DM Litzman: Death When One’s Heart Stops, Not Before

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litzman.jpgThere has been much discussion and dispute in the shomer shabbos community surrounding the new law determining brain death as legitimate under certain well-defined conditions for the sake of organ donations.

Maran HaGaon HaRav Shmuel Halevy Wosner Shlita is one of the gedolei torah who came out against the Chief Rabbinate’s attempt to relax the definition of death towards facilitating organ donations (see YWN story HERE) and now, Deputy Health Minister R’ Yitzchak Litzman has come out in no uncertain terms opposed to linking death to brain activity. Litzman stated gedolei torah have not changed their determination and death must be determined only by the cessation of one’s heartbeat.

Rishon L’Tzion Rabbi Sholom Amar Shlita has also come out and explained the Chief Rabbinate’s ruling is not a determination for organ transplants, and in the case of harvesting an organ, a rabbi must be consulted, each case on its own merit, stating the ruling should not be viewed as an effort to simplify determining time of death.

Litzman’s statement is unwelcome in the medical community, since when one’s heart stops working, the time available to harvest organs is extremely limited according to medical experts.

Litzman’s position caused a stir at a recent medical community gathering discussing transplants, adding if the brain death determination is contrary to the hashkafa of the patient, the plug may not be pulled and nothing may be done to curtail his life. Death must be determined by the cessation of the patient’s heartbeat.

MK (Kadima) Otniel Schneller, a shomer shabbat MK who authored the Brain Death Law, called on Litzman to abide by the law of step down from his post. Schneller insists that Litzman’s opinion can be nothing more than his personal view since the law now sets brain death [within the defined parameters] as the determination of death.

Prof Avinoam Reches, who heads the Israel Medical Association Ethic Committee called Litzman’s statement “absurd”, questing how a member of the cabinet can openly oppose the law and seek to make his position state policy.

Health Ministry officials released a statement stressing the deputy minister does indeed respect the law, but he wishes to direct one’s attention to the clause in the law that demands complying with the sensitivities of the patient and the family in cases in which they demand death is only determined by a cessation of cardiac activity, not brain activity.

(Yechiel Spira – YWN Israel)




12 COMMENTS

  1. Litzman is correct, plain & simple. Besides, the law does not create reality, it only states what the government allows. Freedom of speech is such a right as well and all are free to speak their beliefs.

    The fact is that brain death is more farce than real. Many patients who have been declared dead according to bona fide brain death criteria, have later awoken and had a full recovery. We had one patient in our hospital that met all valid brain death criteria, the 3rd and final exam was performed by a frum neurologist who found NO BRAIN FUNCTION with greater than 24 hours of NO BRAIN ACTIVITY. The next morning the patient awoke and was discharged home within a few weeks fully recovered.

    Prof Reches and MK Schneller can stand on their heads and juggle automobiles with their feet and it will not change the fact that Brain Death Criteria are seriously flawed and patients who are declared brain dead but who can recover if given the time, may then be technically “murdered” by the doctors that harvest of all of their essential organs.

  2. The criteria for brain death in the new law are not arbitrary, and are defined specifically as cessation fo brains-stem function. If the description by Dr. D in post #2 used those criteria, I would like to see documentation, since there are no documented cases of recovery from cessation of brainstem function. (By the way–many cases of recovery from cessation of heartbeat are walking around today after receiving prompt medical treatment) This law was devloped after consultation with any number of Rabbanim and MDs, brain and heart experts, and many others).

    If Asisstant Minister Litzman cannot abide by the law of the land, he should resign his lucrative postion, and we will find someone who will.

    By the way, for poster #3, the patient and family do have ultimate authority on organ donation, which is the major reason for this law. If the patient or family do not wish to donate–this law will not affect them in the least.

  3. #6, respect from every frum yid. Who wants or needs respect from the medical community? The medical community is totally corrupt, every few weeks another “Professor” is indicted for breaking laws or stealing, or both.

  4. Of course they want to hasten real death. They have socialized medicine and it cost money to keep someone alive till he really dies. Think about it.

  5. Correct me if I’m wrong, but DHM Litzman doesn’t have a medical degree, so I’m curious as to his qualifications to make such a proclamation. Let’s leave the doctoring to the doctors, and the politicking to the politicians, shall we?

  6. #7–REally? I am a religious Jew, and I have little respect for the man. You say that “The medical community is totally corrupt, every few weeks another “Professor” is indicted for breaking laws or stealing, or both. ” I could say the same about the Rabbinical community: every few weeks another frum Jew or Rabbi is indicted for breaking laws or stealing, or both.” However, it is nonsense to say that the corrupt are a good representation of the the religious community and it is nonsense to say that thecorrupt are a good representation of the the medical community. Do you not go to a doctor if you are sick?

  7. #8, your post is ridiculous. The doctors and health practitioners in Israel, are hard working people dedicated to their professions. The vast majority of health-care workers are not in it for the money.

    You manage to cast aspersions on the entire Israeli health-care system. It acutually works pretty well. Do you have any evidence at all that it does not?

  8. The minister’s comments bear no relation to reality. He knows — and everyone who works with this law knows — that all it does is provide a mechanism for those families who WANT to donate organs to do so. No one is being forced to donate.

    As for the comments by “Dr D,” I invite him to post details as to his own credentials and some documentation of his claim, as there is no case EVER of someone “waking up” after having been declared brain dead through the criteria being used in the new law.

  9. While I know nothing of brain death etc. let us clarify:

    No-one has ever “woken up” after their hearts have stopped beating. Those who are walking around today were revived through medical intervention. Barring that intervention, they are dead.

    Noone is proposing intervention to prolong the body function of one who is “brain-dead”, merely stating that as they may not be dead in the eyes of Halacha we may not stop their bodily function or treatment that has already begun.

    Basicly the argument is, until death is certain in the eyes of halacha, one may not take any action which may hasten death. A stopped heart is certain death as no organ can continue to function for long without a blood supply. Most organs can function indefinitly following “brain death” with no “new” intervention. This is why harvesting organs from BD patients is so desirable, and also why they are still considered “alive” according to halacha. Death is determined by the body, not the mind.

  10. #16–thinkfact does not have all his/her facts together. In fact, the nerve cells that control breathing are located in the brainstem. Brainstem death means cessation of breathing (unless artificially respired). Without oxygen, the blood flow does not mean much.

    So your statement that “Most organs can function indefinitly following “brain death” with no “new” intervention” is incorrect. The organs need oxygenated blood.

    The initiation of the heartbeat, on the other hand, is not under direct brainstem control. While the nerve cells in the brainstem can speed up or slow down heart rate–the actual heartbeat is controlled by the muscle itself, and the fiber bundles associated with it.