Defining the Moment of Death: Medical & Health Response on Ask the Rabbi
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Defining the Moment of Death

It is my understanding that in order for someone to be a candidate to donate their organs, they need to be declared "brain dead" by two to three physicians, one of whom, I believe, must be a neurologist. Only after several EEG's, will the person be considered "brain dead." Also, even if the person has a donor card in their wallet or if it is stamped on their driver's license, the doctors still require consent from the next of kin.

Twelve people die each day while awaiting a lifesaving organ transplant. On December 21, 1998, my husband Michael was one of them. He died awaiting a liver transplant to replace the one that was ravaged by Hepatitis C. He was diagnosed six years earlier when we volunteered to be tested as bone marrow donors for a child in our community with Leukemia. Each year, thousands of people die, primarily because fearful potential donors don't take that step, to do a mitzvah to save a life. Our Sages teach that "He who saves one life, saves the entire world." I believe that God wants us to be lifesavers; to be His hands, eyes and hearts here on Earth.

I have spoken with donor families who tell me that in the donation of their loved ones' organs, they experience a sense of healing that far surpasses what they would have otherwise. It is of great comfort to know that a part of someone they treasure, lives and loves on in someone else.

What is the halachic (Jewish legal) definition of death? All of the organs have a time limit for safe and effective use, but what does Halachic law say about use of 'extraordinary measures' to maintain life for life's sake? For example, if there is no chance for recovery (end-stage cancer) and a ventilator or feeding tube serves only to prolong someone's death?

The Aish Rabbi Replies:

Thank you for sharing your powerful personal story. I understand that in cases such as heart transplants, the organ has to be so fresh that doctors will remove it before the patient is dead according to the Jewish definition (at least), which under Jewish law is unfortunately classified as murder.

The halachic definition of death, for transplant purposes, is when the person shows no signs of life whatsoever. Maimonides (Avel 4:5) writes: “A person near death (gosses) is considered to be alive in every respect... Whoever touches him [thereby hastening his natural death] is a murderer... Whoever closes his eyes as he dies is a murderer. [Rather,] one should wait a short while, as perhaps he is in a swoon.” It is customary to wait 20 minutes before the body is touched or moved. ("Minchat Yitzchak" by Rabbi Y. Weiss 5:7; "Igrot Moshe" by Rabbi Moshe Feinstein, Y.D. 2:174; "Gesher HaChaim” I)

Igrot Moshe maintains that it is a mitzvah to save a person that is at present in need of a transplant to save his life, assuming that the organ is removed only in post-mortem.

As to medical treatment for terminal patients, when there is pain and agony, and no quality of life, we are obligated to sustain them and relieve them of their pain through oxygen and other measures, but not to actively interfere with their death via aggressive life resuscitation (Igrot Moshe E.H. 4:73). There is also a concept of praying for a suffering terminally ill patient, that he should die quickly without suffering more (Ran Nedarim 40a). We cannot, however, play God, and discontinue life support on our own.

The Talmud (Yoma 85a) indicates that "life" is contingent on respiration. The case concerns a structure which has collapsed on the Sabbath, when construction work is completely prohibited. In this case, since someone trapped in the rubble may still be alive, Sabbath restrictions are pushed aside for the sake of saving a life. The debates how to determine whether the individual trapped in the rubble is alive or not: "How far does one search? Until [one reaches] his nose… as it says (Genesis 7:22): "In whose nostrils was the breath of life."

For more on defining the moment of death, see: www.jlaw.com/Articles/brain.html

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