[Avodah] Brain Death

[kennethgmiller at juno.com]

I wrote:
> Torah Jews *do* believe in Techiyas HaMeisim. It *is* possible
> for one who is dead to live again. However, please recall what
> I quoted from Igros Moshe regarding a decapitation. He wrote that
> such a person is "meis mamash", even though there *is* a method
> by which he can be brought back to life.

R' David Riceman asked:

> Does this mean that a surgeon who removes a person's heart in
> order to transplant a new one is a murderer?

I had long thought that, yes, what RDR says is exactly the view of the Igros Moshe. For indeed, he begins that teshuva (YD 2:174, beginning of second paragraph) by saying that the transplant surgeons are murdering not only the donor, but also the recipient - who they are ostensibly trying to save.

But, thanks to RDR, I have now reviewed some of that teshuva, especially the rest of that second paragraph, and I see that I was mistaken. Rav Moshe's concern for the recipient was not because he'd be dead when his heart was removed, but because the vast majority of such patients lived only a short while after the transplant, trading a potential of many years for just a few weeks or days. And now I understand those who say that Rav Moshe would no longer use that argument today, when the recipients live so much longer (though he'd still oppose it on the grounds of killing the donor).

Further, I noticed something very interesting in Nishmat Avraham (by Dr. Abraham Abraham, English version, ArtScroll 2003). Regarding transplantation of a mechanical heart, he writes on pg 58:

> A responsum I saw [Shu"t Divrei Menachem 27; also see Refuah
> L'Ohr HaHalacha 2 pg 122] forbids such a procedure since the
> patient is "killed" when his heart is removed preparatory to
> transplanting a mechanical one. This opinion is difficult to
> understand, for in every open heart procedure, although the
> heart is not removed from the patient's body, it is
> nevertheless stopped completely, the circulation to the rest
> of the body being maintained by a mechanical "heart" to which
> the patient is attached. I do not know of any posek who
> objects to this type of surgery, nor do I see any difference
> between stopping the heart during open-heart surgery and
> removing it prior to its replacement with a mechanical heart.
> This is the ruling of the Lev Aryeh, and Rav Auerbach zt"l
> concurred.

My incorrect understanding of Rav Moshe's view (which seems to be the correct understanding of the Divrei Menachem's view) was shattered by the Nishmat Avraham's footnote to the above, which quotes the Mechaber Yoreh Deah 40:5: "If the heart is removed - whether by hand or by illness - it is a treifah."

And so a new word enters the lexicon of this discussion: Treifah. A person who has had his heart removed is a treifah - NOT "meis mamash". (And, as he quotes Chazon Ish Y"D 5:3 in that footnote: "Nowadays many treifos can be healed.")

In summary, I was wrong for taking what Rav Moshe said about decapitations and applying it to heart removals.

But I do maintain that even if head transplants might someday become as successful as today's heart transplants, Rav Moshe's argument will still apply, and that one would not be able to argue that successful reattachment proves that the body "was not really meis". (If anyone is interested, there's a Wikipedia article titled "Head transplant" about such operations which have been done to animals.)

Akiva Miller

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