[Avodah] Lecture by Rav Moshe Tendler about Brain Stem Death

[noam stadlan]

Rav Micha has listed the position of many gedolim on brainstem death.
However, it is important to know and think about exactly what they held.
Many held that life is present as long as circulation is present.  In the
era of modern technology this means that a body without any functioning
cells is still considered alive as long as some machine is pumping blood in
the vessels.  So when you think about it a bit, this position makes little
sense.  It is a vestige from a time when every function in the body stopped
with the cessation of circulation. When machines can provide circulation to
anything with tubing, it is necessary to identitify exactly why the person
without circulation is dead.  This means identifying the function or tissue
which is crucial to the continued life of the person.

Currently there are only three major positions that have identified this
function: R. Tendler's brainstem death, R. Steinberg/Chief Rabinate
brain-respiratory death, and R. Bleich's vital motion.  The first two,
while conceptually different, identify a person as dead when they fulfill
neurological criteria for death(Harvard criteria).  R. Bleich defines life
as the presence of vital function, but has failed to define exactly what
that is or how exactly to find or measure it.  (for a more robust but not
comprehensive critique of his position see my paper here:
http://www.yctorah.org/images/stories/about_us/%235%20-%20stadlan.pdf ).
R. Bleich is also dependent on Rashi to transform the gemara in Yoma from a
respiration based concept to a circulation based concept. In the recent
Tradition, R. Daniel Reifman has shown how it is very difficult to argue
that circulation is what Rashi had in mind.  In addition, R. Bleich depends
on the Chatam Sofer, whom R. Reifman also shows did not intend to establish
circulation as a criteria for death independent of respiration.

It is important to also note that there is little to no support for R.
Bleich from other contemporary gedolim.  contrary to the contention of R.
David Shabtai(Defining the Moment), there is little reason to think that
they would automatically move from a circulation based definition of life
to R. Bleich's nebulous 'vital motion'.  Furthermore, even R. Bleich
himself(Tradition 16:4) agrees that R. Moshe defined life as the presence
of respiration, consonant with the Chief Rabbinate and R. Steinberg.  R.
Moshe certainly does not agree with R. Bleich.  SImilarly, RSZA does not
agree with R. Bleich and it is in fact difficult to find any gedolim who
specifically agree with R. Bleich's concept of vital motion.  While they
may agree with his opposition to 'brain death', that does not imply that
they agree with his specific definition of death.

In summary, defining death via neurological criteria(either from a
physiological decapitation source or brain-respiratory source) is presently
the most logical approach.  It fits best with other halachically accepted
determinations of life and death(conjoined twins, etc.). It also is most
consonant with the intent and understanding of the sources in the Gemara,
Rishonim, and many acharonim.

Noam Stadlan
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