April 24, 2020 5:43 pm at 5:43 pm #1853033
So @ubiquitin, since we are literally the only two people commenting on this thread, how are things by you?April 24, 2020 7:59 pm at 7:59 pm #1853062
Ok B”h hospital seems to be past its peak things are on the downswing.
you?April 26, 2020 3:11 pm at 3:11 pm #1853526
How do we get from a loack of kovod hatorah to braindeath?April 26, 2020 4:46 pm at 4:46 pm #1853544
n0mesorah: Rav Sherer zt’l excoriated Tendler for having falsified Rav Moshe zt’l’s position on brain death.April 27, 2020 8:18 am at 8:18 am #1853803
“How do we get from a loack of kovod hatorah to braindeath?”
conversations often switch. Though this one isnt really about brain death. A poster got me excited about the existence of a psak, allegedly “famous,” by R’ Moshe “against using brain death to determine death”
Unfortunalty, it turns out he was lying, and no such psak exists famous or otherwise.
At least not by R’ Moshe Feinstein (which I guess he could claim he never meant, he can always claim he meant R’ Moshe Sherer, or R’ Moshe Honigkvetcher, and if anyone mistakenly assumed he meant R’ Moshe Feinstein, well we need better reading comprehension)April 27, 2020 12:15 pm at 12:15 pm #1853899
@ubiquitin Baruch Hashem! A little stressed dealing with my kids being home 24/7 along with all my every day narischkeit.
@n0mesorah That was my fault. I brought up Rav Moshe’s famous teshuva on brain death to show that even a gadol like Rav Moshe Feinstein ZT”L can say “I don’t know enough about this scientific matter, I’ll allow an expert to decide”.May 1, 2020 8:19 am at 8:19 am #1855735
Well it is a good headline “Lack of Kovod HaTorah leads to Brain death.”May 1, 2020 8:29 am at 8:29 am #1855786YW Moderator-29 👨💻Moderator
Yeserbius: my “or not” was intended to be on his claim that it was deleted due to length, not to deny it was submitted.May 1, 2020 9:17 am at 9:17 am #1855800
YW29: It’s agreed that a) it was submitted and b) it was an official letter from Agudas Yisroel by Rav Moshe Sherrer zt’l to Tendler. If not for the length, why else wasn’t it posted?May 3, 2020 7:40 am at 7:40 am #1856160
Probably because of kovod hatorah.May 3, 2020 1:26 pm at 1:26 pm #1856250
n0m: How are you applying kovod HaTorah to a letter authored by the head of Agudas Yisroel, one of Klal Yisroel’s most important organizations, with the full backing and agreement of the Gedolei HaTorah on the Agudah’s Moetzes Gedolei HaTorah?May 3, 2020 3:04 pm at 3:04 pm #1856332
My understanding of the issue is, that the question was brought up among the Oilam HaTorah when it was a mere hypothetical. Modern medicine went on to all but conclude that brain death does not exist. Yet, it remained a somewhat serious halachic debate. I think Rav Bleich’s sefer finally put it to rest.May 3, 2020 5:49 pm at 5:49 pm #1856404
your understanding of the issue is incorrect.
Not one of your follow up sentences is correct.May 3, 2020 11:36 pm at 11:36 pm #1856548
Please enlighten me. From what I understood, medical ethicists sounded the alarm in the early 1960’s that modern medicine may be able to declare a death based on lack of brain activity alone. (Without major organ failure.) By the mid 1970s experts concluded that this was purely hypothetical, and has no standing in scientific reality. Today every brain death protocol gives heart and lung failure as criteria for brain death.May 4, 2020 12:13 am at 12:13 am #1856585
Your understanding is not at all accurate.
Brain death is accepted as death in all 50 states (though a few allow for a religious exception) and is routinely used in declaring death.
Brain death refers to the lack of function of the brain stem. The brain stem controls certain biological functions including breathing . The heart functions independently of the brain, It has its own pacemaker. Thus a brain dead patient, by definition cannot breathe on his own. However he will have a normal heart beat.
Most poskim reject brain death as a definition of death, they hold as long as there is a heartbeat the patient is alive. A few accept brain death either because they view the brain as decapitated, or because if a person can’t breathe then they are dead (even if the heart is still beating).
There is some question as to what R’Moshe held. He wrote a few teshuvoas on the subject which sound like he supported brain death. There is one yeshiva that is more explicit, but some have scheduled the authenticity of this teshuva
His sons (R Dovid can be seen on YouTube supporting this) and son in law and grandchildren all say he held brain death is halachic death, but others disagree.May 4, 2020 3:15 am at 3:15 am #1856608
I read what you wrote carefully. I understood that the heart could be functioning mechanically – not reflexively. If I got that wrong it changes a lot. Assuming I didn’t, my point was that zero function of brain stem reflexes by itself could never be an actual way to determine death, because if the major (heart or lungs) organs are working, that is proof of some brain activity. The possibility of having life without the major organs is zero, even with a functioning brain stem. Since the patient is not breathing, the only question is how to view the mechanical heart. That is not a question of brain function, as the brain can function (albeit in a meaningless manner) without the heart or lungs. The whole question revolves around a vent and the mechanical impulse of the lungs. Not the brain. Even though the brain is where the measuring takes place, it is the major organs that are being measured. If there is medical brain death without apnea, than I am completely wrong.May 4, 2020 8:02 am at 8:02 am #1856637
The second half of your post sounds right, the first half is confusing.
“I understood that the heart could be functioning mechanically – not reflexively”
I am not sure what you mean by either of those terms. The heart can beat independently of the brain. In fact they have done studies where a heart placed in proper solution of glucose, potassium, with oxygen being pumped etc can keep on beating in the absence of any brain activitiy. This is becasue the signal for he heart to beat does not come from the brain, but rather from specialized cells in the heart itself, that “tell” the heart to beat. This is known as the pacemaker cells or the SA node. Of course the brain (and spinal cord) do send signals to the heart to speed up or slow down as needed but in the absence of these signals ie even with complete severance of the brain and spinal cord from the body the heart will keep beating.
The lungs on the other hand are different. EACH breath is DIRECTLY controlled by the brain steam giving a steady signal: Breathe, Breathe, Breathe, etc. In the absence of the brain steam (or if the nerve that conducts this signal is damaged) the patient will stop breathing.
Again: His heart will still keep beating (assuming you provide a steady supply of oxygen obviously) becasue the heart’s signal to Beat, Beat, Beat…. does NOT come from the brain, it comes from the heart itself
“Assuming I didn’t, my point was that zero function of brain stem reflexes by itself could never be an actual way to determine death,”
Again, I’m not sure what you mean by “never be an actual way to determine death,” do you mean halachaicly? Most poskim do say that (for varied reasons), however some disagree. If you mean legally ALL states disagree with you.
“because if the major (heart or lungs) organs are working, that is proof of some brain activity.”
Again, no the heart can (and has) functioned completely perfectly in the absence of a brain.
“The possibility of having life without the major organs is zero, even with a functioning brain stem.”
I’m nost sure what you mean with this sentence. Patients are put on Heart bypasss machines daily for surgery etc. I believe all would consider them alive even though for a period their “major organs:” werent functioning (after R” Yechezkal Roth underwent cardiac surgery there was a rumpr that he was mekadesh his wife again but even if true, this is far from the standard view)
“Since the patient is not breathing, the only question is how to view the mechanical heart.”
“That is not a question of brain function, as the brain can function (albeit in a meaningless manner) without the heart or lungs.”
I’m not sure what you mean by “meaningless manner” I would think its very meaningfull that a person with an artificial heart and who is ventilated still has his own brain function. In fact according to those who reject brain death, I’m not clear on what basis he is alive There is also the problem of the sheep experiment.
Though IIf I understand your point correctly, I believe R’ Dovid Feinstein made this point when explaining his father’s postition According to R’ Moshe: The brain, in of itself, has no bearing on whether a person is alive or not. If he is breathing independently he is alive, if not not. (note: If a vent is helping him breathe he’d still be alive, if the vent is completely breathing for him then he isn’t) A brain dead patient BY DEFINITION is not breathing on his own your last statment is correct ” If there is medical brain death without apnea, than I am completely wrong.” There is no brain death without apnea, by defintiion. thus according to his teshuvos and family, R’ Moshe held a brain dead person is dead (becasue he isnt breathing not becasue of lack of brain activity per se)May 4, 2020 8:03 am at 8:03 am #1856645
” I understood that the heart could be functioning mechanically – not reflexively.”
I have a longer post pending. but if by “mechanically” you mean artificially ie with some mechanical device or machine, but it can’t function on its own. Then no that isn’t correct. In the absence of any brain function, the heart will keep beating and its normal steady rate as beforeMay 4, 2020 8:55 am at 8:55 am #1856651
@ubuition, what his son in law or grandson opinion is totally and completely irrelevant, do you quote R Aurbachs son in law opinion as his? how about Rav JB Soliviackis son in law. Do you quote Bar Ilan opinion as the Nitzivs opinion because he was his son?May 4, 2020 11:21 am at 11:21 am #1856678
It isn’t totally irrelevant, as his grandson was the compiler of the Igeros Moshe so his explanation of an ambiguos teshuva certainyl carries soem weight, and his son in law was the one with whom he discussed medical halacha.
Also I said “His sons (R Dovid can be seen on YouTube supporting this) and son in law…” I can’t help but notice that you left off “Sons” Was that deliberate? why?
Are you saying That R’ Dovid testifying what his father held is “completely irrelevant”?
As an aside, I have no problem with you saying R’ Dovid testifying what his father held has no bearing either(though it does sounds strange to me) and all that matters is written teshuva beseder so read the teshuva. Skip that line of mine . I think it matters, but if you don’t, I can live with that. BUT you can’t say talmid x said R” Moshe held qrs. Thats inconsistent
“do you quote R Aurbachs son in law opinion as his? ”
No not as his, but if his son said That R’ shlomo Zalamn held xyz, then of course I ‘d say his son held so. Particularly if R’ Shlomo Zalman Wrote several teshuvos that strongly sounded like xyz
how about Rav JB Soliviackis son in law. ”
Of course! all the time
“Do you quote Bar Ilan opinion as the Nitzivs opinion because he was his son?”
Again if he said his father said xyz then I think so. why not?May 4, 2020 12:37 pm at 12:37 pm #1856752
Rabbi Moredchai Telder said in public that the last few irgus moshes were colored by his interpretation of what reb moshe said not necessarily what he said, [meaning that he injected his own opinion] therefore I take the last few igrus moshe with a grain of saltMay 4, 2020 2:03 pm at 2:03 pm #1856817
“therefore I take the last few igrus moshe with a grain of salt”
Absolutely no question.
I’d say more than a grain. Though I wouldn’t say “complelty irrelevent”
in this case though we also have earlier teshuvos eg YD 3:176 written in 5736 (1976) published in chelek 6 which I dont think ANYONE has questioned the veracity of. wcich seems to support brain death
Plus R’ Dovid Y”blch supports this understanding of his father’s positionMay 7, 2020 9:33 pm at 9:33 pm #1858588
I accidentally deleted my response. It is for the better. You write with much more clarity. My point is, since brain death will never be declared on a breathing patient, (Because if they can breath on their own that proves a functioning brain.) the question became inapplicable. (Except for those who think protecting lives only reply to the unborn and the dead.) I think i read somewhere, that the original question was reversed. That because of brain trauma one can be declared dead even though there is a possibility of the lungs still working on their own.May 7, 2020 10:37 pm at 10:37 pm #1858633
@commonsaychel I know the guy who has the original letter. It says what it says. The main thrust to the relevance of this thread is that Rav Moshe ZT”L was uncomfortable paskening on brain death and so he openly and extensively relied on his son-in-law for the psak. Rav Tendler, Rav Dovid, and Rav Reuven compiled the teshuva and that’s how they wrote it.
So Da’as Torah isn’t infallible and often has to rely on da’as of something else.May 8, 2020 7:50 am at 7:50 am #1858697
“My point is, since brain death will never be declared on a breathing patient, (Because if they can breath on their own that proves a functioning brain.) the question became inapplicable.”
Again I’m not sure what you mean. Your first sentence is correct. but not the seocnd People are declared dead via brain dead standard daily. It is not at all inapplicable. As part of the determination, the vent which is ventilating the non-breathing patient s shut off (after pre-oxygenating the patient) and they wait a bit to see if the patient breathes. If he does he is not declared dead. If he doesn’t breathe he is dead. At thsi point the vent is reconnected to potentially allow for organ donation
“That because of brain trauma one can be declared dead even though there is a possibility of the lungs still working on their own”
The lungs don’t “work on their own” each and every breath is directly controlled by the brain (technically brain stem). In the absence of a brain the patient doesnt breathe. Again, NOT becasue there is anything wrong with his lungs (this may have been what you meant) his lungs are perfectly fine (in fact these lungs can potentially be used for someone else by transplanting them). But he is not breathing because the brain isnt “telling” him to.
As a reminder the heart may still be beating, since unlike the lungs, the heart is not controlled by the brain.
So the question becomes what is the halachic status of a person with no brain function, who cannot breathe on his own, but whose heart is still beating .
Most poskim say since his heart is beating he is alive period.
R’ Moshe seems to say in his teshuvas (and his son R’ Dovid explicitly said he held this way) says this patient is not alive because he isnt breathing. R’ Ovadiah Yosef held this way as well
(other poskim held he is dead because it is considered as if he is decapitated which mishna in Ohelos says is dead but whtehr this accurately describes a brain dead patient is questionable)May 10, 2020 8:15 am at 8:15 am #1859006
To make the issue more tenable, I am writing from the perspective of life existing independent from any specific organ. (Like, maybe my hair clippings after a haircut are alive.)
Brain death was not used until 60 years ago. (It was first detected in the late 1950s.) Before then, Death was proven by absence of heart and/or lung functions. When brain death, was clinically diagnosed (proven) there was a fear of people being declared dead, even though their major organs still had independent capability of life. (I’m not sure how science based that fear was, even then.) There is no brain death without total cessation of the lungs. So, the question as it was posed became obsolete.
I thought the resistance to using brain death today, is a fear of hospital bias. And, that the person is breathing on their own, but only because the vent is in. Or, some idea that science cannot determine life or some other thing like that.May 10, 2020 8:15 am at 8:15 am #1859007
In short, brain death with the lungs being able to breath on their own, does not exist.
Please excuse my writing comprehension.May 10, 2020 9:17 am at 9:17 am #1859061
“In short, brain death with the lungs being able to breath on their own, does not exist.”
correct. by definition If someone is breathing on his own he isn’t brain dead.
“I thought the resistance to using brain death today, is a fear of hospital bias.”
That is partly true but a very low extent, and easily remedied, (eg. devise better tests, use multiple doctors to assure done correctly etc) . The bigger issue is most poskim hold if the heart is beating (which a brain death patient’s is) the person is alive (or safek alive ) even if the brain isn’t funtioning and even if patient isn’t breathingJune 4, 2020 11:06 am at 11:06 am #1867892
A Rosh Hakollel was beaten up by someone who was upset that the avrachim in kollel were not wearing masks, why am I not surprised that we have sunk to this low levelJune 4, 2020 1:04 pm at 1:04 pm #1867972The little I knowParticipant
I am left wondering whether the assault helped anyone. Did it put masks on the faces of the kollel yungerleit? Or did this individual release his anger and achieve a state of nirvana or ultimate fulfillment?June 4, 2020 1:13 pm at 1:13 pm #1867982
@the little I know
It help the Justice system stay gainfully employed, a cop arrested him, a lawyer was retained, a Judge is hearing the case, there is a bailiff in courtJune 8, 2020 7:52 pm at 7:52 pm #1869371
Unfortunately, this is not a new low. As we disagreed about elsewhere, people are scared and reactionary about current events.June 8, 2020 10:28 pm at 10:28 pm #1869404
@n0m, your right, beating up a 70 year old rosh hakollel is the new normalJune 9, 2020 8:18 am at 8:18 am #1869467
DRAMATIC ARREST: Man With Knife Tries To Stab Mekubal HaRav David Abuchatzeira in Nahariya
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