Sunday, December 19, 2010

Talmudic Authority and Canonization

Continuing the discussion regarding organ donation: Previously, I explained that Chazal believed the heart (and kidneys) to be the seat of the mind and soul. As such, the approach of figuring out how to define death based on Chazal's statements about physiology is fundamentally mistaken. But if Chazal did believe that life resides in the heart, would we have to follow them anyway, even if they were mistaken?

In the final chapter of my book Sacred Monsters, I discussed the topic of halachos in the Gemara that are based on mistaken views about the natural world. I favored the approach of Rav Herzog and others, which is that the halachos still hold true, for reasons that I explained in the book. But in this case, there are two crucial differences.

First is that in cases where lives are at stake, nobody follows the Gemara. The classic example of this is that the Gemara says that whereas a baby born in the seventh month of pregnancy can be viable, a baby born in the eighth month is not, and thus one may not violate Shabbos to save its life. Now, people come up with all kinds of explanation as to why the Gemara is not binding - nishtaneh hateva of babies, nishtaneh hateva of medicine - but the bottom line is, pikuach nefesh trumps everything. Nobody is going to let an eight-month old fetus die just because Chazal said it's not viable. So if it is the case that a person's soul is seated in his brain rather than his heart - and I think that is clearly so - then there is no essential halachic problem in pulling the plug, and the pikuach nefesh of saving all the people that can be saved with his organs would supersede the importance of upholding Chazal's authority.

The second difference is that it's not as though the Gemara said "A brain-dead person is still halachically alive." Instead, those who do not hold of brain-death infer this position from various halachos in the Gemara dealing with different aspects of life and death, such determining whether people in a collapsed building are alive. Now, the halachos themselves are perfectly valid, given the medical realities of the period. It is only the inferences, which depend upon Chazal's (and Rashi's) understanding of physiology, which are problematic. Thus, even if the inferences are correct from the point of view of analyzing Chazal, but one ignores them because Chazal had a mistaken view of physiology, one is not contravening any actual halachos in the Gemara.

33 comments:

  1. I've always found the whole idea of Chazal and physiology fascinating, especially when it comes to the definition of death.
    Now, here's how the human body works: a nucleus in the brain stem controls the automatic respiration we all use to stay alive. The lungs bring oxygen to the body which the heart then pumps around, including to the brainstem which in turn makes the lungs bring oxygen to... you get the picture.
    Chazal in Yoma are quite clear - no breathing = no life. Understanding the relationship between the brainstem and respiration actually fits with this observation. A person who loses his brainstem will continue to have a heartbeat for a short time, until the blood becomes so acidic that it just stops beating, but he's not longer automatically breathing so he's essentially dead. Most poskim today also acknowledge brainstem death as a valid form of death. So Chazal were onto something when they used breathing as a definition of death.

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  2. "So if it is the case that a person's soul is seated in his brain rather than his heart - and I think that is clearly so"
    Why? How would you know where the soul is?
    Furthermore, the statement that pikuach nefesh trumps everything can be used both ways. If a brain dead person is fully alive, than one cannot kill him to save another. Besides not everyone receiving a donated organ is necessarily classified as in an immediate life threatening situation.
    Not that I disagree halachicly. I do believe that brain dead is death, but for purely halachic considerations. Rabbi Shlomo Amar gave a very convincing shiur about it 2 years ago at Yad Maimon. He failed to see the difference between a brain that was not giving any orders to the body (I forgot his medical terms) and a severed head, which Rambam classifies as dead - even if heart and brain still seem to be functioning independently. He had many other raayos to his position. I do believe that if we were able to remove all the politics and even world views out of the sugya, and had a public discussion about it in strictly halachic terms, there would be a larger amount of people signing up with HODS etc.

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  3. "So if it is the case that a person's soul is seated in his brain rather than his heart - and I think that is clearly so"
    Why? How would you know where the soul is?


    Because if you transplanted Reuven's brain into Shimon's body after Shimon's brain was nuked, and Reuven's heart into Levi's body because of Levi's poor heart condition, everyone would agree that Reuven is now in Shimon's body, not Levi's.

    Furthermore, the statement that pikuach nefesh trumps everything can be used both ways. If a brain dead person is fully alive, than one cannot kill him to save another.

    This particular post of mine was explicitly predicated on the assumption that a brain dead person is not alive.

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  4. everyone would agree that Reuven is now in Shimon's body, not Levi's.

    Where on earth did you get that from? I disagree completely. Reuven would be dead, and Shimon and Levi would be Shimon and Levi, with a new brain and a new heart, A brain is not a person, nor is a person summed up and concentrated in his brain. A brain is no different than a kidney when it comes to organs and transplanting them. I am not my brain, and my brain is not me. If you cut off my head, I am still me, just headless.

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  5. Marcus: so you say that the soul would not follow the brain, but would leave this world when the rest of Reuven dies? Whose soul would inhabit the body now containing Reuven's brain?

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  6. OK, Marcus, I was wrong! Not everybody agrees to it.

    Now let me ask you this: If you received a donor kidney, would you cease to be Marcus? How about a donor liver? A heart? A brain? At which point would you cease to be Marcus?

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  7. I am not my brain, and my brain is not me.

    Maybe not literally, but most people would say that their brains make them who they are.

    http://www.nytimes.com/2009/05/10/us/10mason.html

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  8. NOT FOR THIS STRING.
    IT JUST RELATES TANGENTIALLY.

    You seem to be stating that the critical characteristic of being humanly [or is it all life?] alive is the present and active nature of a neshama-soul. Now, two questions about the neshama.

    In Bereishis, the neshama appears to be breathed by God into the dirt thus imparting some unique portion of divinity to the human. Since we are positing that human [only?] life ends with the leaving of the neshama from the body, I am curious to know more about the status of the neshama.

    1] If we take the neshama as something that exists in reality rather than as a metaphor, where in the evolutionary history of the human would this piece of divinity become present. For example, were earlier homo sapiens like Cro-Magnons endowed with a neshama or does the neshama appear in slightly more distant homonids like the Australopithicus genus. Or, any thoughts about this generally if we don't know any specifics [which seems most probable].

    2] If we are positing that a neshama = a uniquely human mind, then are we saying that the lack of a neshama renders a person to be dead? Or do we say that the body is in a state like "simpler" living beings [like...say... eukaryotes]. Or do we have to stick within our own Kingdom and say though the mind is gone, the body is akin to a jellyfish [for instance....though there are probably better analogies]?

    Thanks,
    Gary Goldwater

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  9. "...but the bottom line is, pikuach nefesh trumps everything. Nobody is going to let an eight-month old fetus die just because Chazal said it's not viable."

    Rabbi, If i misunderstand you I am sorry. But, why would we not let a 8 month old baby die if according to chazal its not viable? The other answers make more sense(nishtana hateva etc). But pikuach nefesh is defined by chazal, so if they say its not a case of pikuach nefesh, then how can one use a halachic mechanism (pikuach nefesh trumps) with something that from a halachic standpoint cant work?

    Eddie

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  10. At which point would you cease to be Marcus?


    When my entire body shuts down and i"m 6 feet under.

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  11. "In the final chapter of my book Sacred Monsters, I discussed the topic of halachos in the Gemara that are based on mistaken views about the natural world."

    But the soul is not part of the natural world. At least I don't think so.

    Be that as it may, I liked your post and probably agreed with all of it.

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  12. This thread has taken a turn in the direction of my professional (working on a Phd in cognitive neuroscience) interests and I feel I should share some of the current science on the topic. First, it should be said if there is anywhere where the conflict between science and religion is sharply expressed, this thread is it.
    The current opinion among most scientists working in the field of the neurosciences is that we do not have souls. This is not just some simple anti-religious perspective. When examined from a historicist perspective one clearly sees philosophers in the time of the Rambam (including the Rambam) closely tying the soul to the intellect. In the time of the Rambam and for many years after there has been a belief that the mind and the body are two separate entities, one physical and the other spiritual. This is also known as Cartesian Dualism. Current scientific opinion has largely discarded this theory. I am being careful not to say all scientific opinion, but again the going dogma is that brain states are mind states. That is, all that we affectionately acknowledge as ourself, our memories, our emotions, our experiences, our personality, these are all functions of activity in the brain. And yes, there is a lot of science to back this up.

    As to the soul, that soul to which I referred above is the nefesh. The ruach and the neshama are far more abstractly defined as to their connection to a person's identity.

    It would seem to me to best approach the question of death from a strictly physiological perspective, so I totally agree with Ironheart's post. The more interesting questions arise in cases of extensive brain damage where the brain stem is still functional but the all memory and consciousness has been irretrievably destroyed. Then what?

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  13. Lawrence Kaplan Comments:

    Rabbi Slifkin: This is far from realms of expertise, but I suggest you read W. Teed Rockwell's Neither Brain nor Ghost (MIT Press).

    The book is a critique of the mind-brain identity theory or the "myth of the autonomous mind-brain." To cite the dust jacket: "Rockwell...proposes that mental phenomena emerge not merely from brain activity, but from an interacting nexus of brain, body, and world. The mind can be seen not as an organ within the body, but as a behavioral field that fluctuates within this brain-body-world nexus."

    I really do not think you should try to bring raayot from hypothetical "brain transplants," which for the meanwhile belong to the realm of science fiction.

    FWIW, I support your general position.

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  14. "Because if you transplanted Reuven's brain into Shimon's body after Shimon's brain was nuked, and Reuven's heart into Levi's body because of Levi's poor heart condition, everyone would agree that Reuven is now in Shimon's body, not Levi's."

    Agreed completely. This would be because our brain houses our consciousness and this is what ultimately defines us as individuals. As dehumanizing as this sounds, at our core we are made up of simple physical entities which, when arranged in sufficiently complex states, form the the cells which constitute our biology.

    "This particular post of mine was explicitly predicated on the assumption that a brain dead person is not alive."

    You wrote previously that normally you follow the halacha as codified by Chazal, even when the science which underlies them was incomplete. You then proceeded to state that this case is an exception to that rule, because it is a matter of life and death, and you are willing to be lenient in such cases. I am inclined to agree with you. However, when I heard a speech given by some Halachic Organ Donor Society Rabbi, I recall him framing the svarah behind preferring brain death differently. To my recollection, he stated that it is possible to learn the sugyot dealing with this subject and conclude that brain death actually does constitute halachic death without resorting to concluding that the din of cardiac death was the result of scientific fallacy, because the din was actually always brain death according to this alternate understanding.

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  15. Yisrael, thank you for your summary. Perhaps, though, you have made one simplification too many? As I understand it, I don’t think current science proves “we do not have souls” rather than we don’t have a discrete soul. In other words, our essence (soul) is a function of the brain as a system of both mass and energy, but we still have an essence (soul) -- we just can't point to it discretely, as it is mostly energy.

    The impact of this is less relevant to the discussion of when death occurs, as to our beliefs regarding what happens after death. It seems to me that science may actually make it more rational to believe in resurrection: i.e. if our essence is energy (encoded as states in our hardware brains) then one can imagine that energy being transferred at the time of death (a popular ploy in Science Fiction).

    Yeshayahu Leibowitz argues that for Rambam “reduces the concept of resurrection of the dead to the half-mystical, half-philosophic idea of the fusion between man’s acquired intellect, which is tantamount to the knowledge of God acquired by a man, and the active intellect – in other words, knowledge of God is what is implied by the resurrection of the dead”. (pp. 58-59 of The Faith of Maimonides).

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  16. "Nishtaneh hateva" can be used to disregard everything and anything that Chazal speak of in the natural world. "Nishtaneh hateva" can also be used to determine if people in a colapsed building are still alive based on current scientific definitions of death.

    Okay, the sun revolved around the Earth in the time of Chazal, but "nishtaneh hateva" and now planet Earth revolves around the sun.

    If you can't beat 'em join 'em.

    Of course it doesn't work for rationalists who don't agree with "nishtaneh hateva" because science does not agree that the tevah has changed since the time of Chazal. (Although science DOES agree that the tevah changed over millions and billions of years, but that's another discussion.)

    But wouldn't it be convenient to be able to, with a wave of the hand, dismiss any of Chazal's determinations based on the natural world which don't fit into our current scientific knowledge (like allowing 8-month-old fetuses to die so as not to be machalel Shabbos) by using the statement "nishtaneh hateva" to say it is no longer a binding halachah?

    The non-rationalists may be onto something here!

    Maybe insects can be halachically permitted for consumption and we don't have to check our fruits and vegetables with lightboxes and magnifying glasses anymore because "nishtaneh hateva". The possibilities are endless!

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  17. "everyone would agree that Reuven is now in Shimon's body, not Levi's."

    And Reuven in Shimon's body can now marry Shimon's sister?

    Shimon's wife can remarry without a get while Reuven's wife is still eshes ish and can live and have children with Reuven in Shimon's body?

    That what everybody agrees on?

    My take: Levi is Levi and Reuven & Shimon are safek dead.

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  18. I believe you might enjoy the following study. Hope you can access it through your university web...

    http://journals.lww.com/neurosurgery/Abstract/2009/10000/The_Anatomic_Location_of_the_Soul_From_the_Heart,.1.aspx

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  19. R. Slifkin said:
    "Because if you transplanted Reuven's brain into Shimon's body after Shimon's brain was nuked, and Reuven's heart into Levi's body because of Levi's poor heart condition, everyone would agree that Reuven is now in Shimon's body, not Levi's."

    Maybe..

    or Maybe not.

    You ask, "then who would now be inhabiting Shimon's body?"

    Answer: I don't know...and neither do you.

    You are imagining that a human brain transplant would have the same transparrent effect that one observes when pulling the hard drive out of one computer and placing it in another...Boot it up and, voila..it's the same computer for all practical purposes.

    It's not that your assertion is not compelling. It's your insistence that "eveyone would agree" to this analogy in the human realm, and that the entirety of Jewish tradition regarding the soul can be so readily simplified, is the reason this post has garnered a 50% - 50% kefira vote.

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  20. DomityangRS, 15 votes emes and 15 kfira. This is impossible. I think poshuter is again up to no good.

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  21. Head transplants have been performed on dogs and monkeys. The transplanted heads continue to function physiologically and, seemingly, mentally as well, sustained by the body, but they cannot control that body. Thus, the matter is not science fiction.

    Also, conjoined twins with two heads and a single heart have independent consciousness, so I'm not sure why anyone should object to R Slifkin's criteria.

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  22. R' Slifkin, you ask: "But if Chazal did believe that life resides in the heart, would we have to follow them anyway, even if they were mistaken?"

    Why isn't the question, "But if Torah itself did believe that life resides in the heart, would we have to follow it anyway, even if it was mistaken?"

    After all, doesn't the Torah say, "For the life of a creature is in the blood, and I have given it to you to make atonement..." -- Leviticus 17:11

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  23. Yisrael, would it be possible for you to send me your email? (You can find my email in my profile!) I am intrigued by the latest developments in the field of neuroscience, and would like to have someone who I could email if I ever had any questions about the science.

    Also, what do you think of dualism as proposed by Karl Popper? IE, that the mind and the matter comprising the brain are both ultimately physical and scientifically reducible, but are separate insofar as much as they act causally upon each other to produce our consciousness. The ideas we envisage with our brain, which while comprehended and stored in a physical manner, represent our brains reconstruction of ideas, which are themselves inherently not physical and, according to Popper, belong in a separate dichotomy of reality unto themselves. (His 3-Worlds Theory) Thanks!

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  24. Why isn't the question, "But if Torah itself did believe that life resides in the heart, would we have to follow it anyway, even if it was mistaken?"

    No, we(the rationalists) would say dibra Torah ki lshon bnei adam and we would contextualize it.

    After all, doesn't the Torah say, "For the life of a creature is in the blood, and I have given it to you to make atonement..." -- Leviticus 17:11

    Not necessarily. See the Hebrew text please: ki hadam hu banefesh yechaper'. Spilling of the blood on the mizbeach atones for the soul according to Chizkuni.
    For a full treatment of blood in the sacrificial service please see Rambam in Moreh (III:46).

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  25. Yona, I checked out Antonio Damasio and it fascinating! Thanks for posting.

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  26. Two comments:

    First at anonymous (a.k.a. Gary Goldwater?). Your first question abou the evolutionary place of the soul is an interesting question. I seem to recall an article by Rav Aryeh Kaplan that suggested that Adam HaRishon was the first human in the sense that he was the first to possess a soul. Before him there were many humanoid primates but they had not evolved sufficiently to receive a soul. That is to say, humans receiving a soul is an evolutionary step.
    Your second point is also interesting. I personally would not equate neshama with mind but let's leave that aside. Your point makes an interesting ethical split between the perpetuation of life and the perpetuation of the person. Essentially what we are saying when call someone brain dead is that the person has ceased to be, the body is now like any other "lesser" order living creature which we have the permission to kill, ending its metabolic process. The flip side would be a person who is artificially kept alive and thereby conscious. Here (except for our intervention) their biological processes would end, we are perpetuating the person.

    @ IH. I was careful not to use the word proof because science has not proven anything with regards to the soul. Science with its empirical tools cannot prove anything with regards to the soul as it is a non-physical entity. What science does say is that there is no explanatory necessity for the soul. This means that all cognitive function previously in history ascribed to a soul is now explainable as brain function. Remember that natural philosophers of old such as Aristotle and co., Avicenna, Averoes, the Rambam and others were the forerunners of today's scientists. The soul in their time was a necessary component of the human being that explained faculties that appeared to be non-physical.
    It should be stated though, that the scientific perspective does not address any soteriological or teleological aspects of having a soul.

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  27. Yisrael, I meant to say concludes rather than proves (or, theorizes, to be more correct). Mea culpa.

    Speaking of word choice, though, I think it is eschatological rather than soteriological that is more germane to our topic.

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  28. I know this isn't the absolute best place for this quote. But it's one that puts the Rational/Religious question in sharp relief.

    "There is a fundamental difference between religion, which is based on authority, and science, which is based on observation and reason. Science will win because it works." — Stephen W. Hawking

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  29. @ IH True, eschatology more relevant here, I agree. For any reward or
    punishment to be relevant the soul must be associated with the
    continuation of the personality. However, this is not what current
    scientific opinion holds. They would say we are the sum of our
    experiences and memories, no more. Our person dies with the body.

    @Adrian, I couldn't find your email, where should I look exactly?

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  30. Yisrael,

    I thought it was enabled on my profile, but it wasn't. So now it is. Thanks!

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  31. Eddie, you are mistaken in believing that 'pikuach nefesh' is necessarily defined by the understanding of the sages. If that were the case, then resuscitation of someone whose heart had stopped and wasn't breathing would be prohibited on shabbat since the person whould have been cosidered dead by the sages. In cases of life and death, we follow current evidence, techniques, and understanding rather than the conclusions of the talmudic sages. In fact, the same is true of all medical issues. The question is, then, why should we act differently when it comes to establishing death and allowing the harvesting of donated organs? Particularly, if it is established that spontaneous breathing is irretrievably lost due to the complete loss of brain function, then the conclusion of Yoma 85a would buttress the current medical understanding that the patient is, indeed, dead.

    As I have noted, it is incorrect to label someone who signs an organ donor card as participating in killing. At worst, it is a sacrafice of one's life to save others - assuming that a 'brain dead' person is not truly dead. Poskim who insist on using such labels appear to be engaged in polemics rather than strictly halachic expositions.

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