Thursday, January 13, 2011

Summary of the Life/Death Issue

This is an attempt to sharpen and summarize the posts of the last few days regarding determining life and death, as well as adding some new insights. I want to convert this into an article for publication, so if people can contribute suggestions of how to sharpen it even more, that would be helpful. I will be constantly refining this post based on the feedback in the comments.

The overall point of this discussion is to show that Chazal's views and rulings on life and death were fundamentally related both to the mistaken beliefs of the era about physiology as well as the limited medical possibilities. Thus, any halachic analysis of this topic must take this into account in order to be valid. Furthermore, our own understanding of physiology, together with the medical possibilities available to us, mean that brain death should be defined as halachic death.

1. Chazal believed that the heart and kidneys are the seat of the mind and free will.

At least some of Chazal - probably most or all - believed that the heart and kidneys are used as the mind and for making decisions (free will). Prooftexts are as follows:

The Rabbis taught: The kidneys advise, the heart considers, the tongue articulates, the mouth finishes, the esophagus brings in all kinds of food, the windpipe gives sound, the lungs absorb all kinds of fluids, the liver causes anger, the gallbladder secretes a drop into it and calms it, the spleen laughs, the gizzard grinds, the stomach [causes] sleep, the nose [causes] wakefulness. (Berachos 61a; similarly in Midrash Vayikra Rabbah 4:4)


This is not an aggadic legend intended to be understood metaphorically. The descriptions of the functions of the tongue, mouth, esophagus, windpipe, lungs, stomach and nose are all clearly scientific descriptions intended to be interpreted literally. The account of the liver causing anger is also consistent with standard belief in the ancient world. Thus, the account of the function of the kidneys and heart are thus also clearly intended to be literal descriptions - and there is no important role ascribed to the brain. This, too, is consistent with standard Aristotelian belief in the ancient world. The Rishonim and Acharonim agree that Chazal were speaking literally, as discussed in my monograph, The Question of the Kidneys' Counsel. Elsewhere, the Gemara relates halachos pertaining to the kidneys of animal offerings to the kidneys' function in man of providing counsel. Other Midrashim likewise echo this understanding of the role of the various organs:

" 'And God said to Moshe: Pharaoh's heart has become heavy (kaveid)' - He was angry. Just as the liver is angry, so too the heart of this one became a liver (kaveid), without understanding, as a fool. (Midrash Shemos Rabbah)

"That is to say, the heart of Pharaoh was turned into a liver (kaveid) -- just as a liver has no understanding to understand and comprehend, so too there was no understanding in his heart to understand and comprehend. Therefore, his heart was hardened and was stubborn for him." (Midrash Lekach Tov)
Like everyone else in the ancient world, Chazal thus likewise interpreted all Scriptural references to the heart (which most people today take as referring to the mind and thus the brain) literally. Scriptural references to the heart having various emotional states, to it housing wisdom and cognition, and to God judging a person based on examining his heart and kidneys, were all taken literally by Chazal.

2. Chazal were mistaken in this regard.

That should be self-evident. We now know that it is the brain that is used for all cognitive processes and for making decisions. The heart and kidneys have no such role. In fact, the heart can be replaced by an artificial pump, and the kidneys can be replaced by a dialysis machine. Doing this does not impair a person's mind in any detectable, significant way.

3. There is a fundamental connection between the mind/ free will, the soul, and the presence of a live person - and thus the mistaken belief that the heart and kidneys house the mind has fundamental ramifications on the question of determining death.

This is the part that some people were disputing. So I will explain it as clearly as possible, incorporating Dr. Stadlan's valuable observations.

The word "soul" is a vague term that has been interpreted differently by various figures over the ages. Some identified it as the intellect, some as consciousness, and some as a kind of metaphysical entity. The first two clearly relate to the mind. The third is essentially unspecified and incomprehensible, but as best as we can ascertain, it fundamentally relates to the mind, which is after all the part of us which absorbs Torah, exercises free will, and guides our actions. Jewish tradition has always maintained that the soul is involved in free will, and acquiring knowledge of God and Torah. Everyone agrees that these functions are accomplished in the brain. If one wants to claim that there are other aspects to the soul, which are housed elsewhere in the body, then what are they? Thus, as best as we can determine, the soul is housed in the mind. And the presence of a soul is certainly linked to the idea of an alive human being. Thus, not only is a functioning human brain the home of the mind, but if we are going to use the concept of the soul, then both the mind and the soul are housed in the brain.

There is further evidence that the soul is not housed elsewhere. The possibility of transplants and artificial organs sheds much light on the fundamental connection between the mind/ free will, the soul, and the presence of a live human being. In all such cases there are no halachic ramifications, such as murder, or transferring financial or other obligations from donor to recipient. One can replace someone's arm with a prosthetic, without being guilty of murder, and without changing the person's halachic status in any way. Clearly, then, the arm does not determine the presence of a person or of a soul. The same goes for many other body organs. Most significantly, one can do so with a heart. There are artificial hearts which have been successfully used for extended periods. Nobody would say that replacing someone's heart with an artificial heart means that you have killed them. This is further evidence that the soul resides in the mind - the one organ that cannot be replaced by an artifical substitute.

As Dr. Noam Stadlan points out, further evidence that the soul is housed in the brain comes from consideration of conjoined twins. "The only time halakhah or modern society even considers whether one or two humans have been born is when the newborn has more than one head. The duplication of every other organ (including the heart) does not raise any question of multiple identities or souls. Therefore, it appears that the universally accepted halakhah regarding issues of organ removal, substitution and transplantation, consciously or not, is based on the brain, and only the brain, being the seat of the soul."

We have to determine, which organ is it that fundamentally defines the presence of a person? Clearly it is the organ which houses the mind and thus the soul. Whichever organ that is, the presence and functioning of that organ will be the fundamental determinant of life. If the heart houses the mind, as Chazal thought, then if the heart is still beating, the person is still alive; if it stops, he is dead. But if it is the brain which houses the mind, then a person dies at brain death. Chazal lived in a world where a person's mind and soul were mistakenly thought to be housed in the heart and to thus be measured via a pulse and respiration, rather than to be housed in the brain, and thus to be measured via neural activity.

Now, it's certainly theoretically possible that there are additional factors which mean that a person is still rated as alive while the heart is beating. But nobody has proposed what they might be, or offered reason to believe that such factors even exist. Furthermore, since it is clear that a mistaken belief that the heart houses the mind would certainly cause one to define death based on the pulse and respiration, we know that Chazal's definition would have been, at least in part, based on an error.

We thus need to re-evaluate the determinant of death based on modern knowledge, rather than solely deducing it from Chazal. We know that a functioning human brain is the home of the mind, and it is the sole organ that needs to be present and cannot be replaced by an artificial substitute. For both of these reasons, we can deduce that the brain is the home of the soul and the sole determinant of life.


4. Even aside from all the above, the fact that maintaining a brain-dead person's circulation and respiration was impossible in Chazal's time, means that drawing inferences to today from Chazal's statements and rulings is fundamentally in error.


If Chazal say that a person is considered alive as long as he is breathing or has a heartbeat, it has to be taken into account that in their day, this was certainly the case, and there are no ramifications for how brain death is rated. Even with someone who considers brain death to be death, if he were to go back in time to Chazal's era and were to forget how to do CPR, he would agree that life and death, in that time, depends on pulse and respiration! So we cannot draw inferences from Chazal's statements about gauging life, which were entirely reasonable for their era, to the modern era.

To put it another way; even if Chazal were to theoretically have known about brain death and rated it as death, they would not have expressed their rulings any differently. So we cannot infer from their words that they did not rate brain death as death.

5. The problems involved in diverging from Chazal and reassessing the halachah are serious, but they have already been overcome in other contexts.

It's no small matter to re-evaluate halachah based on modern science. Some people justly fear that it means sliding towards Conservative Judaism. I myself follow Rav Herzog that in general, canonized halachah in the Talmud should not be changed even if based on scientific error, such as with Chazal's license to kill lice on Shabbos due to their mistaken belief that lice spontaneously generate.

Yet others do indeed say that we should change halachah based on our increased knowledge of science - such as Rav Lampronti in the case of lice. And even Rav Nissim Karelitz and Rav Elyashiv say that one should be stringent due to Rav Lampronti's view (sources to follow this week).

But even according to Rav Herzog's approach, this case is very different from that of lice, for two reasons. One is that we are not necessarily undermining the Talmud at all. The Talmud does not say "brain death is not death"! Rather, it makes some statements about determining the condition of a person buried under rubble, and other such statements, which were perfectly valid given the medical possibilities of the era. It can thus be presented as a case of nishtaneh hateva without having to bring in Chazal's misunderstanding of physiology.

Another difference is that if we accept brain death as death, then organ donation is viable and lives can be saved. It is thus a matter of pikuach nefesh, which always overrides everything. The Talmud gives a formal ruling that one can transgress Shabbos to save the life of a 7-month fetus but not that of an 8-month fetus, because (in Chazal's view) only the former was viable. Forget nishtaneh hateva; this was never true. And nobody follows Chazal's ruling in this.

Finally, we see that virtually all the Poskim today are willing to diverge from following Chazal in cases where they recognize that Chazal were scientifically mistaken and especially in cases of life and death. Virtually nobody follows Chazal in ruling on kidney transplants. Nobody follows Chazal, as explained by Chasam Sofer, that a person who is not currently breathing will never breathe again and is considered dead - everyone would do CPR. And nobody follows Chazal that an 8-month fetus is not viable. It is always presented in a (sometimes intellectually dishonest) way that avoids the idea that we are undermining Chazal, such as by invoking "nishtaneh hateva" even where that is clearly not the case. The same can be done here - and in fact, this really is a case of nishtaneh hateva - of medical possibilities.

124 comments:

  1. Regarding point 3:

    1 - Who says the soul has to reside in any specific place of the body? It is not physical!

    2 - See Tzitz Eliezer 10:25:26 where he disputes this entire line of argumentation at length.

    3 - Who says that artificial brains are fundamentally impossible? Maybe they will be possible in 100 years. Your arguments assumes as an unproven given that they are impossible.

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  2. 1 - Who says the soul has to reside in any specific place of the body? It is not physical!

    I already addressed this in the post. It's clearly not in the arm, because you can replace it with a prosthetic. Etc., etc.

    2 - See Tzitz Eliezer 10:25:26 where he disputes this entire line of argumentation at length.

    I'll check it out. Meanwhile I will point out that Tzitz Eliezer forbids kidney donation because of Chazal's description of the kidneys giving counsel.

    3 - Who says that artificial brains are fundamentally impossible? Maybe they will be possible in 100 years.

    I don't think it will ever happen. Besides, if all functions of my brain can ever be housed digitally, that would remove free will - and thus determining time of death would be the least of our problems! But in any case, if that were possible, then yes, life would be contained in the digital substitute.

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  3. I'm sorry, but there are so many faults with this that it is too difficult to put it all in one comment. I know I'm supposed to contribute something new to a comment, so here it is:

    The assumption that the soul resides in a particular organ is, frankly, so much hooey. You YOURSELF don't think the soul is only expressed by the ability to choose between good and evil, which is what Chazal thought about the heart.

    Understand: The soul does NOT reside in any organ. It resides in a living organism, period.

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  4. This is what I specifically addressed in this post. The soul resides just as much in a person without arms as in a person with arms, correct? So obviously the soul has nothing to do with arms. And the soul resides just as much in a person with an artificial heart as in a person with a real heart, correct? So obviously the soul has nothing to do with the heart. You can strike all the organs off in this way, except one.

    Besides, what do you think the soul actually does? It doesn't have anything to do with free will - with making decisions? It doesn't have anything to do with absorbing knowledge of God and Torah? It was always understood as having those roles. And those functions occur in the brain.

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  5. 1 - You did not really address it. You just say that it makes sense to you without giving it much attention even though it is a critical point to your argument.

    2 - The reason he forbids kidney transplants is because they were dangerous at the time. See Tzitz Eliezer 9:46. In 13:91 he adds as an additional consideration "דמי יודע עוד מה תהיינה הכליות יועצות בגופו של השני"

    3 - Based on what do you think artificial brains will never happen? And if it removes free will, which I'm not sure it will, does that mean that the person is dead? Does the soul depart the body of someone who loses his free will?

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  6. 1 - You did not really address it. You just say that it makes sense to you without giving it much attention even though it is a critical point to your argument.

    No, I addressed it in two independent ways. First of all, by showing that every organ other than the brain can be replaced by an artificial substitute without us saying that the person has lost his soul. Second, by showing that whatever we see the soul as doing, is accomplished by the brain (as per my immediately preceding comment).

    2 - The reason he forbids kidney transplants is because they were dangerous at the time. See Tzitz Eliezer 9:46. In 13:91 he adds as an additional consideration "דמי יודע עוד מה תהיינה הכליות יועצות בגופו של השני"


    Well, there you go!

    3 - Based on what do you think artificial brains will never happen? And if it removes free will, which I'm not sure it will, does that mean that the person is dead? Does the soul depart the body of someone who loses his free will?

    I don't see how a digital process can have free will. But if it does, and if it is indistinguishable from the person's original brain, then yes, that is where his life will reside. I'm not sure what you're trying to argue with these sci-fi speculations.

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  7. To clarify further - I think that Jewish tradition has always maintained that the soul is involved in free will, and acquiring knowledge of God and Torah. Everyone agrees that these functions are accomplished in the brain. If you want to say that there are other aspects to the soul, which are housed elsewhere in the body, I'd like to know what they are - and what happens when those parts of the body are replaced by artificial substitutes.

    I'm going to incorporate these points into the post.

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  8. And the soul resides just as much in a person with an artificial heart as in a person with a real heart, correct? So obviously the soul has nothing to do with the heart.

    No it isn't obvious. Let's see what happens when you detach the brainstem and let it sit there - is that where the soul is now? No - you need it to be connected to something. I ask you - to what?

    Besides, what do you think the soul actually does?

    Sustains life.
    Does an animal have a moment of death? Does an animal have the ability to choose? What in the world are you talking about?

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  9. Gil Student:
    re: the soul being spiritual and therefore not residing in any particular part of the body, the Ramban in Toras HaAdam addresses an analogous question (how can the soul be considered to be "in" a human body, or "in" gehenom).

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  10. Let's see what happens when you detach the brainstem and let it sit there - is that where the soul is now? No - you need it to be connected to something. I ask you - to what?

    To a brain!

    >Besides, what do you think the soul actually does?

    Sustains life.
    Does an animal have a moment of death? Does an animal have the ability to choose? What in the world are you talking about?


    An animal has a nefesh - not a neshamah. One can kill something with a nefesh in order to save someone with a neshamah. Besides, even an animal has a brain.

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  11. To a brain!

    Do you support harvesting organs of an anencephalic baby with a brainstem and no rest of the brain, which no Posek in the world allows?

    An animal has a nefesh - not a neshamah. One can kill something with a nefesh in order to save someone with a neshamah.

    Is it your position that one who has lost his ability to choose has been demoted to an animal, and we can harvest organs from Alzheimer patients?

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  12. Your definition of soul would mean that the soul stops to exist once the brain activity stops. Egro: no immortal soul.

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  13. R'N,

    Nefesh - neshama.

    Now you are using zoharic terminology (or definitions of terms). Nothing wrong with that, there are many studies comparing the kabbalistic stages of soul with modern psychology.

    Just not very "rationalist".

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  14. You would have to mention the Yalkut Shmoni and Gemara Yevamot, which people brought up in the comments,(and probably additional sources) that do attribute cognition to the brain. A more thorough investigation of the general ancient belief about the brain would be important. You might wish to point out that the word moach, marrow, suggests that it is merely marrow of the skull.

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  15. Do you support harvesting organs of an anencephalic baby with a brainstem and no rest of the brain, which no Posek in the world allows?
    Is it your position that one who has lost his ability to choose has been demoted to an animal, and we can harvest organs from Alzheimer patients?


    There are other factors involved there, such as the need to have a "lo plug" about humans.

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  16. Your definition of soul would mean that the soul stops to exist once the brain activity stops. Ergo: no immortal soul.

    Anyone's definition of the soul runs into that difficulty.

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  17. Nefesh - neshama.

    Now you are using zoharic terminology (or definitions of terms). Nothing wrong with that, there are many studies comparing the kabbalistic stages of soul with modern psychology.

    Just not very "rationalist".


    I would leave the soul entirely out of this discussion; I'm only discussing it because other people want to.

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  18. Besides, if all functions of my brain can ever be housed digitally, that would remove free will

    Not sure this is true. If an ordered system can produce unpredictability (chaos), then why can't billions of individually programmed neurons collectively produce a free will phenomenon?

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  19. Just to put things in a lomdish perspective. What if we explain chazal as purely stating the simanim of death as apposed to its sibah. As such we avoid the issue of stating that chazal were mistaken as they were only correctly describing the simanim of of a living person namely heartbeat and breathing since they can be measured externally. Thats not to say that a person with out these simanim are considered dead only that they lack the simanim of life.

    The sugyot do not explicitly deal with the sibah of life. Therefore it is irrelivant whether chazal miistakenly understood where the source of life is located, which today we know to be the brain. Today we understand that brain death is an even stronger siman of death, if not the sibah. Hence your argument does not contradict the sugyot

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  20. You would have to mention the Yalkut Shmoni and Gemara Yevamot, which people brought up in the comments,(and probably additional sources) that do attribute cognition to the brain.

    This would only be significant if it could be conclusively shown that all statements in the Gemara about determining life/death were made by members of Chazal who held that ALL cognitive processes and free will take place in the brain. Which is certainly impossible to even argue, let alone prove.

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  21. R"N,

    "Anyone's definition of the soul runs into that difficulty."

    No. What people are saying is that soul does exist outside of this physical world. Different body functions might 9or might not) be just a manifestation of a connection between the physical body and metaphysical soul.

    Since soul in the Jewish sense is a metaphysical object, only experts in that field can make decisions about it.

    Face it, Judaism is a religion.

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  22. What people are saying is that soul does exist outside of this physical world. Different body functions might (or might not) be just a manifestation of a connection between the physical body and metaphysical soul.

    Fine, well we can use the arguments that I presented in order to determine which body functions and organs are manifestations of that connection.

    Since soul in the Jewish sense is a metaphysical object, only experts in that field can make decisions about it.

    Who are those experts, and how did they become experts? And do they say that the soul is not related to the mind, and is related to different organs? And if so, what is its function? And what happens when those organs are replaced with artificial substitutes?

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  23. In other words, claiming that the concept of the soul refutes the points in this post is just meaningless speculation without any logic or sense to it, or any reason to believe that it is actually true.

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  24. Berachot 10a:

    מה הקדוש ברוך הוא מלא כל העולם - אף נשמה מלאה את כל הגוף; מה הקדוש ברוך הוא רואה ואינו נראה - אף נשמה רואה ואינה נראית; מה הקדוש ברוך הוא זן את כל העולם כלו - אף נשמה זנה את כל הגוף; מה הקדוש ברוך הוא טהור - אף נשמה טהורה; מה הקדוש ברוך הוא יושב בחדרי חדרים - אף נשמה יושבת בחדרי חדרים;

    Just as HaKadosh Baruch Hu fills all the world, also the Neshama fill the whole body. Just as HaKadosh Baruch Hu sees but is not seen, also the Neshama sees but is not seen. Just as HaKadosh Baruch Hu maintains the whole world, also the Neshama maintains the whole body. Just as HaKadosh Baruch Hu is pure, also the Neshama is pure. Just as HaKadosh Baruch Hu resides in hidden chambers, also the Neshama resides in hidden chambers.

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  25. Is that supposed to support my post, or challenge it? If the latter, then how?

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  26. I think when talking about the mind it is important to distinguish between "is housed in" and "is".

    The brain is not your mind, but your mind resides in your brain.

    This is analogous to a computer's hardware and its software. The most advanced computer in the world is useless if it has no software running on it. The thing that makes it useful and interesting is the software and the ways the software interacts with the hardware and the rest of the world. The hardware is meaningless without the software, and the software requires hardware in order to do anything. And it is possible to move software to otherwise-incompatible hardware, if that hardware is sufficiently advanced and has emulator software of its own.

    Similarly, a brain by itself is not useful. It is when the brain houses a mind that it becomes useful and interesting and capable of interacting with the world.

    A brain without a mind is useless, but a mind without a brain is equally useless (and possibly even a meaningless concept.)

    Could one make an artificial brain? Theoretically, I see no reason why not. But it would be useless unless there would be some way to transfer the recipient's mind from his natural brain into the artificial one.

    Now, I've only said "mind" and not "soul" and that is deliberate. I am not even close to the level of understanding to discuss what a soul is or how it may or may not be the same as a mind, let alone discuss where in the body it might be housed or if one could fashion an artificial receptacle to house one.

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  27. I apologize, I'd like to agree with you, but in this post there is too much that I disagree with. Your analysis of the Agadatah, your connection between the soul and these other attributes associated with organs, the conflation of kidney/heart in the specific topic of determining death, and the impossibility of artificial brains. However I will stick to what is "impossible".

    I am going to provide a series of links, each of which is an example of a part of the brain being altered and enhanced by computers/robotics. And the last is a link about machine learning, which 20 years ago would have seemed impossible.

    One last point before the links, all those people who do not believe that the soul as a whole is tied to any specific body part, do not have any kashas regarding the immortality of said soul.

    http://tiny.cc/lsexe

    http://tiny.cc/h1jk5

    http://tiny.cc/fxy4o

    http://tiny.cc/0c9br

    http://tiny.cc/jfjpg

    By basic point is that humanity seems to be able to replicate each part of the brain, one step at a time. It seems almost foolish to declare that brains could never repaired or replaced the way hearts and kidneys can.

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  28. Meir,
    But to take that one step further one could argue that we don't know what the sibah chazal were looking at and thus the siman they used can not be extrapolated to new simanim (or put another way- as I've said before- IIUC R'NS's approach is based on "understanding" what Chazal saw as the existential meaning of death and then showing that while the robust tests they used worked in their times, our ability to create states of existence that they did not have the ability to imagine , and their lack of scientific understanding of how the body works, means that we need to use new tests to determine whether the new criteria based on updated scientific knowledge, are met.
    One could take the position that Chazal in their infinite wisdom, or based on the direct mesorah, may have given reasons for the tests, but the tests they had, and only those tests, test for the true existential definition of death provided halacha Moshe Misinai or in their infinite wisdom they resonated to.
    Both approaches have been used by various authorities over time to various questions and so imho we go back to who gets to make the call.
    KT
    Joel Rich

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  29. It is thus a matter of pikuach nefesh, which always overrides everything.

    It is a matter of pikuach nefesh in either direction. If the matter of brain death is a balanced uncertainty, then we would weigh towards ruling that it is not death.

    If brain dead is dead, and you do not harvest organs, you have allowed another to die by inaction. If brain dead is alive, and you do harvest organs, you have killed a person directly.

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  30. My basic point is that humanity seems to be able to replicate each part of the brain, one step at a time. It seems almost foolish to declare that brains could never repaired or replaced the way hearts and kidneys can.

    Fine, so let's say it might be possible. It doesn't remotely affect my arguments.

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  31. One could take the position that Chazal in their infinite wisdom, or based on the direct mesorah, may have given reasons for the tests, but the tests they had, and only those tests, test for the true existential definition of death provided halacha Moshe Misinai or in their infinite wisdom they resonated to.

    But nobody takes that position with regard to Chazal's statements about 7/8 month old fetuses, or kidneys.

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  32. You cannot compare to 8mo. old fetus and kidneys. In that case, to be stringent is a matter of pikuach nefesh without the possibility of killing anyone. (At least nowadays when kidney removal is considered safe).

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  33. >It is thus a matter of pikuach nefesh, which always overrides everything.

    It is a matter of pikuach nefesh in either direction.


    My statement about pikuach nefesh was predicated upon the presumption that all my previous arguments were correct, and that a brain dead person really is dead.

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  34. You cannot compare to 8mo. old fetus and kidneys. In that case, to be stringent is a matter of pikuach nefesh without the possibility of killing anyone.

    I don't understand your point. My point was that all Poskim overrule Chazal, because Chazal were mistaken.

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  35. The key here is to realize that when we can amputate limbs, transplant organs, and replace organs with machines, it is necessary, halacha l'maaseh, to determine what organs and function need to be present in order for that collection of tissue to be considered a human being. I would challenge all those who are criticizing Rav Slifkin to answer the question with precision. Those who define life and death by the presence of neurological function have a very simple answer- the person is alive if the brain is present and has some function. So yes, all that is actually necessary is the functioning brain. If you define the boundary of life and death only by the presence or absence of circulation, without further stipulations, then you have to accept that ANY tissue that has the benefit of circulation has to be considered alive, even an ear or a big toe.

    With regard to artificial brains. IF it is possible to make a computer with free will, then it is necessary to decide if such a computer fulfills halachic requirements to be a person. Certainly if a person's brain has been removed and destroyed, and a computer installed, that person, by neurological criteria, is now dead. The question of creating life via intellegent computers has been actually addressed here: Azriel Rosenfeld, "The Heart, the Head and the Halakhah," New York State Journal of Medicine, 70 (1970), pp. 2615-2618. 148.
    and also his article Religion and the Robot available to Tradition subscribers here: www.traditiononline.org/news/article.cfm?id=105121

    The question is actually much worse for those who hold a circulation definition of life and death. Since we actually DO have machines that provide circulation, have we created life just by turning the machine on? If I take a mummy with intact arteries and hook it up to a circulation pump, why is it not alive? It has circulation.

    And finally, if someone is going to insist that some part of the circulation definition of death is immutable, that it is akin to halacha l'Moshe m'sinai, then it is necessary to state which part. For example, you may want to state that the irreversible loss of circulation is the defining point for death, and this can never be changed. However, when someone performs CPR, circulation is produced. You can actually feel a pulse. Therefore, you can go to the morgue and find people who have been declared dead, push on their chests, and they will have a pulse and circulation. Circulatioin in today's age is actually never lost until the arteries decay. If you wait only 20-30 minutes(times taken from R. Bleich's article on Time of Death) after you no longer can find a pulse, you actually have not determined that the loss of circulation is irreversible. So, if you truly believe that the immutable halacha mandates irreversible loss of circulation, then you have to wait days if not weeks to declare someone dead.

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  36. The key here is to realize that when we can amputate limbs, transplant organs, and replace organs with machines, it is necessary, halacha l'maaseh, to determine what organs and function need to be present in order for that collection of tissue to be considered a human being. I would challenge all those who are criticizing Rav Slifkin to answer the question with precision. Those who define life and death by the presence of neurological function have a very simple answer- the person is alive if the brain is present and has some function. So yes, all that is actually necessary is the functioning brain. If you define the boundary of life and death only by the presence or absence of circulation, without further stipulations, then you have to accept that ANY tissue that has the benefit of circulation has to be considered alive, even an ear or a big toe.

    With regard to artificial brains. IF it is possible to make a computer with free will, then it is necessary to decide if such a computer fulfills halachic requirements to be a person. Certainly if a person's brain has been removed and destroyed, and a computer installed, that person, by neurological criteria, is now dead. The question of creating life via intellegent computers has been actually addressed here: Azriel Rosenfeld, "The Heart, the Head and the Halakhah," New York State Journal of Medicine, 70 (1970), pp. 2615-2618. 148.
    and also his article Religion and the Robot available to Tradition subscribers here: www.traditiononline.org/news/article.cfm?id=105121

    The question is actually much worse for those who hold a circulation definition of life and death. Since we actually DO have machines that provide circulation, have we created life just by turning the machine on? If I take a mummy with intact arteries and hook it up to a circulation pump, why is it not alive? It has circulation.

    And finally, if someone is going to insist that some part of the circulation definition of death is immutable, that it is akin to halacha l'Moshe m'sinai, then it is necessary to state which part. For example, you may want to state that the irreversible loss of circulation is the defining point for death, and this can never be changed. However, when someone performs CPR, circulation is produced. You can actually feel a pulse. Therefore, you can go to the morgue and find people who have been declared dead, push on their chests, and they will have a pulse and circulation. Circulatioin in today's age is actually never lost until the arteries decay. If you wait only 20-30 minutes(times taken from R. Bleich's article on Time of Death) after you no longer can find a pulse, you actually have not determined that the loss of circulation is irreversible. So, if you truly believe that the immutable halacha mandates irreversible loss of circulation, then you have to wait days if not weeks to declare someone dead.

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  37. The argument that the sages did not mention lack of brain function as a death criterion because they were unaware of its critical and defining functions is a bit too facile - in my opinion. First, they do discuss the case of a headless animal which is considered to be dead despite its movements. Unfortunately, they don't appear to discuss a comparable case with humans. Second, they base themselves on torah verses such as "..He blew into his nostrils the breath of life, and Adam became 'a living soul'(animated)", and "For blood is the animating spirit" and "the animating spirit of all flesh is its vital blood". These verses appear to be the basis for the conflicting claims in the talmud as to whether the lack of breath or the lack of a heartbeat is the primary criterion for death. The primary talmudic source appears to conclude that absence of breathing is the key criterion for death.

    I don't know that we can simply dismiss these talmudic criteria based on our greater medical knowledge. However, I would argue that a total lack of brain-stem function coupled with a brief interruption of a respirator to demonstrate the absence of spontaneous breathing should be a fully adequate determination of death. I believe this is the view of Rav Moshe Feinstein which satisfies both medical and talmudic criteria.

    The remaining question is the feasibility or insurance that such a momentary discontinuation of a respirator will be done prior to removing organs from the patient. Perhaps one of the medical professionals who have written on this subject will address this queston.

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  38. Second, they base themselves on torah verses such as...

    They also based their statements about the kidneys on Torah verses. And their statements about the firmament.

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  39. But nobody takes that position with regard to Chazal's statements about 7/8 month old fetuses, or kidneys.
    ==============
    The interesting question to me has always been - how did that happen, over what time period and who "kashered" it. I'm sure it wasn't "One morning I woke up and I new you were really gone.
    A new day, a new way,
    And new eyes to see the dawn.
    Go your way
    I'll go mine and carry on.(from R's CSN&Y)" . Perhaps they went through a transition period as well or perhaps there were other factors that convinced them it was a new day (or nishtaneh hateva if you like to be frum)
    If the technology curve continues its exponential explosion, the questions you are dealing with will seem like child's play in less than a generation
    KT
    Joel Rich

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  40. My point is that you should stop using terms like "soul" (in the Orthodox Jewish meaning) and pretending they are completely rational.

    I think you would agree that the real experts on lets say "immaculate conception" are hardly professors or scientists.

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  41. Mr. Slifkin,

    Please correct me if I'm mistaken, but I think you have forgot to incorporate the original text in your analysis.

    I think it would be beneficial to compare relevant verses in Chumash with the halachic statements.

    For example, Lev 17:11 & 17:14 says that the soul is in the blood.

    Also, there are numerous prohibitions (i.e Numb 19:11) that make anyone who were in contact with the dead body unclean (think - organ donation)

    Wouldn't it be more prudent to analyze death issue from this perspective ? From the perspective of the original text and its statements?

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  42. Actually it says that the "nefesh" is in the blood. But, no, I don't think it's worthwhile analyzing the pesukim. After all, the pesukim say that the kidneys give counsel, and that the sky is solid.

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  43. "Fine, so let's say it might be possible. It doesn't remotely affect my arguments."

    I believe it greatly affects your argument.

    If brains are theoretically replaceable, just as kidneys and hearts are, then momentary lack of brain activity, which is then replaced by a computer or another brain is, by your arguments, longer death. Just as a person does not lose their soul, and thus is not dead while momentarily not having a kidney or heart.

    This means that the statements of chazal regarding life being with blood and hearts and breathing is similar to statements regarding bishul. Scientifically inaccurate, but also not relevant to the halacha.

    Your entire argument is based on the idea that the brain, unlike all other organs is not replaceable.

    @noam: I think the only question is whether or not artificial breathing and circulation under normal conditions counts as halachic breathing and circulation. I personally don't consider a person on a life support machine as halachically alive unless that person has the chance to later live without that machine.

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  44. If brains are theoretically replaceable, just as kidneys and hearts are, then momentary lack of brain activity, which is then replaced by a computer or another brain

    In your extremely speculative sci-fi scenario, who says there will be a momentary lack of brain activity? Maye it will just be "uploaded"?

    And if there is momentary lack of brain activity - maybe they are indeed dead, just like someone who is cryogenically frozen?

    This means that the statements of chazal regarding life being with blood and hearts and breathing is similar to statements regarding bishul. Scientifically inaccurate, but also not relevant to the halacha.

    How you think that you have undermined the arguments in my post is beyond me.


    Your entire argument is based on the idea that the brain, unlike all other organs is not replaceable.


    Not replaceable by something mechanical. If you want to speculate that maybe scientists will one day be able to make an artificial brain - heck, maybe they'll be able to make an artificial soul!

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  45. A. "Yet others do indeed say that we should change halachah based on our increased knowledge of science - such as Rav Lampronti in the case of lice. And even Rav Nissim Karelitz and Rav Elyashiv say that one should be stringent due to Rav Lampronti's view "

    Just for clarity's sake, did you mean "lenient"?

    B. "But, no, I don't think it's worthwhile analyzing the pesukim. After all, the pesukim say that the kidneys give counsel, and that the sky is solid."

    I think it's worthwhile to have a long post on what it should mean to us to believe that a divine Torah has incorrect information.

    C. "This is not an aggadic legend intended to be understood metaphorically."

    Just to be fair, I think this should say: "This is not an aggadic legend intended to be understood metaphorically, according to the vast majority of commentators."

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  46. "But, no, I don't think it's worthwhile analyzing the pesukim. After all, the pesukim say that the kidneys give counsel, and that the sky is solid."

    The chumash says this? Where?
    As a rule, I believe quotes from Tehilim are considered asmachtas. But really, you keep saying that they base kidneys and firmaments on Torah verses, but really they base them on nach verses, while the statements about life actually do come from the Chumash.

    And just as a point, I disagree with your view of these statements of chazal as being literal. While it is certainly possible they are literal, they don't fully match a literal context or other statements of chazal. Certainly chazal can dissagree over non-literal statements, but it seems unlikely that they would so be willing to make logically exclusive statements regarding literal views. (such as source of the yetzer harah, or the structure of the firmament)

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  47. Just for clarity's sake, did you mean "lenient"?

    No, stringent, i.e. not to kill lice on Shabbos.

    I think it's worthwhile to have a long post on what it should mean to us to believe that a divine Torah has incorrect information.

    I discussed it at length in the third edition of Challenge Of Creation and in my Kidneys monograph.

    Just to be fair, I think this should say: "This is not an aggadic legend intended to be understood metaphorically, according to the vast majority of commentators."

    According to ALL the Rishonim and early Acharonim. I don't count Acharonim who are clearly just trying to avoid a conflict between Chazal and science and have no serious basis for arguing that it is metaphorical.

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  48. But really, you keep saying that they base kidneys and firmaments on Torah verses, but really they base them on nach verses, while the statements about life actually do come from the Chumash.

    The name rakia appears in Chumash, and other pesukim in the Chumash show that it means something solid. The description of the heart as acting as the mind and having emotions is in the Chumash.

    And just as a point, I disagree with your view of these statements of chazal as being literal. While it is certainly possible they are literal, they don't fully match a literal context or other statements of chazal.

    Why not? The context certainly shows them to be literal. The descriptions of the functions of the tongue, mouth, esophagus, windpipe, lungs, stomach and nose are all clearly scientific descriptions intended to be interpreted literally. In what way do they not fully match a literal context? And the fact that OTHER members of Chazal MAY have held differently, does not mean that this statement does not mean what it says!

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  49. "If brains are theoretically replaceable, just as kidneys and hearts are, then momentary lack of brain activity, which is then replaced by a computer or another brain is, by your arguments, longer death. Just as a person does not lose their soul, and thus is not dead while momentarily not having a kidney or heart."

    I was thinking this also. But the corollary question will be, if one builds such a computer, having bechirah (given quantum factors or however you want to deal with it), would shutting it down then be retzichah? Ultimately, we're all dancing around the fundamental question of how to define the essential "human" WRT the prohibition of retzichah.

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  50. Firstly, I think Dr. Stadlan's challenge is key. For all the shakla vetarya across the blogs, I have yet to see a heart-death advocate clearly answer his challenge.
    Secondly, I think Rav Slifkin gave in too easily on the brain replication argument. It is clear that if you replicate somebody's body bit by bit, and replace all their organs with prosethtics, until only the brain is left, and you then remove the brain and replace it with a computer; so that the 'person' only consists of prosethetic limbs and some silicon chips, then you no longer have a human being. Otherwise, you will have to start saying that robots are mechuyav in mitzvos. I find it hard to believe that the poskim who advocate heart-death would agree with that.
    Finally, I think it may be unnecessary to argue that Chazal were wrong, all that is necessary is to prove that ANY definition of life is incoherent if you adopt the heart-death stance.

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  51. "In your extremely speculative sci-fi scenario, who says there will be a momentary lack of brain activity? Maye it will just be "uploaded"?"

    Please, did you even read the articles I linked to?
    Parts of the brain can be replaced by surgery with computer chips which act in place of biological neurons. This is being done TODAY, not in some hypothetical future.

    I would not be surprised to read in the next 5 years about a surgical procedure to repair memory loss.

    And if there is momentary lack of brain activity - maybe they are indeed dead, just like someone who is cryogenically frozen?

    I would not consider such a person dead, just as I do not consider a frozen/hibernating frog to be dead. Nor do I consider a person in the middle of a heart transplant operation dead.


    How you think that you have undermined the arguments in my post is beyond me.

    Your entire argument is that Chazal were mistaken regarding where the "soul" resides, and because we know its in the brain, (which can not be replaced or transplanted) then obviously life is based on the brain.

    Since I am arguing that the brain can be replaced and transplanted without the loss of the soul or a loss of life, then it only follows that the location of the soul is not the criteria for death.

    Further, just like in the case of Bishul or lice on shabbat, the words of Chazal here are not based on "Science" but instead based on halacha, and halacha that should not be changed. (Just as bishul and killing lice on shabbat should not be changed.)

    The most obvious solution to this problem is the one someone quoted earlier from R. Moshe Feinstein.

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  52. But, no, I don't think it's worthwhile analyzing the pesukim. After all, the pesukim say that the kidneys give counsel, and that the sky is solid.

    I will take it as sarcasm...

    But can you please then explain to me what is the whole issue is all about then?

    As far as the original text goes, any dead person is considered unclean. This means that you cannot really transplate organs because they would also be unclean.

    On the other hand, if person is not "obviously" dead (i.e someone on artificial life support), this would mean that the organ transplant is also not possible as it would constitute murder.

    Please do not get me wrong, but I think the logic is pretty straight forward here...

    Am I missing something?

    I would really appreciate if you could explain it to me in laymans terms.

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  53. Your entire argument is that Chazal were mistaken regarding where the "soul" resides, and because we know its in the brain, (which can not be replaced or transplanted) then obviously life is based on the brain.

    No, it's not. PART of my argument is that Chazal were mistaken regarding where the MIND resides.

    Since I am arguing that the brain can be replaced and transplanted without the loss of the soul or a loss of life, then it only follows that the location of the soul is not the criteria for death.

    No. You are speculating that one day it might be possible to replace the brain. And it's not really "replacing" the brain; rather, it's uploading all the software in the brain to new hardware.

    Further, just like in the case of Bishul or lice on shabbat, the words of Chazal here are not based on "Science" but instead based on halacha, and halacha that should not be changed

    Bishul is based on science, but approximates it for practical purposes, and thus extends beyond it (e.g. you can cook in a kli shlishi). Lice is entirely based on science.

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  54. >But, no, I don't think it's worthwhile analyzing the pesukim. After all, the pesukim say that the kidneys give counsel, and that the sky is solid.

    I will take it as sarcasm...


    Er, no, actually I was being serious. Looks like you are new to this blog.

    As far as the original text goes, any dead person is considered unclean. This means that you cannot really transplate organs because they would also be unclean.

    Eh? I don't know what you're talking about, or the relevance of it.

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  55. Noam: This statement seems key but circular to me: Certainly if a person's brain has been removed and destroyed, and a computer installed, that person, by neurological criteria, is now dead.

    Why are using neurological criteria? Because if you remove the brain the person is dead. But you are only using neurological criteria because if you remove the brain the person is dead. The question is whether neurological criteria should be definitive.

    Arguments calling for free will are weak because that requires mixing hashkafah into this discussion. And if that's where you want to go, we can take this discussion in interesting but non-definitive directions.

    You rightly criticize other criteria for failing tests of limb removal. I'm just not sure your criteria passes the test either.

    And what if someone were to find a way to connect a dead brain to a computer and shoot electrical signals through it. Would you call that resurrection or just temporary, artificial mechanical activity?

    You should not be constrained by current medical ability. Things that 50 years ago were science fiction are now reality. We have no reason to doubt that the same will be true in another 50 years.

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  56. Aleksandr Sigalov seems to be asking an interesting theoretical question. What about tumah and taharah? I mean, almost nobody learns that because we don't practically keep the rules today, but let's be honest about it:

    If a brain-dead person is really dead, his body is tumay. Right? So I take out his kidney. It's tumay meis. Right? So I put it in to Cohen the Kohain. Wouldn't that make Cohen permanently tumay-meis, regardless of any way of getting rid of it. There's a technically dead kidney in him.

    Aren't kohanim supposed to avoid graveyards for fear of becoming tumay-meis?


    And the part about not going back to the actual Bible... Well... Interesting intellectual question, but the relation between Halacha and the actual Tanach is tenuous at best.

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  57. The descriptions of the functions of the tongue, mouth, esophagus, windpipe, lungs, stomach and nose are all clearly scientific descriptions intended to be interpreted literally

    I respectfully disagree. The list is a classic case of "some of these are not like the others"

    You have some organs described as being involved with emotions, some describing physical events, some do things directly, and some cause things to happen.

    Some things are grouped together in a way they are connected (mouth,esophagus, windpipe, lungs) while others are not grouped together (eyes, nose, mouth) And why are the eyes absent from the list do they not serve any function?

    One could write pages about this aggadatah, but I don't want to waste either of our time since that isn't the topic of this post. Maybe another post about the agadatah might be more relevant. I will just say that in my opinion, each of those descriptions are actually describing methods of character refinement (i.e. mussar)

    The description of the heart as acting as the mind and having emotions is in the Chumash.

    Again, you conflate the heart and the kidneys. That you equate them, but l'maisah we treat them very differently should be telling. And I don't think that examining a words etymology equates to a statement by the Torah on the subject. Not every drasha is equal to a direct statement in the Torah.

    And the fact that OTHER members of Chazal MAY have held differently, does not mean that this statement does not mean what it says!

    Of course the text means what it says, but it doesn't say "This is what these organs physically and literally do in a scientific way." And it is a clear statement in the Talmud that the Yetzer Tov does not exist until the bar-Mitzvah. However, nowhere does it say that the Kidneys do not exist until the bar-mitzvah. (nor have I ever heard any suggestion that anybody ever thought this might be the case) Thus I can only deduct that the kidneys themselves are not the source of counsel in a literal sense. If this was meant to be literal we would have more statements reconciling the two.

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  58. And what if someone were to find a way to connect a dead brain to a computer and shoot electrical signals through it. Would you call that resurrection or just temporary, artificial mechanical activity?

    R. Gil, what would YOU call it?

    Besides, do you mean that the original mind comes back? Well, if science finds a way to do that, and you don't consider it to be resurrection, maybe it will find a way to also bring back someone who is cardiac and respiratory dead. With these sorts of arguments, you can abolish ANY determinant of death!

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  59. I respectfully disagree. The list is a classic case of "some of these are not like the others"

    You have some organs described as being involved with emotions, some describing physical events, some do things directly, and some cause things to happen.


    But all the other organs on the list were clearly thought to literally have these functions.

    I will just say that in my opinion, each of those descriptions are actually describing methods of character refinement (i.e. mussar)

    The only reason you are saying that is that you don't want Chazal to be wrong. Nobody every learned Chazal that way before modern medicine. The Rishonim were clear. Why don't you read my kidney essay.

    Again, you conflate the heart and the kidneys. That you equate them, but l'maisah we treat them very differently should be telling.

    Yeah, what it tells me is that people haven't studied the topic properly.

    And it is a clear statement in the Talmud that the Yetzer Tov does not exist until the bar-Mitzvah... Thus I can only deduct that the kidneys themselves are not the source of counsel in a literal sense.

    Come off it, there's a million ways of reconciling that. It's not license to ignore the fact that all the other organs in the list are literal descriptions, and that all the Rishonim and early Acharonim (who also knew about the barmitzvah) learned Chazal literally.

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  60. Eh? I don't know what you're talking about, or the relevance of it.

    Mr. Slifkin, again, with all due respect, I simply fail to understand the reason for discussion of what Chazal thought was a dead/alive person?

    If you do not put this discussion in context (i.e organ donation or compliance with Chumash) then it is, at best, just a pointless philosophical debate.

    But like I pointed out, if you do put this discussion in context, the solution to this problem (IMHO of'course) is much simplier than you trying to make it to be.

    Aleksandr Sigalov seems to be asking an interesting theoretical question.
    Yes, thank you Josephus. This is kinda what I was trying to say...

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  61. "As far as the original text goes, any dead person is considered unclean. This means that you cannot really transplate organs because they would also be unclean."

    Actually, it just means that you have to purify yourself after removing the organs. Just as you have to purify yourself after a burial.


    "No. You are speculating that one day it might be possible to replace the brain. And it's not really "replacing" the brain; rather, it's uploading all the software in the brain to new hardware."

    PLEASE, read the articles I linked to. When Retina Implant AG, produces a chip to transmit light to the brain, they do not "upload" anything from the patient into the chip. The chip communicates directly with the brain. When the U.S. army surgically implants a chip into an amputees brain so that they can feel and sense touch with their new robotic arm, there is no transference of existing "software" into new hardware. It is exactly as if they were able to transplant a new arm onto the person and it hooked up to the nerve endings. Or to say it another way, they were able to replace a part of the brain.

    If you have the time or intellectual curiosity, I also suggest looking up "emergent behavior" programing.

    My point about the lice and cooking, was that just as you believe that a kli shishi is allowed to be used on Shabbat, and you are allowed to kill lice on shabbat, there is no reason to think that the halacha regarding decleration of death should also be changed. Your reasoning isn't supported by the scientific facts.

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  62. The articles you linked to are not the same as the speculative scenario you are proposing of complete mind transfer.

    I already explained several reasons why this case is different from lice.

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  63. ameteur said: @noam: I think the only question is whether or not artificial breathing and circulation under normal conditions counts as halachic breathing and circulation. I personally don't consider a person on a life support machine as halachically alive unless that person has the chance to later live without that machine.

    Barney Clark had his heart removed and had an artificial heart for 112 days. Was he dead for those 112 days? If he received a heart transplant at day 110, would that have made him alive? how do you classify a heart transplant, artificial or not? How about Christopher Reeves, who couldn't breath for many years, and had no possibility of doing so on his own. Was he dead for all that time he was on the ventillator? I am sorry to say that your position makes no logical sense.

    I have not had a chance to read the references you posted, but as a general rule it is very difficult to get a brain(central nervous system) neuron to attach and function with something implanted, and difficult to replace neurons that have been damaged. Your optimism about the future is, I think, misplaced. That being said, brain transplants are not a challenge to the concept of 'brain death.' The identity of the person goes with the brain, so, new brain, new person. As I mentioned, the issue of artificial intellegence and artificial body parts are a much more practical challenge for those who do NOT advocate brain based definitions of human life. And finally, let us take this thought idea without the brain transplant. If you have a person, and take out the brain, are they still alive? They are by circulation criteria.

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  64. Well, well, this thread certainly developed quickly. I will first say I haven't read everything that everybody said. I'm just going to address the original post.

    First of all on point one (and in general). You are not clear with your use of terminology. The concept of 'mind' as we use it is not present in the literature of Chazal as far as I know. When Chazal say 'The heart considers' it seems to be referring to conscious thought, self-aware thought. Is it an organ that produces thought? Is it the seat of self-awareness? These are certainly elements of mind as we use the term today. However, we tend to separate between cognition and self-awareness to a certain degree.

    Point three is complicated. Very complicated. The question is when does life cease. Although there is free will, and a living person when a healthy brain is present in the body there are plenty of cases like advanced Alzheimer's where free will is absent. In fact in severe dementia the person is effectively wiped from the body. One could contend that this person is now less alive than a healthy dog that also displays some vestiges of free will.

    I agree that for the sake of this discussion the topic of the soul is effectively irrelevant. There is no way to determine its presence or absence. The soul is a topic for faith, not science.

    So when does death occur. There are two issues at hand. One is simply biological. Is there or isn't there metabolic function? This obviously has nothing to do with the real question. We are not asking whether biological function continues, we are asking if the person is still there. Death is when the person has irretrievably ceased to be. Now we have to define what is the person. This is difficult.

    First we must consider what is a person in the most minimal sense, in severe pathological situations. Obviously there needs to be awareness, consciousness. Advanced Alzheimer's is included in this even though the person we knew and loved is no longer with us. What about someone in a coma? i f there is a chance they may awake then they are still alive. Brain damage? Neuroscience has sufficiently advanced to be able to determine to some degree if there is activity in the brain in response to sound or light. If there is it is hard to say that the person is not present but unable to communicate with us. Finally in the case of brain stem death, there is no activity in the cortex i.e. no thought, the body will only function through machines. The person is absent and the body is just a metabolizing collection of tissue. Time to pass on the parts to a living person who can use them.

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  65. "The only reason you are saying that is that you don't want Chazal to be wrong. Nobody every learned Chazal that way before modern medicine. The Rishonim were clear. Why don't you read my kidney essay"

    I read it, and disagreed with it.
    I could care less if Chazal were wrong or not. However it hurts my artistic eyes to see someone try to suggest that there was no conscious decisions being made in how that agadatah was formulated, and even worse, to suggest that it was actively formulated in such a way as to be unorganized and wildly incomplete.

    But let me just be clear on what I think -could- be read literally and what obviously is not. Though I read all of it non-literally so that each phrase builds upon and augments the previous one.

    Literal:
    tongue, esophagus, windpipe, lungs, gizzard

    Non-Literal:
    stomach, nose , liver gallbladder, mouth, kidney, heart

    Come off it, there's a million ways of reconciling that. It's not license to ignore the fact that all the other organs in the list are literal descriptions, and that all the Rishonim and early Acharonim (who also knew about the barmitzvah) learned Chazal literally.

    Again, I disagree. Mainly because this division between literal and non-literal is fairly modern. It would be like suggesting that the early rishonim did not care about ethics because they did not write commentary focused on Mussar.

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  66. Literal:
    tongue, esophagus, windpipe, lungs, gizzard

    Non-Literal:
    stomach, nose , liver gallbladder, mouth, kidney, heart


    So you're claiming that the list includes both literal and non-literal descriptions, and that instead of being neatly separated, they are intermingled? And you consider that reasonable?

    Besides, a full stomach does cause sleep, and a whiff of sharp scents does cause wakefulness, and the mouth does complete speech. For that matter, the liver was thought to house anger in the ancient world, and the kidneys were thought to give counsel and the heart to house the mind - even by non-Jews. So if you want to argue that Chazal meant something different, you're going to have to come up with something pretty darn good!

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  67. "The articles you linked to are not the same as the speculative scenario you are proposing of complete mind transfer."

    Brain transfer, not mind transfer.

    "but as a general rule it is very difficult to get a brain(central nervous system) neuron to attach and function with something implanted,"

    So its difficult. Tell that to the army vet who can now feel again because it worked. If the brain works the way scientists believe the brain works, then there is nothing stopping the complete replacement of a damaged brain with synthetic neurons, given enough research and technological improvements.

    "I am sorry to say that your position makes no logical sense."

    I'm sorry I wasn't precise enough. by artificial circulation and respiration, I meant that the person is stuck in the hospital and has become non-mobile and/or a has major hindrances to basic activity. (such as eating or going to the bathroom)

    Also, after the third day (maybe 30th?) of the artificial heart working, the person has a chance to survive and not die from the heart condition.


    "If you have a person, and take out the brain, are they still alive? They are by circulation criteria."

    Isn't that the whole point of the argument? If you have a person and take out their heart, are they still alive? How about the lungs? The stomach? The spinal cord?

    If you take out a person's brain, and then put it back in, does that mean you have resurrected the dead? I would say not.


    "I already explained several reasons why this case is different from lice."

    Yes, because Mind == brain == soul == life. And I think I've pointed out, that the brain != soul or life.

    But the truth is, you don't even need recent scientific discoveries to know this point. You have classic psychological cases from the early century where people have had brain parts removed, and changed personalities. Is it really suggested that these people gained new souls?

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  68. http://abcnews.go.com/2020/Health/story?id=1951748&page=2

    Rabbi Slifkin, is it truly your opinion that this girl only has half a soul or is only half alive?

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  69. Brain transfer, not mind transfer.

    If that's what I think it means, then you are talking about making a new person, not transferring the old one.

    If you take out a person's brain, and then put it back in, does that mean you have resurrected the dead? I would say not.

    If the brain didn't stop functioning, I agree!

    You have classic psychological cases from the early century where people have had brain parts removed, and changed personalities. Is it really suggested that these people gained new souls?

    Who knows? Who cares?

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  70. "So you're claiming that the list includes both literal and non-literal descriptions, and that instead of being neatly separated, they are intermingled? And you consider that reasonable?"

    No, I am not claiming that at all. I am only saying, that I can understand a person who would think that some of those things were literal.


    Besides, a full stomach does cause sleep, and a whiff of sharp scents does cause wakefulness, and the mouth does complete speech.

    Staying up late also causes sleep, as does a lot of wine, or counting sheep, or going to a shiur given by someone speaking in monotone. Loud noises also wakes a person up, as does a kick in the ribs, or falling off your bed. The mouth also begins speech, and it finishes kisses, it also finishes food or songs.

    It's really not so much a question of "do these body parts do these things".. its the fact that none of the things attributed to these body parts can only be done by these body parts, nor are these the only things these body parts do. Also it is the fact that many body parts are not listed (eyes, ears, arms, legs, intestines, teeth, hair etc etc.)

    However, the agadatah clearly shows a progression of events, which creates a cycle. Advice, consideration, articulation, completion, reception, absorbtion, anger, calming of that anger, laughing, deconstruction, sleeping and then waking up to do the whole process over again, every day. This is the process of working and living.

    One could say that the question is not what does each organ do, the question is, how does one get through the day. And the answer is that our bodies are made to help us along the way and here is what you should do about it, and what you can expect to happen.

    Sure, it might sound like a venture capitalist marketing pamphlet, but it sure makes more sense that a mishmash of random body parts and their precise medical uses.

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  71. The third is essentially unspecified and incomprehensible, but as best as we can ascertain, it fundamentally relates to the mind, which is after all the part of us which absorbs Torah, exercises free will, and guides our actions. Jewish tradition has always maintained that the soul is involved in free will, and acquiring knowledge of God and Torah. Everyone agrees that these functions are accomplished in the brain.

    The last sentence is quite a jump from the previous.
    These functions are "accomplished" in the brain? How about a more cautious "facilitated" by the brain?
    We can all agree that the soul and mind constitute the human personality. But the brain, (not unlike every other organ of the body,) is merely a facilitator to to give that mind/soul expression in the physical world. The brain need not be identified with the human personality in any way whatsoever.

    In this way we can understand how the soul is ubiquitous throughout the body since all parts of the body gives expression to the soul.

    One indication of this principle is that when you lose any limb, it has to be buried--it produces tumas meis. Why?
    The soul has left that limb.

    So it makes perfect sense for Chazal to define death as a failure of a vital system of the body as a whole-- like respiration or circulation-- instead of any particular organ.

    Questions about artificial circulation and respiration are important ones, but questions alone cannot relocate the soul to any particular organ.

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  72. "If that's what I think it means, then you are talking about making a new person, not transferring the old one."

    If giving a person a new heart doesn't make them a new person, then why would giving them a new brain make them a new person?
    Does removing parts of their brain make them a new person? Why not?

    How many Phineas P. Gages where there? One or two? If he was Jewish would his parents have to sit shiva for the first one?

    I just see no correlation to a person being a person and the state their brain is in. Even more so when it becomes possible to revive a person who might be suffering from brain death, just as we can now do CPR.

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  73. There are other factors involved there, such as the need to have a "lo plug" about humans.

    So you are jettisoning normative Halachic methodology because of what you think is Pikuach Nefesh, and INVENTING NEW LO PLUGS that Chazal never stated to limit your own range of Pikuach Nefesh considerations!!??
    I can't believe I am reading this!

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  74. Natan: With these sorts of arguments, you can abolish ANY determinant of death!

    That's precisely my point. Noam uses those arguments against R. Bleich and R. Schachter but I am saying that his proposal is equally subject to them. He is simply relying on medicine as it is today to criticize viewpoints from 20 years ago without contemplating whether his view will be subject to the same criticism in 20 years.

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  75. Ameteur- as I noted, whether we can replace the brain or not has no impact on how we define life. It is not useful to devote more time to that argument.

    I have no idea what you mean by this: " by artificial circulation and respiration, I meant that the person is stuck in the hospital and has become non-mobile and/or a has major hindrances to basic activity. (such as eating or going to the bathroom). Also, after the third day (maybe 30th?) of the artificial heart working, the person has a chance to survive and not die from the heart condition." Halacha does not make life and death distinctions on whether someone can to go to the bathroom or not. In addition, life, even for less than 3 days, is still life(see the whole sugya of chayei sha'ah).

    If you take a human being and remove the heart, stomach or lungs, as long as there is brain function, the person is alive. I see that you have not yet put forth your definition of what tissue and function needs to be present in order for a human being to exist.

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  76. While this is fun for a sci-fi geek like me, I think you've all gone very far afield of the main issue.

    The fundamental question is: Were Chazal relating some type of absolute information, probably from God, as to the definition of death, or were they using scientific information of the day to determine death?

    If you believe the former then all else is moot, but you are required to be morally honest and not take any organs for yourselves or loved ones from a person who is not dead according to your reasoning.

    If you believe the latter, then all this talk of brain transplants is a red herring. Right now, today, when the brain dies, the person dies. Just as 2000 years ago when the heart stopped the person was dead. If we discover a way to resuscitate the brain in the future then clearly this halachic discussion will evolve. But as is stands, if you're in this "camp" then a dead brain and a beating heart is God given opportunity to save a lot of lives.

    BTW, if/when in the far future we develope the technology to replicate the human brain and "download" its contents into a machine, then my guess is that we really won't be needing organs anymore.

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  77. Ameteur said...

    http://abcnews.go.com/2020/Health/story?id=1951748&page=2

    Rabbi Slifkin, is it truly your opinion that this girl only has half a soul or is only half alive?


    No, she seems to be fully functional. But if she was lacking left-brain functioning, then while she would be fully alive, she would be lacking certain capabilities.

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  78. In this way we can understand how the soul is ubiquitous throughout the body since all parts of the body gives expression to the soul...
    So it makes perfect sense for Chazal to define death as a failure of a vital system of the body as a whole-- like respiration or circulation-- instead of any particular organ.


    That's the first reasonable counter-suggestion I've come across in this thread. But it's not nearly enough, for the following reasons:

    1. If the mind - i.e. everything uniquely human about the person - has gone, then what you have left is essentially an animal; in fact even less than that.

    2. Sure, it's POSSIBLE that Chazal had your idea in mind. But how can you be sure that they didn't have what I say in mind?

    3. Along with everyone else, you have ignored point 4 on the list. (which I am updating and expanding).

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  79. If giving a person a new heart doesn't make them a new person, then why would giving them a new brain make them a new person?

    Ameteur, if someone you know was given a new brain, I guarantee that you would consider them a new person.

    Does removing parts of their brain make them a new person?

    Not completely, but it changes them.

    I just see no correlation to a person being a person and the state their brain is in. Even more so when it becomes possible to revive a person who might be suffering from brain death, just as we can now do CPR.

    And what about when it becomes possible to bring back to life a person who suffered cardiac and respiratory death?

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  80. Re: an anencephalic baby with a brainstem and no rest of the brain

    There are other factors involved there, such as the need to have a "lo plug" about humans.

    So you are jettisoning normative Halachic methodology because of what you think is Pikuach Nefesh, and INVENTING NEW LO PLUGS that Chazal never stated to limit your own range of Pikuach Nefesh considerations!!??


    Basically I think that such a person isn't really humanly alive in any meaningful sense. But due to the delicate issues of the case, and the lack of any pressing reason to kill it, of course nobody is going to pasken that you can kill it.

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  81. Noam uses those arguments against R. Bleich and R. Schachter but I am saying that his proposal is equally subject to them. He is simply relying on medicine as it is today to criticize viewpoints from 20 years ago without contemplating whether his view will be subject to the same criticism in 20 years.

    I think that I already explained why you can't. If you upload the mind to a computer, then you have just transferred the life of a person from the body to the computer. If you bring the brain back to life, then either that is resurrection, or it would mean that we have reached a point in time when death no longer exists. Yemos HaMoshiach!

    Besides, Gil, none of this actually counters the 2 main points of this post: that Chazal's mistaken views of physiology would have fundamentally affected their views, and that the limited medical options available to them means that making technical inferences to today is mistaken.

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  82. I don't see how a digital process can have free will."

    I don't see how a physical process can have free will. Why are you so sure it exists?

    "Your definition of soul would mean that the soul stops to exist once the brain activity stops. Ergo: no immortal soul."

    Anyone's definition of the soul runs into that difficulty.


    The definition still must survive the challenge, as some world views do not have that difficulty as they do not postulate souls.

    No. You are speculating that one day it might be possible to replace the brain. And it's not really "replacing" the brain; rather, it's uploading all the software in the brain to new hardware.

    The last thing I want to do is argue about what people have said, but it is surely true that there are several different cases we can discuss.

    One case involves replacing organic circuits with mechanical circuits a few at a time. Note that circuits alternate between "firing" and "not firing", so one could theoretically replace an entire brain by only replacing it one idle bit at a time!

    The other case is if we could have a human mind in a machine. This could happen by a) following up the above method with simply duplicating its electronic activity, b) by scanning the organic brain well enough to duplicate it, or c) by duplicating human processes such that a mind indistinguishable from a human one developed inside a machine.

    "You have classic psychological cases from the early century where people have had brain parts removed, and changed personalities. Is it really suggested that these people gained new souls?"

    Who knows? Who cares?


    It seems to me that the best evidence indicates that the mind has a one to one correspondence with parts of the brain. This has implications for what we can say about the soul, which addresses what Chazal knew and what they were wrong about.

    Modern case studies pose an additional challenge. People with the corpus callosum connecting the halves of their brain severed function in some ways as if they have two minds. Halves can answer any question differently, including such questions as: Do you believe in HaShem?

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  83. I just added the following paragraph:

    As Dr. Noam Stadlan points out, further evidence that the soul is housed in the brain comes from consideration of conjoined twins. "The only time halakhah or modern society even considers whether one or two humans have been born is when the newborn has more than one head. The duplication of every other organ (including the heart) does not raise any question of multiple identities or souls. Therefore, it appears that the universally accepted halakhah regarding issues of organ removal, substitution and transplantation, consciously or not, is based on the brain, and only the brain, being the seat of the soul."

    (see http://www.hods.org/pdf/Problems%20Defining%20Life%20and%20Death%20by%20Circulation.pdf)

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  84. This comment is more related to this blog in general and a certain sect of an unnamed religion but your blog and its commentators gives an underground world of Jews hope that others care that their religion has been dominated by those that care not for logic but love the idea that faith is a good enough excuses to accept outright lies and want our minds back in Europe. I gave up religon several years ago and though I have returned I can not imagine raising my child in the irrational approach that is expected only to have her discover the lies and get dishearten and leave like I did.

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  85. Review of the links posted by Ameteur
    1. retraining the nerves in the tongue- excellent idea, but it has nothing to do with regenerating nerves or making new ones, It is only retraining existing ones to do something a little different

    2. another use for sending impulses to existing nerves

    3. control over an arm using brain waves or picking up signals from nerves that are still under brain control to move a robot arm. Again, a great idea, but does not involve connecting one nerve to another.

    In summary, NONE of the 4 links I followed show anything about making one nerve cell connecting to another nerve cell. They are very cool ways to pick up signals from existing nerves or transmit electrical signals to existing nerve cells. All of this takes advantage of existing neural function, and none of it creates new neural function. So all the claims based on these links, I am sorry to say, are false.

    Regarding the girl with half a brain, it is an accepted procedure for the treatment of severe seizures to remove half the brain(usually it isn't the entire half, but most of it, and at least disconnect it from the healthy side). There are people who have had strokes destroy half a brain as well. This has no bearing on life or death. They have brain function. This is an irrelevent discussion.

    R. Gil: you quoted me as writing:

    Noam: This statement seems key but circular to me: Certainly if a person's brain has been removed and destroyed, and a computer installed, that person, by neurological criteria, is now dead.

    Gil: Why are using neurological criteria? Because if you remove the brain the person is dead. But you are only using neurological criteria because if you remove the brain the person is dead. The question is whether neurological criteria should be definitive.

    Sorry to be confusing. A person whose brain has been removed is dead. period. If Reuven's brain is replaced with a computer, Reuven is still dead.

    The discussion concerning theoretical possibilities is interesting, but theoretical. I would state first that an definition that exists all EXISTING situations, is prefereable to one that cant even do that. Secondly, there are an infinite number of possibilities that can be imagined. The reality at present is that scientists cannot recconect spinal cords, cannot get Central nervous system neurons to regrow, to say nothing of recconecting in the proper place, and to think that all of a sudden we will get trillions of neurons to grow and connect in the proper places to make a brain is extraordinarily speculative.

    Finally. There is a mystery regarding human life that science cannot explain. We can get close, but if we believe that God has implanted a soul in the human being, and we believe that we are not God, it is an act of hubris to believe that we will be able to fully understand when a soul is present and when it is not. Future scientific developments may prove me wrong. However, in the meantime what this means is that pretty much every definition of life and death will reach a point where it cannot be subdivided. We started with a full human being. We have reached the point where we have located the source of the human being to the brain. It is hard to subdivide further. That does not mean that the definition is false. It means 1) it is better than any other definition and 2) it is the best we can do given the state of science and technology. As rational human beings, we have to realize that since the definition of death has changed over time with medical advances, there is no reason to posit that we have reached the summit of those advances, and it is not unlikely that the definition of death can change in the future. However, we have to deal with reality as we understand it, and medicine as we understand it, just as those before us did. When I close my medical lectures on this topic, I paraphrase Winston Churchill- death by neurological criteria is the worst definition of death, except for all the others.

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  86. For those wondering about brain transplants and their ramifications, and wonder what "artificial humans" and "uploading brain data" mean, one site to check out is ieet.org

    They have essays with titles such as:

    Do artificial beings deserve human rights?

    and

    What Are Mindfiles?

    Note: most of the writers on this site are atheists, in case you care.

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  87. #Joe- The way I would look at it is that the brain is a physical object that has a function. The mind is the result of the function of the brain. Whether there is more to the mind than just the physical mechanisms of the brain is a matter of debate, with those of a religious orientation adding in the elements of the soul. From my point of view, the soul is not necessarily contained in the brain, it is just that when brain function is present, it can be known that the soul is present, and when brain function has been irreversibly lost, the soul is gone. However, you can instead of the soul you can use the concept of personal identity or other substitutes.

    Your analysis of the presence of the soul is interesting, but is based on an unstated assumption that when recognized, torpedoes the entire concept. If you detach an arm, and supply it with circulation(with a pump), does the soul still stay with that arm? When you moved the arm from the rest of the tissue, which part was removed from which? In other words, you are assuming that the arm was detached from something that you are calling the body? How did you know that was the body? You have to establish criteria for what is a body and what is a part. If you took off lots of parts, and the retained circulation, is the soul in lots of parts? are all of them considered human beings? What if you keep the circulation in the arm, but destroy the rest of the body. Is that person still alive? The concept of the soul being in the entire body falls apart when it is necessary to define the word body, and ultimately, it is necessary to decide what is necessary for human life to be present, and what isn't. If you dont do that, you wind up with illogical results.

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  88. "It is always presented in a (sometimes intellectually dishonest) way that avoids the idea that we are undermining Chazal, such as by invoking "nishtaneh hateva" even where that is clearly not the case."

    I guess this means that sometimes it is sometimes presented in an intellectually sound way. Can you give such an example?

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  89. More re: an anencephalic baby with a brainstem and no rest of the brain - You can't bring evidence against my position on brain death from the fact that no posek allows killing such a baby, because my whole point is that no posek (of the type that you consider a posek) acknowledges the points in my post!

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  90. Then don't be intellectually dishonest and inconsistent. Say that you want the Poskim to allow organ harvestation from anecephalic babies too! And Alzheimer's patients too!

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  91. But I don't want them to do that, for lots of reasons.

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  92. Nothing consistent. It is just current medical ethics overriding what should be, by your standards, Pikuach nefesh.

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  93. "Is that supposed to support my post, or challenge it? If the latter, then how?"

    I thought to bring a source not to be forgotten in your article. I am not challenging your post, and certainly not its conclusion. To me it is obvious that brain-death is death, and frankly I am stunned to see that this is not obvious to "Olam HaTorah". From the point of Kabbala, the חדרי חדרים are clearly the Mochot, from where the body is nurtured and "filled".

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  94. Regards to the 8/7month fetus. I was taught that a seven month fetus to assumed to actually be a 9 month fetus except there was confusion in the counting of the months where as a 8 month fetus can never really be a 10 month fetus.

    I.e. the gemorah was dealing with claims of 7/8 months, not with theoretically proven facts as we might deal with today.


    *I am on my phone ans may or may not respond to Noam before shabbat.

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  95. Just a quick comment, don't you need both breathing and circulation to be alive? I don't see a limb breathing without a head and chest attached to it. I feel as though the difference is between a gesault of alive and individual organs being functional.

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  96. From the point of Kabbala, the חדרי חדרים are clearly the Mochot, from where the body is nurtured and "filled".

    What are the mochot?
    I think that use of the phrase in other contexts shows that chadrei chadarim refers to the chest/stomach cavity (but I have to check). If so, then this is further evidence that Chazal believed the soul to be housed there, and for its influence to extend throughout the body.

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  97. Regards to the 8/7month fetus. I was taught that a seven month fetus to assumed to actually be a 9 month fetus except there was confusion in the counting of the months where as a 8 month fetus can never really be a 10 month fetus.

    Interesting. Do you have a source? But in any case, it still shows that Chazal were giving an incorrect psak.

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  98. "What are the mochot?"

    Regarding man, Mochot, or Mochin, are the left, right, and center parts of the brain.

    Kabbalah views both man and the Cosmos in terms of "Rosh" and "Guf," both divided in left, center, right, up, down, front, and back, in various ways. The Rosh represents the spiritual, the hidden, which nurtures the Guf. Perfectly in line with what I quoted from Berachot 10a. And perfectly in line with the brain-death approach.

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  99. 1 - Rabbi Slifkin, I think if you are writing an article on this, then you need to explain to the layman that brainstem death is not the same as vegetative state. Particularly that a person who is “brain dead” can only be supported by health machinery for 2-3 days at most, and that they will die (all their other organs and systems will stop) in a matter of hours no matter what modern medicine will try to do to prevent that.

    2 - I am pro organ donation, but would like to play devil’s advocate for a moment. I think that various claims will be made by those who are anti organ donation from a halachic standpoint in the case of brain death.

    Menachem Lipkin said “… but you are required to be morally honest and not take any organs for yourselves or loved ones from a person who is not dead according to your reasoning.”

    I would imagine that some rationalizations to this would be:

    a. “Morally honest” is not a halachic concept.

    b. The brain dead person has already agreed to donate their organs, which means that their organs will be harvested one way or another. The family of the one who is brain dead (in honoring the wishes of the one who is brain dead) is asking for the brain dead person to be “killed” and his organs removed for donation. This is a given. The person is being “killed” either way. The question is only who gets those organs.

    c. The recipient of an organ donation is not the “killer” of the brain dead person donating them. He is not authorizing the removal of the organs, or doing the action of organ removal. He cannot prevent organ removal from the brain dead person. Organ removal from the brain dead person will occur regardless of who the recipient is. If the organ recipient is not the one doing the “killing” why is it a problem if he is a recipient of the organs of someone who was “killed”?

    d. An example of the above would be if someone stipulated in their will that they wished that their money be donated to certain people who fit a certain criteria. Why should it make a difference to the recipient of the money if that person was killed, committed suicide, or they died of natural causes? Either way the money is rightfully the recipient’s if he fits that specific criteria. Even if he was killed for his money, if the recipient wasn’t doing the killing he is not responsible for the killing of that person.

    Again, I am PRO organ donation at the time of brainstem death. I am just stating the arguments of those who will claim that there is no halachic moral or ethical issues with receiving donated organs even while one is against donating their own organs “for religious reasons…”.

    3 - Another point. I think Yeshivish/Chareidi Orthodoxy is moving towards an era of “Because I said so, that’s why.” Halacha has become about who has the religious authority, not about building a halachicaly, logically, or morally sound case. Because of this, if you succeed in proving your point, the opposition will just stand their ground and continue to respond “Because The Gedolim said so.”

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  100. Michapeset, you'll notice that I didn't play the "morally untenable to take organs but not give" card at all. I don't like that argument.

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  101. you need to explain to the layman that brainstem death is not the same as vegetative state. Particularly that a person who is “brain dead” can only be supported by health machinery for 2-3 days at most, and that they will die (all their other organs and systems will stop) in a matter of hours no matter what modern medicine will try to do to prevent that.

    Good point. I discovered that quite a lot of people don't realize that.

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  102. Michapeset, you'll notice that I didn't play the "morally untenable to take organs but not give" card at all. I don't like that argument.

    However, this argument can and should be a motivator for morally minded people who are on the fence.

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  103. Did you see the article on Cross-Currents about that argument?

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  104. Already commented. :)

    I think Rabbi Fischer went way overboard.

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  105. This morning, unfortunately during davening, I thought of a potential argument for the cardiac death is divine side.

    We believe in a metaphysical component to our existence and it's pretty clear that this mind/consciousness/soul is associated with our brains. I happen to like Dr. Schroeder's analogy that our soul is like radio waves and our brain is like a receiver. Each person is uniquely "tuned" to receive his "soul".

    Now it may just be that as long the body, the brain specifically, has blood flowing through it, it's possible that, at a level modern science can't yet measure, our brains are still "receiving" this "signal" and only when blood flow completely stops does reception completely cease.

    I guess the short answer would be that halacha generally only deals with what's measurable.

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  106. A thought experiment:
    What will be the difference in halachos between a Torah written by a machine...and/or human...using a sofer's duplicated artificial intelligence versus the present halachos of a Torah written by a sofer?


    Or, do you think it's too early to think in those terms?

    And....if it's too early to know, then doesn't that support being machmir on saving a life through organ donation?


    For those of you with some training in these matters, how about:
    another view of "lo ta'amod 'al dam rei'echa": Don't just stand there, get the organs to someone who can live by them.

    Gary Goldwater

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  107. Now it may just be that as long the body, the brain specifically, has blood flowing through it, it's possible that, at a level modern science can't yet measure, our brains are still "receiving" this "signal" and only when blood flow completely stops does reception completely cease.

    Menachem - As Noam pointed out above, you can get the blood flowing of a dead corpse in the morgue. So that criteria does not work.

    But I do like the radio waves/receptor analogy and it works to help answer those who say that we (who are pro organ donation at the time of brainstem death) are denying the accepted religious belief in a soul since we are not tying it to the heart pumping or the person breathing. You can still believe in a soul, and that the soul is only attached to the body while the brain stem is viable. At the same time, I don't think Rabbi Slifkin should be tackling the subject of souls, as it is not clearly delineated.

    Rabbi Slifkin - You might add that a person in what is known as a "vegetative state" can live on for many years supported by medical machinery, and that is NOT what we are discussing. As you said, way too many people don't know this! People think of events that are newsworthy, the most recent in the USA being the case of Terry Schiavo whose husband wanted to shut off life support and fought in court with her parents for the right to do so. He won after a long, highly publicized legal battle. She was in her 30's and in a vegetative state. Please make clear in your article that this is NOT what we are talking about.

    And in terms of the moral/ethical question of receiving organs while not donating them, it is the reason being emphasized by the rabbanim who are pro organ donation. It was also emphasized in a recent letter signed by many rabbanim in response to the RCA study.

    Also, you might want to be careful about how you talk about "the soul" in your article. As you can see in the comments above, "the soul" is a fuzzy topic, with no real clarity about how it is determined. On top of that, the layman considers his local rabbi, and “The Gedolim” to be our current-day experts on the soul. And it could then become a "He said X, He said Y" situation, with the layman leaning towards "The Gedolim" who "know" about the soul vs Rabbi Slifkin (who only knows about the kidneys and some zoo animals.) (Just Kidding!! :)

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  108. Rabbi Slifkin, I’m not sure I understand your answer to the following line of questioning:

    Joel Rich 1/13/11 8:18pm: One could take the position that Chazal in their infinite wisdom, or based on the direct mesorah, may have given reasons for the tests, but the tests they had, and only those tests, test for the true existential definition of death provided halacha Moshe Misinai or in their infinite wisdom they resonated to.

    Rabbi Slifkin 1/13/11 8:21pm: But nobody takes that position with regard to Chazal's statements about 7/8 month old fetuses, or kidneys.

    Big Maybe 1/13/11 8:26pm: You cannot compare to 8mo. old fetus and kidneys. In that case, to be stringent is a matter of pikuach nefesh without the possibility of killing anyone. (At least nowadays when kidney removal is considered safe).

    Rabbi Slifkin 1/13/11 8:32pm: I don't understand your point. My point was that all Poskim overrule Chazal, because Chazal were mistaken.

    If the claim is being made that the tests that Chazal gave for determining death are based on mesorah and existential spiritual facts provided as halacha L’Moshe MiSinai, and the reasoning Chazal gave was only meant for illustrative purposes or for people of that time or the layman to understand their reasoning, then there is really nothing to argue against that. The fact that they don’t following that about 7/8 month old fetuses or kidneys doesn’t seem to be a good argument because as Big Maybe said, “to be stringent is a matter of pikuach nefesh without the possibility of killing anyone.”

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  109. michapeset- it is reasonable to say that chazal gave us something that is unchangeable, but if someone is going to make that particular claim, it is necessary to identify exactly what position it is that is unchangeable, and then make sure that the rules are made to adhere to that particular condition.

    For example, some claim that chazal's equation of circulation with life is unchangeable. They say that life ends when circulation has been lost irreversibly. As I have mentioned, circulation can be provided with CPR(pushing on the chest)or with machines, so it isn't actually irreversibly lost until days to weeks have passed when the arteries deteriorate. Therefore, those who truly believe that we cant change this defintion need to change the details of how they determine life and death. You can see that this hasn't occured. Therefore, it is impossible to give credence to this position as long as the method of determining death doesn't fulfill the very criteria that the advocates say has the force ofHalacha L'Moshe M'sinai. Furthermore, even circulation advocates such as Rabbi J.David Bleich and RSZA held, at least theoretically, that total destruction of the brain could be equal to death, which obviously doesn't necessarily have anything to do with circulation in the rest of the body.

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  110. Ameteur, if someone you know was given a new brain, I guarantee that you would consider them a new person.

    I don't consider people with severe brain damage to be new people, so I'm not sure why I would consider a person with a new brain to be a new person. There is plenty of evidence today (one only has to search briefly) of people having complete personality changes when something happens to their brain. We don't consider them new people, nor do we sit shiva for the person pre-brain-change.

    L'maiesa, we don't consider the brain to be the only defining aspect of a person. Interestingly, though done only symbolicaly, some people do sit shiva for people who have made a major life change without any brain damage. So I'm not really understanding this line of argument.


    In summary, NONE of the 4 links I followed show anything about making one nerve cell connecting to another nerve cell. They are very cool ways to pick up signals from existing nerves or transmit electrical signals to existing nerve cells. All of this takes advantage of existing neural function, and none of it creates new neural function.

    I do not understand your line of argument. The computer chip in the brain, creates new nueral function, and passes on that function to the rest of the brain. As was stated more explicitly by , if you can replace one part of the brain with a chip, then there is nothing to prevent the slow progression of replacing all parts with a chip. If the brain stem fails, but other parts do not, and the technology exists, you can remove the stem, instert an artificial brain stem, and away you go. Slowly, over time this could be done with all parts of the brain, and you would have a fully functioning 100% artificial brain inside of a person.

    This is in essence, the same technology that allows us replace hearts, kidneys, lungs, etc.


    In my view, brain death is only death inso much as it prevents the body from continuing the circulation and breathing process. Whenver one is able to bring a person back from death, by any means, we consider this a wonderful miracle, but failure to do so, does not mean that we have killed them.

    Perhaps you can explain why the suggestion made earlier, of stopping the heart from pumping for a second to demonstrate that the body is only pumping due to outside forces and thus is not alive, and then pumping the corpse again, would prevent organ donations.


    "Sorry to be confusing. A person whose brain has been removed is dead. period. If Reuven's brain is replaced with a computer, Reuven is still dead."


    Based on what non-circular logic?


    regarding the 7/8 month fetus: I will have to look it up when I get the chance, but I believe it was the commentary in the artscroll that was my source for that understanding. Either that, or it was a daf yomi shiur. Either way, the point was that it was a means of determining human error as a basis for going the proverbial extra mile.

    And just to restate my point. It seems to me like there is a needless attempt to redefine death in a categorical sense (not an actual l'meisa sense) based on an argument that could easily be reversed or have to be changed again in 10 years time. The alternative is maintain the categorical definition of death, and only redefine the means by which we know the state of those systems change.

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  111. Noam - I hear your point. It seems to me that the bottom line is that because the Gemara was not clear in discussing the present-deay realities that we are faced with, like much else, we face the necessity of having to figure it out on our own. Each side (pro vs anti halachic organ donation) is deciding where it wants to go, and then paving a road to get there. Halacha seems to have been doing this for centuries, only now religious fundamentalism is in vogue and in Israel has also become a part of the political process.

    Again, when the religious fundamentalist camp is going to use methods of halachic determination that are basically equivalent to "because I said so, that's why" then there is not much to discuss. And my fear is that similar to so much that we have inherited as our religious legacy (in terms of practical minhagim and how we do things), practices and approaches that are adopted today will become unchangeable as they become canonized and a part of what religious/observant Jews do. In the meantime, Rabbi Slifkin, and others who are in the minority and who are trying to methodically, ethically, truthfully and halachically come to halachic rulings that can balance both modern life and Torah, are confined to the margins of Orthodoxy. It is very distressing for me to watch this happen. And I cannot help but wonder what Orthodoxy will look like in 100-200 years from now, while cringing at the thought that the fundamentalists will "win".

    And even though Rabbi Slifkin will have left a very methodical, thorough, analytical and rational paper-trail of how he came to his conclusions, it doesn't stand a chance against a religion of "do it because I said so" or "because that is our minhag" or "that is just the accepted way that we have been doing things and we follow precedence." We are, today, creating the precedence that tomorrow's generations will stand upon. A very frightening thought while watching the religious fundamentalists "winning".

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  112. In sefer Emunos veDeos page 207-208 (all references are to Kafiach's bilingual edition) Rav Saadiah discusses the question if the punishment for transgressions and reward for virtue is received exclusively by the soul, or by the body, or by both of them together. In the context of this discussion he writes (translation is my own and is not literal):

    'The opinion of Binymin (a Karaite contemporary) is that it is received by the bones. He found a posuk 'And their sins were on their bones' and a posuk 'All my bones are proclaiming
    Hashem who is comparable to you'. And he understood that these psukim mean the bones literally. Indeed, in the books of anatomy it is written that the skeleton is the foundation of the human body and that all the other organs serve it and protect it. However, this opinion is due to the ignorance of the correct use of the language. For every discipline has its own terminology and their is no similarity between the terminology of anatomy and terminology of Torah. Bones or skeleton in these psukim mean one's whole being - the body and the soul together.'

    It is clear from this passage that Rav Saadiah doesn't think that Torah CAN teach us science because it uses poetic and allegorical rather than precise and scientific language.

    On page 201 he explains that the soul resides in the heart, but what is his reasoning?

    'The soul can express itself by means of the body. It became apparent to me that its abode is in the heart because all the muscles which enable the body to move and feel are connected to the heart.'

    Rav Saadiah here uses contemporary science to decide location of the soul. Ayen shom ki kizarti.

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  113. I pulled out my gemorahs and looked up the 8 month/7month old baby issue and was reminded of my source.

    My source was my shul rabbi who explained to us what the baraita in Shabbat was thinking after we had some questions about a cross reference in Yevamot.

    In Yevamot it defines any baby that is not fully developed as 8 months, and any baby that is born early, but fully developed as 7 months.. by definition, not just by description. (And artscroll here was a complete non-help, raising more questions than it answered)

    On the face of it, this defies logic, and so there were a few explanations for this. The mistaken calculation and assumption of a 9 month term always, is the most naturalistic explanation we were given. (The others are based on numerological drashot which would not get any respect in this forum)

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  114. Please pardon the delay and extended response.

    That's the first reasonable counter-suggestion I've come across in this thread.

    Thank you for the compliment. I hope we can continue the discussion in a fruitful manner.

    But it's not nearly enough, for the following reasons:
    1. If the mind - i.e. everything uniquely human about the person - has gone, then what you have left is essentially an animal; in fact even less than that.


    What do you mean by “gone”? Not being able to express itself through its host body (brain) in no way means that it’s “gone”! I would say its simply “trapped”.

    2. Sure, it's POSSIBLE that Chazal had your idea in mind. But how can you be sure that they didn't have what I say in mind?

    I quote from Moshe Rephael’s source above to which you never responded:
    רפאל said...
    Berachot 10a:

    מה הקדוש ברוך הוא מלא כל העולם - אף נשמה מלאה את כל הגוף; מה הקדוש ברוך הוא רואה ואינו נראה - אף נשמה רואה ואינה נראית; מה הקדוש ברוך הוא זן את כל העולם כלו - אף נשמה זנה את כל הגוף; מה הקדוש ברוך הוא טהור - אף נשמה טהורה; מה הקדוש ברוך הוא יושב בחדרי חדרים - אף נשמה יושבת בחדרי חדרים;

    Just as HaKadosh Baruch Hu fills all the world, also the Neshama fill the whole body. Just as HaKadosh Baruch Hu sees but is not seen, also the Neshama sees but is not seen. Just as HaKadosh Baruch Hu maintains the whole world, also the Neshama maintains the whole body. Just as HaKadosh Baruch Hu is pure, also the Neshama is pure. Just as HaKadosh Baruch Hu resides in hidden chambers, also the Neshama resides in hidden chambers.
    January 13, 2011 7:53 PM

    3. Along with everyone else, you have ignored point 4 on the list. (which I am updating and expanding).

    I don’t see the relevance to my point. If Chazal understood the soul/mind to be connected to the body as a whole, then systemic failure of the body as a whole is the most reasonable criteria for death --regardless of medical science advances. It's more a theological issue than a scientific one.

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  115. noam said...
    #Joe- The way I would look at it is that the brain is a physical object that has a function. The mind is the result of the function of the brain.


    I would put it primarily in the reverse—or at least some co-ordination between the two in tandem.
    What tells your brain to search its memory for a specific piece of information-- if not your mind? This means the brain’s activity is result/function of the mind’s/soul’s will and not the reverse.

    Whether there is more to the mind than just the physical mechanisms of the brain is a matter of debate, with those of a religious orientation adding in the elements of the soul. From my point of view, the soul is not necessarily contained in the brain, it is just that when brain function is present, it can be known that the soul is present, and when brain function has been irreversibly lost, the soul is gone.

    Again, why “gone” and not simply “trapped”-- meaning present, but without an ability for physical expression?
    This is how we view the severely retarded individual or comatose individual as well. Their souls/minds are trapped in an unresponsive/uncooperative body/brain.

    Your analysis of the presence of the soul is interesting, but is based on an unstated assumption that when recognized, torpedoes the entire concept. If you detach an arm, and supply it with circulation(with a pump), does the soul still stay with that arm? When you moved the arm from the rest of the tissue, which part was removed from which? In other words, you are assuming that the arm was detached from something that you are calling the body? How did you know that was the body? You have to establish criteria for what is a body and what is a part.


    That is a valid demand. I would say: an entity that contains a system which can potentially connect all the various components of an entire human being to that system is called the body, and each separate component connecting or contributing to that system is a part.

    Any individual part severed from the system ceases to be alive.
    Human body parts can be replaced with artificial parts, but those replacement parts will not contain a parallel component of the soul/mind. It is like the body holding a wooden crutch (or plastic pumping machine).

    But the system called the body retains the essential soul/mind until the system as a whole has lost life--i.e. has entered the process of decay. Not that it merely ceases functioning mechanically.

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  116. Well said Joe :)

    You cleverly defined what I could only think of as a gestalt.

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  117. I saw a video on YouTube of HaRav Dovid Feinstein, telling over his father's psak, that death is when a person stops breathing on his own. Even a person on life support if unable to breathe if the machine was turned off is considered already dead.

    What's the problem with that? I dont understand this entire discussion. The Gadol HaDor has already decided the answer, end of story.

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  118. Ameteur- what you posted is about new function, using existing neural circuits for new functions. There is nothing about making new neurons or making them connect to existing neurons. Your analagy to replacing the brain 'chip by chip' is scientifically way off base. Please read some basic neuroscience

    Joe wrote regarding defining a body:


    "That is a valid demand. I would say: an entity that contains a system which can potentially connect all the various components of an entire human being to that system is called the body, and each separate component connecting or contributing to that system is a part."

    ok. Now all you have to do is define what you mean by connection. Is it arteries? nerves? duct tape? Next, what are the various components of an 'entire human being?' And finally, you really haven't defined in exact terms what is the 'system' and how to distinguish it from the parts. I do admire the effort to confront the topic, and it does answer some of the questions.

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  119. "The Gadol HaDor has already decided the answer, end of story."

    The irony is that Rav Moshe Feinstein himself was very much opposed to such sentiments.

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  120. ok. Now all you have to do is define what you mean by connection. Is it arteries? nerves? duct tape?

    This is a sugya called אבר המדולדל in the 9th chapter of Chullin and 3rd perek of Krisus. Chazal determined to which degree of severance will a limb emit tumah. I intuitively equate the emission of tumah to be a sign of departure of the soul and therefore death.

    Next, what are the various components of an 'entire human being?'

    That's easy: all the components that every healthy human being is born with. No more and no less.
    Anything less is not an entire human being. (I have a feeling you are leading me somewhere without telling me in advance where you are taking me.)

    And finally, you really haven't defined in exact terms what is the 'system' and how to distinguish it from the parts.

    I did the best I can. I think any individual organ or limb can be called a part. But there is a threshold where enough removed or replaced parts will leave you without a viable system.
    To borrow terms from tumas meis- perhaps rov minyan or rov binyan of original parts constitutes a human body.
    But I admit this is the murky and speculative.

    I do admire the effort to confront the topic, and it does answer some of the questions.

    And I admire your willingness to hear new ideas and new ways of approaching the topic which makes sense of the traditional view.

    It is a sign of intellectual honesty to be capable of backing down from a challenge that one thought was truly insurmountable.

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  121. Joe- until you resolve the 'murkiness' I will stick to my claim that the circulation definition of death fails to define the term 'body' with any coherence.

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  122. 1.
    Let's assume *for the sake of argument* that you're correct that Chazal based their views on outdated science of their times. So what? Who says the halachos of establishing death are not parallel to establishing whether an animal is a treifa? IOW not subject to change based on contemporary observation/science (even for rationalists)?

    2. i fail to see the relevance of establishing the presence of 2 persons with conjoined twins from the presence of a brain (a point on which you cite Dr Stadlan). These are separate issues. It's one thing to establish brain =soul/personhood. It's a second question to determine if this brain *is living* It is not nec. true that where one thinks the soul resides determines how one thinks life/death is determined! The assumption that chazal's position on determination of life/death connects to their view of the location of the mind/soul strikes me as just that: assumption.

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  123. My gosh, this discussion has gone so far afield. Let me try to get it back to the ground.

    We're looking for an operational definition of death that real physicians in the real world can use in real time. The soul, and even the mind, are metaphysical concepts. Philosophers have been ruminating on the "mind/brain problem" forever. You cannot build an operational definition on metaphysical concepts.

    Up until a generation or two ago, the heart, lungs and brain were interdependent. The heart needs oxygen supplied by the lungs and neural signals from the brain, the lungs need nutrients from the heart and signals from the brain, and the brain needs nutrients and oxygen from the heart and lungs. All three stopped within minutes of one another and death was determined by cessation of heartbeat and/or respiration, which were easily measured. Now we are able to oxygenate the blood artificially and keep vital functions, including heartbeat, going, hence the problem.

    I was privileged to listen to a lecture by Rav Moshe Tendler, who delineated the issues clearly in terms an educated layman can understand. If I understand him correctly, brain death equals irreversible cessation of function of the entire brain including the brain stem. No signals to the heart or lungs means that neither can function on their own for more than a few hours. Persistent vegetative state is not death. Irreversible coma is not death. Anencephalic babies, Alzheimer's patients and the like are not dead, despite the absence of the higher brain functions we associate with being human. Terri Schiavo was profoundly disabled but was not dead until her caregivers, with the blessing of an American court, starved her to death.

    A potential organ donor, who presumably suffered traumatic brain injury and was placed on life support, and whose brain stem subsequently ceased functioning, may be taken off the ventilator for 20-30 seconds to make absolutely certain that he cannot breathe on his own. At that point he may be pronounced dead. While his doctors are filling out the death certificate, the transplant team puts the body back on the ventilator and harvests the organs. Rav Tendler asserts that part of the problem is semantic. We speak of the brain-dead donor as being on life support when there is no life to support. If we mean that he is on an organ perfusion system, we should say so. The 20-second wait then becomes the dividing line between "life support" and "an organ perfusion system."

    All of this assumes that we have the means of determining whether the brain stem ceased functioning. Rav Tendler says that we do. If he is correct, we now have an operational definition of death, using neurological criteria. Some physicians will not be happy, since "the entire brain including the brain stem" will reduce the already low supply of organs for transplant. Religious fundamentalists won't be happy since they live in a Fantasyland where the heart is the seat of thought and emotion, the kidneys give counsel, the earth is 5771 years old, ad infinitum ad nauseam. I do not believe that the Torah was given to make religious obscurantists and ethically challenged physicians happy.

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  124. This issue has taken on a 'new life' in the Jewish blog world - as befits its importance. Given that much has been written by both sides in the 'brain death' dispute, I will focus on one troubling aspect - the tendency by some to dismiss both torah verses and talmudic opinions as irrelevant in the light of modern scientific/medical knowledge. While I concede the need to reinterpret some torah verses that appear to conflict with scientific facts, I object to their wholesale dismissal as mere idioms of no practical consequence. Thus, the verses in Genesis that appear to associate life with breath are considered of no consequence - despite their use in B.T. Yoma 85a and elsewhere to provide a practical definition of the distinction between life and death. While the talmudic sages occasionally appear to use verses merely as pegs (asmachtot) to buttress established halachot, this doesn't appear to be the case in this instance.

    A consequence of such an argument is that we would require a test of the absence of spontaneous breathing in addition to other means of establishing total and irreversible brain-stem non-function in order to establish that the victim is, indeed, dead prior to using his organs.

    The issue of a heartbeat or natural blood circulation as a second (or third) criterion for a life/death determination is more complicated. While there are verses in Leviticus that associate blood and life, a heartbeat (or blood circulation) appears to be treated as a secondary indicator of life/death in the major talmudic source, Yoma 85a. There the key indicator is breath which requires no further examination - unless access to the heart is more convenient. At least, that appears to be the more evident way of understanding that sugya. I suspect that the contrary understanding of some great latter-day poskim (Acharonim) is motivated by the standards of their time (absence of signs of cardio-pulmonary function). In which case, the modern standard of brain-stem 'death' should be equally valid.

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