[Avodah] Brain Death

[Micha Berger]

On Tue, Feb 01, 2011 at 09:13:54AM -0500, David Riceman wrote:
> RMB:
>> 1- Chai vs meis, which for all we know may not be a physical issue.<snip>
>> 2- Diagnosis --<snip>
>> 2b- Chazaqah --<snip>
>> I still think the machloqes is on the first level.>>

> And I think it's on the second level.
...

WRT the case of someone lost in mayim sheyeish lahem sof and assuming he
is dead so his wife my remarry:
>> Someone who almost definitely drowned is meis by whatever that word means.
>> The question of being very specific in our definitions isn't the central
>> one to knowing whether or not this woman is an almanah.

> The problem with this argument is, again, the tshuvah of RMF which
> RAM cited. He argues there that, by definition, someone who has been
> decapitated is dead, and cites ma'amarei Hazal as evidence. According to
> you, what's the point? Someone who has been decapitated is also "meis
> by whatever that word means". And in Hazal's time someone whose heart
> had stopped beating for a sufficient length of time was
> "meis by whatever that word means".

> If you insist that Hazal must have defined death somewhere, you need
> a method to distinguish definition from description, and you need to
> justify that method.

I am not insisting that we have a text that tells us what any of Chazal
held was the definition of misah. Actually, the only sources I know of
from chazal are Ohalos 1:5 (a/k/a 1:6) and the cases in Yuma 85a. If
anyone can point me to more, I would appreciate it.

What I am saying is that Chazal give pragmatic diagnostic tools
for determining whether one is dealing with a chai, or the body of a
meis. Now we have a wider potential toolkit. In order to know which tools
are usable and which aren't, we need to reverse-engineer a definition of
misah from those tests and how their discussion is phrased. Otherwise,
we simply can't know what we're measuring.

Ohalos says that a body (of a person or animal) with no head is meis,
even if it still is jerking around.

Yuma: How do we establish if someone died, that we must stop digging
them up on Shabbos:
    1- Breathing -- check under nose
    2- Heartbeat -- so you have to dig out the body until the navel
       to see motion

(This then gets tied to a non-diagnostic question -- a *rejected*
hava amina. The gemara asks if this machloqes related to the beraisa
where the tana qama says the baby is formed from the head, and Aba Shaul
says from the middle. (And that /everything/ was created from the middle
outward). IOW, the gemara asks whether it's head vs body because life is
about top vs middle. But as I said, that hava amina is rejected bedavqa
because the order in which something was made doesn't correlate to which
part does the central function of living.)

R' Papa's version of the machloqes is that the body is being dug out
feet first. Therefore, it becomes
    1- Don't rely on heartbeat, check breathing too
    2- Relying on heartbeat is enough

The gemara sites a pasuq -- "kol asher nishmas ruach chayim be'apav"
to probe it's about breathing. Close of sugya.

R' Papa's explanation of the machloqes fits that closing:
    1- Heartbeat is insufficient to establish a chazaqah of misah, you
       have to do the actual dianostic.
    2- Heartbeat is sufficient chazaqah.

Notice the issue I raised, that souls are spoken in idioms of breathing,
is also implied by the gemara's choice of pasuq. As an implication, one
might say: alive = the soul leaving the body, which happens when the body
breathes for the last time. But that's implication from chazal's choice
of pasuq, not their own words, nor is it *compelled* by the quoting of
that pasuq.

So, lemasqanah, what I get from Chazal is:
Ohalos: someone with no brain is dead
Yuma: someone who is not breathing is dead, with a machloqes as to whether
   you need to actually check breathing once heartbeat was ruled out


Someone who drowned is dead by all the suggested definitions. Our question
for the agunah is truly one of chazaqah: can we presume he drowned,
and thus dead (by any definition one holds)?

Chazal tell us someone who is decapitated (which is taken to include
one whose brain went to mush -- moach tefuchah) is dead. You asked how
I know this is not the definition of "meis" -- well, I know of people
(and I bet you do too <grin>) who were buried with the full knowledge of
numerous poseqim, with their brain attached and having the usual viscosity
(or even less liquidy).

Thus, whatever feature meisim have in common that makes them meisim,
the mishnah in Ohalos is obviously not giving it.

I am taking it as a diagnostic statement:
    A body in such a condition can't support chayim.
Or in the chazaqah (2b) form:
    We can at least presume that a body in such a condition isn't
    supporting chayim.

This gives us another data point as to what chayim is, by which we can
assess new tests like EEG, not being able to elicit swallowing/gagging/
couphing/corneal etc... reflexes (all brain stem functions), radionuclide
cerebral angiography, etc...

And, since Yuma makes a point of telling us checking breathing is primary
based on a pasuq, I was looking for ways to tie brain activity to breathing.
Possibilities:

1- Until the 20th cent, it was a valid chazaqah that people whose chest
wasn't connected to a normal brain weren't breathing.
2- It's not breathing, it's autonomous breathing.
3- Nishmas chayim links to breath that supports the moach in particular.
etc...

Was I clearer this time?

Tir'u baTov!
-Micha

-- 
Micha Berger             It is a glorious thing to be indifferent to
micha at aishdas.org        suffering, but only to one's own suffering.
http://www.aishdas.org                 -Robert Lynd, writer (1879-1949)
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