Thursday, February 10, 2011

Who Are The Experts?

(Note - there are some announcements at the end of this post)

Over at Hirhurim's Symposium on the Ethics of Brain Death and Organ Donation, Rabbi Yaakov Weiner of the Jerusalem Center for Research: Medicine and Halacha, concludes his article with the following sentence:

While medical technology has changed, the definition of death remains constant and we have to turn to our mesorah, halachic sources and our gedolim to determine which signs today demonstrate that a person’s soul has left his body.


Echoing a similar view as to who is an authority on such matters, Dr. Leon Zacharowicz made the following proposal:

I suggested... setting up a ‘yarchei kallah’ type program on this sugya, similar to the yarchei kallahs I’ve helped Rabbi Weiner run in Jerusalem and around the world since 1998. These chavrusa-style learning programs have included shiurim by some of the most renowned halachic authorities and experts worldwide, including (partial listing): Rabbi E. Blech, Rabbi Y. Breitowitz, Rabbi Mordechai Eliyahu ztl, Rabbi Zalman Nechemiah Goldberg, Rabbi Jacobowits, Rabbi Kaufman, Rabbi Simcha Bunim Lazerson, Rabbi David Morgensten, Rabbi Yehoshua Neuwirth, Rabbi Hershel Schachter, Rabbi Dr. Avraham Steinberg, Rabbi Moshe Sternbuch, Rabbi Mordechai Willig, Rabbi Yitzchak Zilberstein, and others... Why not learn these sugyas in depth, “inside,” with the sources, and then have a chance to hear what the major poskim have to say? One can then, in an appropriate fashion, raise questions, make suggestions, and hear what the poskim have to say.

Here lies the crux of the problem. There is a vast epistemological gulf which separates the worldview of those who reject brain death as death and those who accept it. It revolves around the following question: What qualifies someone as an expert to determine whether brain death is death?

For people with a charedi worldview (and note that you don't have to be charedi to have a charedi worldview - but it helps!), the answer is as Rabbi Weiner presented it: the Gedolim are the experts. Dr. Zacharowicz included the YU Gedolim in his list, but the idea is still the same. Those who have achieved greatness in Gemara and halachah are (a) automatically qualified to have an opinion on the topic, and (b) are the most (and effectively only) qualified people to have an opinion on it.

But there is a different view.

As noted in several previous posts, there are a few problems with a conventional reliance on Chazal, Rishonim and Acharonim in tackling the topic of brain death. One is that these sources just don't address it. If you have a charedi worldview, you are likely to fail to acknowledge this, and still seek to make (unwarranted) inferences from earlier halachic sources in order to address it. But if you have - dare I say it - a rationalistic worldview, you will acknowledge that the Gemara in Yoma 85b is just not going to determine the halacha for brain death. The same goes for other sources, as I shall demonstrate in a future post.

Another problem with a conventional reliance on Chazal, Rishonim and Acharonim in tackling the topic of brain death is that one has to be familiar with the scientific worldview of these sources. It's not just a matter of being aware of modern science (the importance of which is acknowledged by many Poskim) - it's also a matter of being aware of ancient science, and being able and willing to understand the statements of Chazal, Rishonim and Acharonim in light of that.

There are also other differences in worldview between rationalists and non-rationalists which affect one's conclusions in this area. I'm not just talking about questions such as to what extent is the nature of the soul a metaphysical matter, and to what extent a scientific matter. I am also referring to more general and fundamental differences, with regard to questions such as to what extent can one take initiative and be innovative, to what extent can one trust one's own evaluations, and other issues relating to rabbinic authority. This is similar to how Orthodoxy post-Chasam Sofer had a different approach to halachah than traditional Judaism pre-Chasam Sofer. It's not a matter of "right" versus "wrong," but it is two very different approaches, and someone who subscribes to one need not automatically accept the authority of someone who subscribes to the other.

Thus, to say that Poskim who have achieved greatness in Gemara and halachah are automatically qualified to have an opinion on the topic of brain death, is something which non-charedim would (and should) challenge. And to say that people who have not achieved renown as Poskim are not qualified to give opinions on this matter is likewise something which non-charedim would (and should) challenge.

I personally know three physicians who I think are extremely qualified to have opinions in this matter. They are not considered Poskim. Yet they are extremely learned in Shas and halachah - particularly in the area of medical halachah. Of no less importance is that they are knowledgeable not just in modern medicine, but also in the history of medicine, which means that they have a better understanding of Chazal, Rishonim and Acharonim. (For example, they understand that when Rashi says to check the heart, his intent is to check for respiration, not pulse.) And also of no less importance in my eyes is that they are capable of analyzing issues methodically, rationally and comprehensively - more so than some of those renowned as Gedolim in both charedi and non-charedi circles.

(Note that Rabbi Broyde comments that "Nearly every person I respect as a Torah scholar of substance who is also well trained in the sciences supports the view that Jewish law ought to accept brain stem death when combined with respiratory failure, notwithstanding the opposition to this view by many eminent poskim." And a well-known physician who specializes in Jewish medical issues told me that virtually every frum doctor he knows accepts brain death as death - and that the few who do not are all charedi.)

All this reminds me of the Torah-Science controversy. For some people, it was obvious that the Gedolim were vastly more qualified than me to have opinions on Torah-science topics. And for others, precisely the reverse was true. It is important to recognize that these reflect fundamentally different worldviews. It is also important for rationalists not to make the mistake of unthinkingly adopting the charedi view that only Gedolim are qualified to have opinions and thereby to argue that there are other Gedolim too - although sometimes this may be a strategic move.

For further reading, see my posts Who is an Expert in Science? and Who is an Expert in Torah?

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The Challenge of Creation, Sacred Monsters, Perek Shirah: Nature's Song, and Man & Beast - each book is $27 including shipping anywhere in the US.


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24 comments:

  1. Correct me if I'm wrong, but it sounds like you are just arguing the position that Doctors and Scientists make better law-makers/lawyers than professional policy-makers?

    Sounds like another Plato era debate :)

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  2. see nazir 52a where chazal asked the doctors for their opinion regarding anatomy. now why did they have to do that? :)

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  3. I think an important qualification which you do not sufficiently emphasize in this post is that while knowledge of modern and ancient science is necessary in order to make an informed halachic decision on a topic such as this, no less so is knowledge - broad and deep knowledge - of halacha. Knowledge not just of this specific topic, but of halacha, of Torah, in general. You can't just "learn up" this sugya and render a psak on it. The only people qualified to decide matters such as these are be people steeped in Torah knowledge, and who also have obtained the necessary secular knowledge in order to accurately understand the issues.

    This matter is different from the Torah/science issue in that this is ultimately a halachic question, whereas the accuracy of Chazal's science is (at least in both our opinions) a historical and scientific question, not a matter of psak halacha. Those best qualified to decide a historical-scientific question are those with expertise in science and history. Those best qualified to render a halachic decision are those with expertise in halacha. In both cases, these experts' knowledge must be supplemented and their decisions informed by relevant information from other disciplines; but expertise in their primary discipline is of paramount importance.

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  4. "Note that Rabbi Broyde comments that "Nearly every person I respect as a Torah scholar of substance who is also well trained in the sciences supports the view that Jewish law ought to accept brain stem death when combined with respiratory failure, notwithstanding the opposition to this view by many eminent poskim."

    This is a little misleading, since Rabbi Broyde's very next sentence in his comment (which you omitted in your post) was -

    "This compounds my uncertainty as to what the halacha really is."

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  5. DES - agreed, but the question is how one defines "steeped in Torah knowledge" and "possessing expertise in halachah." That's the sort of thing that will be defined differently by different communities/ schools of thought.

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  6. "personally know three physicians who I think are extremely qualified to have opinions in this matter. They are not considered Poskim. Yet they are extremely learned in Shas and halachah - particularly in the area of medical halachah. Of no less importance is that they are knowledgeable not just in modern medicine, but also in the history of medicine, which means that they have a better understanding of Chazal, Rishonim and Acharonim. "
    ================
    In the most recent Tradition, David Flatto discusses talmud study from more than the Brisker derech and how the other more academic approaches enrich the understanding. I can't help but think that your statement above and Dr. Flatto's take are at the heart of a debate which keeps playing out - namely do we really care what chazal thought or only what the baalei mesorah in between us and them thought they thought. Since there is clear disagreement on this premise, the rest of the debate reminds me of flatlanders perhaps talking louder to convince the other dimensional beings of the truth of their position.
    KT
    Joel Rich

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  7. "do we really care what chazal thought or only what the baalei mesorah in between us and them thought they thought."

    I don't understand what you are saying here. The issues that I raised in the post are relevant to both Chazal and the baalei mesorah in between Chazal and us.

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  8. I think one of the most important sources for this subject ("who is an expert?") is the second teshuva in Noda Beyehuda OC, where in response to a query concerning the proper pronunciation of adonai, he writes to the inquirer הנה אני תמה על שבחרו לשלוח שאלות הללו לחכמים ולרבנים זיל קרי הוא שאלו לבעלי מקרא. A very bold statement - and there are most definitely halachic implications in pronunciation, particularly in this word! To be sure, that doesn't stop him from writing the rest of the teshuva, but we see that he at least had the concept that there are experts who are neither rabbis nor sages who are the real appropriate address for a query concerning what is, in fact, a branch of Torah!

    Granted, posekim who do involve physicians and whomever may have expertise may well be fulfilling the spirit of his view, but I'm not sure if they share his belief or would ever be surprised that they're receiving an inquiry about what is in essence a matter of physiology.

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  9. To say that people who have not achieved renown as Poskim are not qualified to give opinions on this matter is likewise something which non-charedim would (and should) challenge.

    Renown is not relevant in determining whether one is qualified. But clear mastery of halacha (not just this halachic topic) is. I assume you agree.

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  10. It is also important for rationalists not to make the mistake of unthinkingly adopting the charedi view that only Gedolim are qualified to have opinions and thereby to argue that there are other Gedolim too - although sometimes this may be a strategic move.

    As in my last comment -- depending on how one defines "gadol," perhaps one need not be one in order to render a psak. But one must be a great Torah scholar. Again, I assume you agree.

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  11. Yes - but criteria such as "mastery" and "great Torah scholar" are going to be defined differently by different people/ communities/ eras.

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  12. Meaning that it doesn't matter if in retrospect we now are "sure/ think" rashi was talking about repiration, if later poskim understood him to talk about circulation then that's what he , for halachic purposes, was talking about.

    KT
    Joel Rich

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  13. I am going to expand a little on what DES is saying here. First, I want to bring a great example about how some "gedolim" are qualified to speak about topics that require secular knowledge and some "gedolim" are not.

    My father was telling me why he had much more respect for Rav Gedalia Shwartz than a certain Aggudah Rabbi (no names necessary). He attends halacha in medicine classes sometimes and when we first moved to Chicago he went to this renowned Aggudah lecturer.

    My father told me that after he went to this lecture he decided he could never go again. Why? He told me that this Rabbi clearly did not understand many aspects of the subjects that he discussed. He either did not consult an expert, or he did not ask enough questions from the expert he consulted. Either way, it was clear he knew almost nothing about the several topics he was discussing about medicine.

    However, when he attended Rav Gedaliah Shwartz's lecturers on halacha and medicine, he was very satisfied with his understanding of the medical topics he discussed.

    The ability to give psak halacha comes from an expertise in halacha and torah knowledge as well as a clear and precise understanding of the topic being discussed. This is true about medicine, engineering, electricity and so many other topics.

    Rav Moshe would constantly consult Rav Tendler when it came to medicine and other scientific areas. Why? Because Rav Tendler was and is considered to be very proficient in these areas.

    Rabbis that do not try their hardest to actually understand every aspect of the subject they are paskening on do not have a right to poskin on that subject.

    Isn't this why the Rabbis on the Sanhedrin needed to know all 70 languages and study all types of wisdom?

    So the answer to "Who is an Expert" is someone who is a great Torah scholar and knows or consults experts in order to understand all the intricate details on a subject.

    My Rebbe in High school (Skokie Yeshiva) told me (when the "gedolim" were banning RNS' books) that RNS actually researched the topic and these "gedolim" didn't, so how can they know enough to pasken on it?

    It is not enough for someone to tell them it is treif, they need to actually research and understand all the intricate details.

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  14. " a well-known physician who specializes in Jewish medical issues told me that virtually every frum doctor he knows accepts brain death as death - and that the few who do not are all charedi"

    That is my experience as well. Many are former students of Rav Tendler at YU -- which itself brings up a significant point. Is there ANY other talmid chacham of Rav Tendler's stature, anywhere in the world, who has his level of training in biological sciences?

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  15. "You're wrong."

    That isn't much of a correction. You have not brought forward any other primarily "halachaist" as the counterpoint. But rather have only suggested experts in the field relevant to the particular halachic question.

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  16. I see a problem hereFebruary 10, 2011 at 11:09 PM

    (Note that Rabbi Broyde comments that "Nearly every person I respect as a Torah scholar of substance who is also well trained in the sciences supports the view that Jewish law ought to accept brain stem death when combined with respiratory failure,

    If you analyze this sentence carefully, it could very well play out as follows.
    Lets make a "Torah scholar scale" of 1-10. 1 being the lowest and 10 the highest.
    Now let's say the upper range between 5-10 is the level Rabbi Broyde "respects as a Torah Scholar".
    But, what he is not telling you is that he will not find many Torah scholar in the 8-10 range to also be "well trained in the sciences". You only find those in the 5-7 range.

    That means most of the top tier Torah scholars without scientific training are in halachic opposition to the middle tier Torah scholars who have that training.

    Once you look at it this way, it is not at all obvious that the halachic truth is more likely to be with the Torah scholars that are also well trained in the sciences.

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  17. E-Man

    >Isn't this why the Rabbis on the Sanhedrin needed to know all 70 languages and study all types of wisdom?

    >So the answer to "Who is an Expert" is someone who is a great Torah scholar and knows or consults experts in order to understand all the intricate details on a subject.

    Just wanted to point out that the seifa does not totally match the reisha. If they were the same, then Sanhedrin members would not need to know languages and wisdom, they'd only need to consult people who do.

    I see a problem here,

    I see a problem too. It's unclear how being an 8-10 in Torah compensates for being a 0-2 in the relevant chochma, while being a 5-7 with, let's say, 6-8 in the directly relevant chochma doesn't add up to as reliable if not more. Or at least it's not clear why 8-10 always wins. Maybe there is such a thing as "halachic truth" (Hell, George Orwell) but it is clear that most poskim - if not all - recognize that they need some kind of extra input from doctors, engineers and other experts in chochma, or they need some proficiency themselves, in order to pasken. So the poskim themselves act as if they do not agree that all you need is to be really, really big talmidei chachomim on tech questions to arrive at the "halachic truth."

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  18. Halachic truth?, how does the seifa not match the reisha?

    The sanhedrin needed to understand the 70 languages and other wisdom. Who says they didn't go to experts to learn to understand them? That is what I am saying, either they learned it already or they go to an expert to teach it to them before they give a psak on it. In what way are these ideas inconsistent?

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  19. Charlie Hall: "Is there ANY other talmid chacham of Rav Tendler's stature, anywhere in the world, who has his level of training in biological sciences?"

    I don't want to play this rabbi-comparing game, but just to throw some names:

    Prof. Rabbi Avraham Steinberg MD
    (Encyclopedia of Jewish Medical Ethics, 7 volumes, etc.)

    or

    Prof. Rabbi A.S. Abraham, MD
    (Nishmat Avraham, 6 volumes, etc.)

    They are both involved in the the Schlesinger institute at the Shaarei Tzedek hospital.

    http://www.medethics.org.il/

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  20. WADR, Rav Tendler does not satisfy some of the criteria mentioned in this post. For example, while he is proficient in modern medicine, he is not proficient in ancient medicine, and has interpreted some sources (such as Rambam) anachronistically.

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  21. I see a problem hereFebruary 11, 2011 at 2:08 AM

    I see a problem too. It's unclear how being an 8-10 in Torah compensates for being a 0-2 in the relevant chochma, while being a 5-7 with, let's say, 6-8 in the directly relevant chochma doesn't add up to as reliable if not more.

    I would say that being well-informed by experts in the medical field would jack up the 8-10 Torah people at least a 3 in the science if not more.
    But that imbalance as important as you think because the issue at hand is ultimately the halachic one--not the medical one.
    Issues of safek retzicha can potentially exploit any slight medical uncertainty to overrule the "unanimous" medical view.

    So the 8-10 in Torah gives a qualitative edge whereas the 6-8 in science only gives a quantitative edge.

    Also, you put words in my mouth with this:

    Or at least it's not clear why 8-10 always wins.

    I never said it was clear. In fact, I think I said just the opposite.

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  22. This business of comparing the scientific credentials of rabbis is irrelevant. If this was completely a scientific debate I would say that may the rabbi with the greatest Phd. win. However this is about defining what we know about science to underlining halachic principles.

    Now I have not scene the so called rejectionist side actually rejecting the possibility that lower brain death would constitute halachic death. I have scene it as a position based on sofik on whether or not it is death throws. Also Rav Slifkin has made an assessment that the massora does not address the issue and I will quote "As noted in several previous posts, there are a few problems with a conventional reliance on Chazal, Rishonim and Acharonim in tackling the topic of brain death. One is that these sources just don't address it." .

    Once you say that, then we have a big old sofik on a shaila that involves sofik retzach. Now it was my understanding that Rav Tendler is of the opinion that the massora does deal with this issue hence he brings in the Rambam who says that one is tumas meis at the moment of decapitation. He then goes on to infer that lower brain death or "physiological decapitation" is the same thing. My understanding of the other side (I might be wrong) is that they have a doubt whether or not this fits the Rambam's desription. It is not a rejection per say but a doubt versus a vaday.

    One might even say that the other side may hold as Rav Slifkin said that the massora does not deal with the issue (or at least clearly enough to transfer distill a halachik principle that would deal with are case. Then the case on the table is potential retzach.

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  23. It could also be that the other side might hold that science is an on going venture. Talk to any neurologist and they will tell you that they are learning new things about the brain every day (I have by the way and I mean professors). When I say this I mean that they are constantly having to reassess how they understand things over and over. Particularly in the brain sciences.

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