halachic non-heart beating donation, refers only Jews—to the exclusion of non-Jews— were not purporting to disagree with a health-care proxy form that would is absolutely correct that a large major- death, I refer readers to Iggerot Moshe to comatose patients whose hearts stop would most likely cause eivah (enmity) Rav Moshe; rather, in their view, Rav authorize the removal of vital organs ity of the medical profession regards (YD 3:132) and Rav Moshe’s letter to as a result of being removed from a res- between Jews and non-Jews. Out of Moshe himself did not necessarily from a respirator-dependent, brain- brain death as equivalent to death for Dr. E. Bundi, the grandson of Rabbi pirator. He omits other kinds of non- fear of eivah, one is allowed to violate endorse BSD as a stand-alone criterion. dead patient for transplantation pur- all purposes—whether it be termina- Yosef Breuer. Rav Moshe’s position was heart beating donation such as those Biblical commandments to save the life It should be noted that in YD 3:132— poses. Although the form was tion of life-support or removal of also confirmed by Rabbi Dovid that come from patients who were of a non-Jew, and this applies equally the very teshuvah that Mr. Berman cites approved by the RCA’s central admin- organs. It is also true that for almost Feinstein, Rabbi Shabtai Rappoport, originally brain-stem dead—whose ces- in America (Iggerot Moshe, OC 4:79). as support—Rav Moshe quotes with istration, its provisions on brain death two decades it has been the dominant Dr. Ira Greifer and Rabbi Dr. Moshe sation of breathing is already deter- On a practical level, even if all of approval the ruling of Chatam Sofer, were opposed by a majority of the American legal definition of death as Tendler. mined to be irreversible—and who one’s eight life-saving organs were to YD 338, who explicitly enumerates lack RCA’s own Va’ad Halachah (Rabbis well. However, two points need to be Furthermore, in 1986 the Chief then undergo cardiac arrest. He also be donated to non-Jews, this would of pulse (heartbeat) and lack of respira- Rivkin, Schachter, Wagner and considered: First, it is beyond the Rabbinate of Israel appointed a com- omits uncontrolled-donation. This sit- directly move eight Jews closer to the tion as necessary prerequisites for the Willig). It is obvious that at least some purview of science to determine when mittee of rabbinic scholars and neurol- uation arises when CPR is being per- top of the list of 80,000 people who determination of death. In CM 2:72, a eminent posekim within the RCA do a person is dead. Medicine can ogists to investigate the halachic status formed on a patient for a prolonged need organ transplants, thus increasing teshuvah written two years later, Rav not agree with the organization’s posi- describe with greater or lesser accuracy of BSD. Not only did the scholars period of time and the physicians final- their chances of receiving an organ Moshe reiterated a point he made some tion. In light of this disagreement at the level of functionality an organism unanimously conclude that BSD was ly declare him dead. Compressions are and having their lives saved. years earlier that removal of a heart the highest level of the RCA’s posekim, may possess, but whether that level is halachic death, but they were also of continued, however, until the family constitutes murder of the donor. Since the positions of the rank and file equivalent to death or life is a moral the unanimous opinion that Rav Moshe can be contacted to approve or deny Robby Berman under American law hearts are not frankly assume less importance. The and religious question, not a medical himself accepted BSD as halachic organ donation.
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