Thursday, December 16, 2010

With all your Heart, With all your Soul



Continuing with my elaboration of my reasons for signing up as an organ donor, here is a discussion of the first part of the first of my two reasons. (About a year ago, I noted that when people give two reasons for something, it's usually the second reason which is the real reason, and the first one is a smokescreen. That is not the case here!)

As noted, I have not extensively studied the topic of organ donation - which is why I am explicit about not giving a thoroughly-researched conclusion on the matter. But I have extensively studied the topic of Chazal's knowledge of science in general, and Chazal's view of the kidneys in particular (and I plan to e-publish a monograph on this specific topic in the near future). And this gives two critical insights on the matter, both relating to the fact that the very act of analyzing different passages in the Gemara in order to determine whether Chazal considered life to fundamentally depend upon respiratory, circulatory, or neurological activity, misses the point entirely.

First of all (and this was a point that only occurred to me yesterday, so I am not yet certain of this), as Rabbi Breitowitz notes, in the ancient world there was no practical situation in which there was a differentiation between brain death and cardiac death. All vital systems - respiratory, circulatory, and neurological - would fail at approximately the same time, and there was no way of keeping one system going while another had failed. Thus, the failure of any one of them would be a satisfactory indicator of death. As such, any argument that the Gemara demonstrates Chazal to have conditioned death on a particular one of these systems is in error.

Second, after studying the matter very carefully in Chazal, the Rishonim, and Acharonim, it is abundantly clear to me that that Chazal, consistent with standard belief in the ancient world, mistakenly believed that the mind and free will are housed in the heart (assisted by the kidneys), not in the brain. There was no concept of organ transplants back then, but if there would have been, Chazal would definitely have held that the person's identity and soul is transplanted with the heart and kidneys, not the brain. We today, on the other hand, say that a heart transplant has no religious significance, whereas if a brain transplant would be possible, it would mean a person's mind and soul are being transferred. So even if it can be argued that Chazal considered a person's life to reside in the heart, this is irrelevant, since Chazal were mistaken as to which bodily organ houses a person's mind and soul.

Is there any Posek who agrees that Chazal were mistaken as to which bodily organ houses a person's mind and soul, but says that nevertheless they considered cardiac death to be actual death and were correct to do so? If so, I would like to know about it, because it would challenge my reasoning. But as far as I am aware, no Posek who does not accept brain death as actual death says such a thing. As such, the significance of my following this particular aspect of the topic is not so much that I agree with the reasoning of those Poskim who accept brain death, but more that I disagree with the reasoning of those who do not accept it, as I believe that they are fundamentally in error regarding Chazal's beliefs.

I am convinced that if Chazal would have understood the true nature of the heart and brain, and would have lived in a world where one could distinguish brain death from cardiac death, and where it was possible to save lives by using the organs of someone who is brain dead, they would have urged us to do so.

38 comments:

  1. Shulchan Aruch (hilchos Tefillin) certainly held that the neshama is housed in the brain. I am pretty sure that is the standard view of most Rishonim. It is true that intellect is usually housed in the heart, but Rabbeinu Bachaye (Bereishis 4:1) and a few others locate thought in the brain.
    I have a shiur on the topic (though there is a lot more to be said which I didn't know at the time Heart and Soul shiur

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  2. In medieval Europe at that time, it had become widely accepted that the mind is housed in the brain.

    (By the way, Redak in Sefar HaShorashim says that the intellect is housed in the heart.)

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  3. Why is it that when I think, it feels like my thoughts are happening behind my eyeballs, i.e. the brain? Is it because I've been conditioned to believe that?

    So in ancient times people felt thoughts happening inside their hearts?

    My point is it seems more plausible to me that the reason thoughts feel like they're happening inside my skull is because that's actually where they're happening. How could ancients have ignored that?

    Emotional responses, in contrast, do feel like they happen in the heart area. So perhaps those sources in Chazal (which you didn't quote) are referring to emotional thoughts and not intellectual?

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  4. Rabbi Slifkin - I don't fully understand why you equate the physical question of when an organism is considered dead with the metaphysical question of which part of the body holds the mind and soul of the person. Even if we are to assume that the first question is also a metaphysical one, I don't see why the two questions should be linked.

    As you say, at the time of Chazal, they thought that the kidneys were one of the main organ involved in thinking and decision making. Yet (correct me if I'm wrong) I don't recall any opinion stating that the definition of death is when the kidneys cease functioning. (And yes, I did note in your post that you said the heart, assisted by the kidneys. Still, I would expect that if the "housing of the mind and soul" were the crucial criteria, then the kidneys would at least get a mention. After all, one opinion is that breathing is the criteria, yet no one in those days thought that the lungs were where the mind and soul were housed.)

    If I recall correctly, the various opinions in the gemarah about what is considered death are all based on various drashos of pesukim in the Torah. I would think that these drashos were honestly-held opinions about the proper interpretation of the pesukim, independent of the only tangentially-related question of which organ houses the mind and soul.

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  5. Why is it that when I think, it feels like my thoughts are happening behind my eyeballs, i.e. the brain? Is it because I've been conditioned to believe that?

    Yes, absolutely! That is the only reason. You are not feeling your brain activity!

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  6. I don't fully understand why you equate the physical question of when an organism is considered dead with the metaphysical question of which part of the body holds the mind and soul of the person. Even if we are to assume that the first question is also a metaphysical one, I don't see why the two questions should be linked.

    The following thought experiment should help:

    Reuven takes an explosive bullet in the head which turns his brain to mush.

    Shimon has his heart totally fail.

    Levi has his brain transplanted into Reuven's skull, and his heart transplanted into Shimon.

    Now, where is Reuven, Shimon and Levi?

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  7. As you say, at the time of Chazal, they thought that the kidneys were one of the main organ involved in thinking and decision making. Yet (correct me if I'm wrong) I don't recall any opinion stating that the definition of death is when the kidneys cease functioning.

    The kidneys only provide counsel to the heart. Also, in ancient times, if your kidneys failed, you died anyway.

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  8. If I recall correctly, the various opinions in the gemarah about what is considered death are all based on various drashos of pesukim in the Torah. I would think that these drashos were honestly-held opinions about the proper interpretation of the pesukim, independent of the only tangentially-related question of which organ houses the mind and soul.

    A wise insight. I'll have to wait to respond to this until after I conclude my discussion of the firmament. והמבין יבין.

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  9. Re.: ספר השרשים לרד"ק

    R'NS: "[...] (By the way, Redak in Sefar HaShorashim says that the intellect is housed in the heart.)"

    Are you referring to a remark under ל-ב-ב for

    קהלת י/ב: "לב חכם לימינו ..."
    :
    רד"ק: "...ולפי שהלב הוא משכן השכל."
    [Single-page PDF at hebrewbooks.org.]

    If this isn't the citation I can avoid sending you a pointless comment.

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  10. First of all (and this was a point that only occurred to me yesterday, so I am not yet certain of this), as Rabbi Breitowitz notes, in the ancient world there was no practical situation in which there was a differentiation between brain death and cardiac death. All vital systems - respiratory, circulatory, and neurological - would fail at approximately the same time, and there was no way of keeping one system going while another had failed. Thus, the failure of any one of them would be a satisfactory indicator of death. As such, any argument that the Gemara demonstrates Chazal to have conditioned death on a particular one of these systems is in error.
    ============================
    Listen here: http://download.yutorah.org/2010/2817/752286/Defining%20The%20Moment:%20What%20Does%20It%20Mean%20To%20Be%20Dead.MP3 where the 1st point is made. But having said that I think one can only conclude based on your reasoning that we do not know what chazal would have said had they had the technology and knowledge we have today. IMHO that's the reason why most poskim say it's forbidden at least as a safek, to use brain death as a criteria.

    As far as the drasha from psukim issue, it depends on your view of how chazal operated. If this was all a mesora from Sinai, then case closed. If not, then we can discuss how they darshened, but we no longer have the power (until the next sanhedrin) so it's really a moot point.

    KT
    Joel Rich

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  11. I fail to see evidence from the primary sources that the activity of the heart is the main determinant of life. As previously noted, that is one alternative view in Yoma 85a which appears to be disregarded in the subsequent discussion. Some poskim have, apparently, interpreted Rashi there to imply that there must also be evidence of a lack of heart function. That, however, is not the evident understanding of Rashi's words. He refers to the victim being motionless as a potential sign of possible death, rather than not having a heartbeat. The general view in Yoma and elsewhere is that breathing is the main sign of life. That is both a practical determination as well as having some scriptural basis. The question of lack of brain function, whose implication the sages may not have fully appreciated - although they considered a headless animal to be dead, despite continued movement, is a new but secondary consideration. As I see it, if a number of definitive tests have not found evidence of any brain activity - including the brain stem, and the condition is considered irreversible, then a confirmation of the lack of spontaneous breathing should then constitute a definition of death - both medically and according to primary halachic sources.

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  12. Rabbi Slifkin,

    It's interesting that you're relating the question of death to the question of where one's soul and mind reside. As "er" wrote, is it so obvious that these two questions are related?

    Second point: If you are right, wouldn't your line of thinking also have great implications for people who lie in vegatative states hooked up to a respirator? They may have some very limited brain function but can you really say these people's "souls" are alive in any meaningful sense?

    I'm not criticizing. I'm simply saying that if you closely relate halachic death to where the soul is located, we may get to even more interesting halachic conclusions than organ donation.

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  13. A chareidei friend of mind states:

    >>Unlike the Author who had time to read all the "Chazal, the Rishonim, and Acharonim" that deal with this matter, and who somehow found the one topic in all of shas that every one of them agrees on (so it would seem to read!), I do not have that kind of time to invest, but I do occasionally wear tefillin, and remember the tefilla that is said when donning them "שהנשמה שבמוחי" - "the soul that is in my brain" so unfortunately, the Author, for all his erudition, is wrong.<<

    I hope you can address his points.

    Thanx

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  14. "Chazal, consistent with standard belief in the ancient world, mistakenly believed that the mind and soul are housed in the heart and kidneys, not in the brain."

    Thinking about my previous business, here's a possibility: the Headquarters for the soul could be in the heart, and Operations could be in the brain.

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  15. but I do occasionally wear tefillin, and remember the tefilla that is said when donning them "שהנשמה שבמוחי" - "the soul that is in my brain" so unfortunately, the Author, for all his erudition, is wrong.

    Hey, I never thought of that!

    Just kidding. Honestly, do people really think that I am unaware of such simple things?

    I didn't claim that the Rishonim and Acharonim believed that the heart is the seat of the mind. I said that CHAZAL believed that to be the case.

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  16. here's a possibility: the Headquarters for the soul could be in the heart, and Operations could be in the brain.

    Other than that idea being appealing, what reason do you have to think that it is true?

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  17. Speaking of tefillin, doesn't the pasuk say you shall put them "on your lev and on your nefesh?" Since the vav has a shva, that implies connection between lev and nefesh (in the next pasuk, the vav is used for the halachah that you need shel yad before shel rosh IIRC). While I am no expert in the field, I have never seen the word lev translated as "brain", but rather always as "heart" (a mistranslation similar in many respects to the mistranslation of rakia). If we assume that Chazal were adept at being medaraish psukim, it would appear that they believed the nefesh was in the heart.

    QED

    For the tefillah by tefillin to be a proof against this it would need to be demonstrated that it was written before the gemara and by someone who didn't believe in the four-part soul structure.

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  18. To add on to my previous post, IIRC there are several halachot of tefillin based upon interpreting the word lev to mean heart (ex. the shel yad should face inwards) so it appears that Chazal overall thought lev meant heart.

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  19. Me: here's a possibility: the Headquarters for the soul could be in the heart, and Operations could be in the brain.

    R' Slifkin: Other than that idea being appealing, what reason do you have to think that it is true?

    My answer: Well, first I figured, why is everyone assuming that the soul is based, so to speak, in only ONE of those two organs? Why not both?

    Also, I suppose my reason to think it /might/ be true is probably the same reason one thinks it might /not/ be true. And that is: A stab in the dark.

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  20. Why do Chazal refer to comments that were not thought out as coming from מי שאין לו מוח בקדקדו?

    (Yevamos 9, Menachos 80)?

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  21. For the second time what is IIRC?

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  22. Meir - there are two possibilities. "Chazal" is not a monolithic entity - it's many people over a long period in different places. It could be that some of Chazal absorbed the idea that the brain houses the intellect. Alternatively, even according to the Aristotelian model that the intellect is in the heart, the brain had a role in cooling the blood; perhaps someone "without a brain" was someone who was too hot-blooded to think straight.

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  23. Carol - Google is fantastic, if I recall correctly!

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  24. Why is it that when I think, it feels like my thoughts are happening behind my eyeballs, i.e. the brain? Is it because I've been conditioned to believe that?

    I think its all in your head

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  25. "Chazal" is not a monolithic entity - it's many people over a long period in different places. It could be that some of Chazal absorbed the idea that the brain houses the intellect.

    Rabbi Yehudah Hanassi says this to Levi, cited in the Bavli and Yerushalmi, and his issue is contended with through the generations. They had a Mesorah on the wording.

    Alternatively, even according to the Aristotelian model that the intellect is in the heart, the brain had a role in cooling the blood; perhaps someone "without a brain" was someone who was too hot-blooded to think straight

    I'm sure you realize this is quite weak. Herophiles predates Rabbi Yehudah Hannasi by some 400 years. In light of the close relationship between Rabbi Yehudah Hanassi and Rome, Galen probably also played a role in Rabbi Yehudah Hanassi's acceptance of the brain as the seat of the intellect, and Galen coincides with Rabbi Yehudah Hanassi's time period.

    You must at least concede that the Rishonim held Chazal's scientific knowledge to be up to date.

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  26. And yet, despite this phrase, there are explicit statements in the Gemara about the heart (rather than the brain) accepting counsel from the kidneys. So even if R. Yehudah HaNasi accepted Galen, it didn't filter through to everyone else.

    You must at least concede that the Rishonim held Chazal's scientific knowledge to be up to date.

    Why? They certainly didn't think so regarding astronomy.

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  27. The heart accepting counsel can be explained allegorically, or as housing the emotional response as opposed to intellectual ability. (See Nefesh Hachaim 1:14.) I think it quite farfetched (that's the most Yeshivish English word I know, along with "toppled") that an open statement by Rebbe that was handed down through the generations didn't "filter down".

    regarding the knowledge of Chazal being consistent with the most advanced knowledge of their day, I thought Rabbeinu Avraham said that, but now I seem to recall it was Rav Hirsch.

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  28. It can't be explained allegorically. The context of it clearly shows that it was meant literally.

    What I meant about R. Yehudah HaNasi's statement was not that the statement didn't filter down, but rather that the physiological view that it represented did not filter down.

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  29. By the way, even if R. Yehudah HaNasi accepted that the brain has a cognitive function, it doesn't mean that he rejected the idea that the heart and kidneys also have a fundamental role in the mind/ soul.

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  30. Rav Slifkin,

    I think it is important to stress in the body of your next post that there are many competent poskim who do paskin that brain stem death is halachik "death" based on their careful reading of chazal. Once that has been established, your other points as to why you chose to become an organ donor will fit into context and it will not seem as if you are personally paskining this issue purely based on the fact that chazal had a misunderstanding of where the mind and soul were housed. I think much of the misunderstanding in the last few posts have rested on the fact that many readers do not yet understand that many poskim hold of brain stem death as halachik death.

    But one question: from my knowledge of the "sugyah," it doesn't seem like the poskim who hold of brain stem death hold that way because they believe chazal had an improper understanding of where the mind and soul were housed. Rather, they paskin that way based on their reading of certain divrei chazal (Mishnah in Ohalot, Gemara Yoma, etc). So, based on your reasoning, had chazal said explicitly that death is defined as cessation of the heart beat, would the fact that chazal were wrong in their placement of the mind and soul now allow us to change the definition of death? Meaning, would your reasoning alone (of the incorrect view of where the mind/ soul is housed) be enough for us to change the halacha? Or, is your reasoning only a way for you to further lean towards the poskim who hold of brain stem death?

    Thanks!

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  31. For a different perspective on the heart and body's role in consciousness and thought, see the work of Antonio Damasio, Paul Pearsall, Candace Pert, Joseph Clinton Pearce, Michael Jawer, and Michael Gershon.

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  32. Adam B. - see my next post. I think that I have already stressed that I am not "paskening" at all!

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  33. I have been an organ donor since the day I reached legal age - the same day I first gave blood. When I am brain dead I will have no further use for those parts and from a scientific, if not necessarily religious, viewpoint I will be dead.

    If this comes up in the Final Judgment I will call on the recipients and their descendants as character witnesses and hope for the best.

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  34. www.pbs.org/bodyandsoul/203/heartmath.htm

    Maybe this article might change your mind about the role of the heart in consciousness. As a physician I can tell you this view is rapidly gaining ground.

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  35. http://www.randi.org/site/index.php/swift-blog/1202--is-heartmaths-emwave-personal-stress-reliever-scientific-.html

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  36. I personally don't care much for the randi.org site, who is he anyways? There is much on that site that is pure nonsense.
    it's not Torah misinai or even close.

    BUT I'm not trying to sell heartMath I have no idea of its validity. I just chose that PBS site since it explains in simple terms the principles of a newly emerging field of neurocardiology. Do a pubmed search for scientific articles on this topic.

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  37. Heres another easy readable article

    http://www.scientificamerican.com/article.cfm?id=the-neuroscience-of-heart&page=2

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  38. Not sure why you think that has any bearing on this post.

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