Friday, February 17, 2012

Dying to Help

With the increasingly strange reactions to the declining health of Rav Elyashiv, one story stands out: A Jerusalem avreich donated one year of his life to Rav Elyashiv. According to the report, he said that “we are in a time that the gedolei yisrael are the pillar of our existence." The report also states that he asked for, and received, permission and encouragement from other gedolim. (Alas, their names are not given.)

Most of the "frum" discussion about this story is centering on whether it is possible to do such a thing. There is a Midrash about Adam HaRishon making a deal with God to donate seventy years of his life to David HaMelech. However, translating ideas from Midrashim to today is problematic (which I will be posting about on another occasion - feel free to send in examples).

I would like to focus on a different aspect to this story. Let us first ask the following: Does this person, and the rabbis that he consulted, really and truly believe that this could work? Or is it just something to make himself feel good and/or inspire others?

I'm not entirely sure of the answer. On the one hand, it doesn't seem likely that he doesn't believe in it. But on the other hand, if he really believes that it works, and that it is a worthwhile sacrifice because Rav Elyashiv, even at this advanced stage of life, is the "pillar of existence" of the Jewish People, then why is he only donating one year?

But, putting this question aside, let us consider the fact that this person is being praised for his gift. Given the assumption that Rav Elyashiv's continued survival really is of critical necessity to the Jewish people, this is indeed understandable. It is true that we do not normally permit the taking of one person's life in order to help another - "Who says that your blood is redder than his?" However, there can be cases where one person's life is, objectively speaking, worth more than the life of another. Furthermore, we see in the Gemara, regarding Papus and Lulianus being praised for giving their lives to save the community of Lod, that a person has more autonomy over their own life, empowering them to choose to give it away, than they do over someone else's life. Thus, to give up one's life in order to save the lives of others can be a legitimate and noble sacrifice.

But here's where things get especially interesting. It is precisely this line of argument which demonstrates that, even if one does not rate brain-death as death, organ donation should be permissible. Even if one considers the brain-dead person to possibly be alive, his life is certainly worth much less than that of a chayey sha’ah, a terefah, or even a goses, since he is incapable even of thought. For a person to volunteer in advance to give up that life in order to save several healthy people is surely even more worthwhile a sacrifice than for this avreich to give up an entire year of his life for a 101-year-old.

And yet, virtually nobody in the Charedi world accepts this argument. Why?

Personally, I think that the answer is simple. Indeed, such a sacrifice is noble and legitimate. However, for the chareidi world to accept it, it also has to sound frum. What this avreich is doing sounds really frum. But organ donation, for various reasons, does not sound frum.

NOTE: For discussion about the halachic option of "noble sacrifice" for organ donation even if brain death is not death, see Rabbi Yehudah Dik, “Terumat Eivarim Mi-Goses LeHatzalat Chayey Adam,” Assia vol. 53-54 (Elul 5754/ August 1994) pp. 48-58; Rabbi Naftali Bar-Ilan, “BeInyan Mi SheTorem Lev O Kaveid LeHashtalah,” Assia 47-48 (Kislev 5750), pp. 131-141; “Terumat Lev HeHashtalah,” Assia 83-84 (5769) pp. 108-118; Rabbi Dr. Michoel Avraham, “Terumat Evarim,” in Techumin (5769) 29 pp. 329-339; Rabbi Shmuel Eliyahu, Chief Rabbi of Tzfat, at the HODS Rabbis & Physicians Seminar, Albert Einstein College of Medicine (video available at HODS.org). For an analysis of the philosophical framework behind such determinations, see Rabbi Dr. David Shatz, “As Thyself: The Limits of Altruism in Jewish Ethics” and “Concepts of Autonomy in Jewish Medical Ethics,” in Jewish Thought in Dialogue (Brighton, MA: Academic Studies Press 2009) pp. 326-384.

57 comments:

  1. Good point. I just thought I should add that there's a story out there about someone (a shamash?) giving up years of his life for the Shpoler Zeide who was supposed to shortly die. There's also a story out there about the Baal Hatanya's daughter doing the smae for him.

    I'm just telling you this in case you didn't know. I am not passing an opinion on the matter.

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  2. I think this avreich (and especially his comment about pillars) brings to mind the north korean citizens again like I mentioned in another post.

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  3. Papus and Lulianus was giving up life through a dibbur,

    organ donation is a maasah (like submitting to to hakofos rosh)

    a person could not give up his liver also to a gadol, even though his life is worth more. (we can disagree on the reason)

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  4. There’s literature on giving up your life for a greater person – seems to start with sefer chassidim 698 and a r’ akiva/ reuvain ben itztrolibi which I can not trace any earlier. If anyone has earlier cite, let me know please.
    The whole rshut/chiyuv/recommended question is fascinating.

    KT
    Joel Rich

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  5. THere is also a story of prisoners donating years of their lives for R. Aryeh Levine.

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  6. Dovid - why is organ donation a maaseh? You're just notifying that it should be done. Similar to our avreich notifying Hashem that his life should be taken early.

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  7. Joel Rich - see the sources that I just added at the end of the post.

    Yaacov Dovid - a minor correction - if I recall correctly, they were giving years to his daughter.

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  8. On the positive side, the comments on yeshivaworld are almost all disparaging (some quite amusing) regarding this foolishness...

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  9. Organ donation is different because other people actually need to kill you (assuming you're not halachically dead yet).

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  10. DES - that is addressed by Rabbi Dr. Michoel Avraham, “Terumat Evarim,” in Techumin (5769) 29 pp. 329-339.

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  11. This post does not really have relevance to halacha, if our point was to expose charedi hypocrisy-kudos, but you have not proven your point at all.

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  12. If every Jew donated a year to R. Elyashiv, he would live 13 million more years. Sounds like a plan

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  13. natan,
    if you notify me that i should cut your peos off,and I do so, you also transgress on a lav, by instigating and co operating,no ?
    similarly I would have thought instigating and bringing about your death would also be a lav

    as for asking for heavenly help, surely that falls outside halachik domains

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  14. My point is just that the case of organ donation is not conceptually identical to the case of the fellow who wants to donate a year of his life to R. Elyashiv. No one has no aid and abet the latter in his attempt to donate a year of his life.

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  15. >>>> if every jew donated 1 minute, it would still give him 25 more years

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  16. There is a well know story about giving up a minute of life by the Chafetz Chaim or Naftali Trop.

    (See it quoted here
    http://www.shortvort.com/shemini-parasha/11700-parashas-shemini-journey-to-the-centre-of-the-torah)

    Obviously, it is not meant to literally give time of life as the story shows. What it means is that one should live the amount of time he donates in a heightened awareness of religious existence in merit of the sick person. A person should feel so distraught that he is willing to donate his life in merit of the recovery.

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  17. Wow, you managed to connect this to organ donation. Wrong in at least three ways I can think of as I'll write in a later comment.
    Does this whole discussion not strike some as callous?

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  18. The difference is that organ donation actually works (as in the donor dies) while the avreich giving his years to R' Elyashiv does nothing so it's harmless.

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  19. Daniel Schwartz 4:31 raises an excellent point. I find it hard to countenance the idea that people actually believe this exchange "works", given that no one believes that Rav Elyashiv could live 13 million more years or even 100 more years (if, let's say, 100 of his closest associates each donated a year).

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  20. Do you get a tax receipt for a year's dontation?

    [Someone asked this on an email list I participate in. The answer was: what kind of avreich would pay taxes to begin with?]

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  21. Utter nonsense. You're putting the cart before the horse. The reason it doesn't sound frum is because the Gedolim disaaprove. If they would approve, it would already sound like the frummest thing in the world. And you ought to know that.

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  22. I'm so curious if the avreich consulted with his wife and kids.
    (This is a serious question, so don't respond with, "yes, in fact his wife recommended he donate twenty years!")

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  23. " and that it is a worthwhile sacrifice because Rav Elyashiv, even at this advanced stage of life, is the "pillar of existence" of the Jewish People, then why is he only donating one year?"

    You should be asking why he is willing to donate so much time, rather than asking why he is not donating enough.

    1 minute or 1 hour, if this really worked would be "too much" (According to the stories I've heard on this topic)

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  24. I see a huge difference. In this case the person is leaving up to God to make the decision. You cannot determine who's blood is redder than the other. However God obviously can make such a determination.

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  25. Perhaps this avreich has it backwards? The death of tzaddikim is supposed to atone for the nation's sins. Losing a great rabbi is a loss, but it is also supposed to bring a benefit (according to mystical thought). It is also taught that tzaddikim are greater (ie, have more influence over the world) after death than during life.

    "Suffering and pain may be imposed on a Tzaddik as an atonement for his entire generation. Such suffering also includes cases where a Tzaddik suffers because his entire generation deserves great punishments bordering on annihilation but is spared via the Tzaddik's suffering. In addition there is a special higher type of suffering that comes to a Tzaddik who is even greater and more highly perfected than the ones discussed above. to provide the help necessary to bring about the chain of events leading to the ultimate perfection of mankind as a whole" (Ramchal, Derech HaShem II:3).

    Years ago, I read a book about the Baba Sali by a rabbi who was his assistant. He noted that Baba Sali could sometimes be heard praying for someone (one of those people who had stood in line for hours to get his blessing, I assume), "Let it happen to me instead" -- in other words, let my suffering be an atonement for that person. In a sense, that is what the avreich wants to do in giving up a year for R' Elyashiv. But it seems to make more sense for it to be the other way around -- a great rabbi asking to be an atonement for someone of smaller stature who is suffering.

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  26. By the way, I'm not so sure why this idea of donating a year should sound so ludicrous from a rationalist piont of view. How is it different from regular tefilla? Plenty of us ask Hashem for certain things and the assumption often is that Hashem may answer us in the the zechus of something we've done or will do.

    Why, then, would a person not be able to ask Hashem to reward someone else for something we've done, even if at our own expense? In other words, the person is saying to Hashem: Perhaps you were going to reward me for something I've done by letting me live to 71 instead of 70. Instead, though, please let me die at 70 and give that extra reward of life to this other person.

    I know some people think of tefilla very differently. But I don't think it's inherently irrational to view tefilla the classic way (seeing Hashem as a parent or teacher handing out rewards and punishments based on our behavior and special pleas we make).

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  27. Hagaon Rav R. Serling has a responsum on the topic here: http://en.wikipedia.org/wiki/The_Self-Improvement_of_Salvadore_Ross. It may be worth "watching" this t'shuvah for additional insight.

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  28. "The difference is that organ donation actually works (as in the donor dies) "

    Correct. If brain death is not death, the donor is murdered by the doctors doing the transplant in order to save the life of the recipient. There is no way to pilpul around this.

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  29. " If brain death is not death, the donor is murdered by the doctors doing the transplant in order to save the life of the recipient. There is no way to pilpul around this."

    You don't need much pilpul.

    Not every death by another human being is "murder".

    When a soldier is given permission to be in an army during a war, that Soldier is never guilty of "murder" even though they will be killing many people.

    There is no reason at all, why the doctor here would be committing "murder". There is no malice, there is no intent to do harm, and they are helping other people by saving lives.

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  30. 1. "Dovid - why is organ donation a maaseh? You're just notifying that it should be done. Similar to our avreich notifying Hashem that his life should be taken early."

    So, by that logic, hiring a hitman to kill someone is the same as praying fr someone's death. Does anyone believe that?

    2. I am pretty sure that the Talmud has statements to the effect that great talmidei chachamim have a zechut that benefits the world at large. (I could be wrong - please let me know if you know sources for this or if I am mistaken).

    So, the outpuring of concern for this talmid chacham isn't something that should be condemned, It should be respected, even if not shared. This has nothing to do with the political manifestations of what some call 'da'as torah' or the problems in the chareidi world today. It is concern for beloved talmid chacham.

    3. Is this blog ever going back to be being about Rationalist Judaism? If not, why not change the name to Anti Chareidis 'R' Us or something?

    G-d bles you all.

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  31. I saw on haaretz
    that the Rav is in a medically-induced coma. Does the frum press censor this information out?

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  32. I am pretty sure that the Talmud has statements to the effect that great talmidei chachamim have a zechut that benefits the world at large
    ..

    one source may be

    Berachot 17b
    The entire world is fed in merit of Chaninah my son, yet Chaninah himself is content with merely one measure of carobs every week
    ..
    I wonder if rationalists find this statement at all problematic

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  33. did it cross your mind that there is a diff. betw. killing yourself (or someone else) and asking God to "transfer" your life to someone? not that o think this is a good idea, but for someone who prizes the reasoning faculty so highly, yours seems to provide only ammunition to those who seek evidence of its shortcomings

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  34. It seems to me that Herschel is confusing here praying for Gadol to get healthy and giving year of ones life to Gadol. I assume that person who is giving a year of his life, actually believes that it works, and if it does work, so in effect he is killing himself (by shortening one's life) to save Gadol.
    Again, the logic is that he shortens life to save other life.

    That is different than simply praying for a Gadol to get better.

    If you argue back - that giving year doesn't really work, then it is a different story. But we are going with approach that it does work, at least in the minds of avrech and Gedolim who approved of him.

    It is irrelevant if it is maasei or dibbur - the point here is if it works (acc to avrech camp) then it is similar to organ donation.

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  35. According to this logic, if someone can pray to die (e.g., Moshe, Yonah), he can also ask someone to shoot him.

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  36. The story is not reported as the avreich asking if Hashem would like to take his life. It was reported as him giving it, as a done deal.

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  37. Rabbi Slifkin,

    You write: "... for the chareidi world to accept it, it also has to sound frum."

    I didn't follow the reasoning that's implicit after your penultimate paragraph. Are you referring here to the rabbinic leadership, the citizenry, or both? Could you give another example of this particular phenomenon -- perhaps a more everyday one?

    Alternatively: Might you write a blog post on this subject?

    (As one who's spent most of his years in the rational-style camps, I wonder if there's an anlogous phenomenon there of "having to sound modern".)

    Thanks.

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  38. A bit more, but tangentially:

    Unlike many commenters, I think it's highly important to study the phenomena that occur right in front of us in the "Jewish political space", and to strive to understand them through Torah-rational categories. Consider how Rabbi Dr. Haym Soloveitchik began his 1994 Rupture and Reconstruction from the point of view of his own political situatedness: "This essay is an attempt to understand the developments that have occurred within my lifetime in the community in which I live. The orthodoxy in which I, and other people my age, were raised scarcely exists anymore. ..."

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  39. Ridiculous. Anyone who engages in such a thing is, in essence, saying that they power over life and death can be usurped somehow from the powers of HKB"H. That's not only ridiculous, but it's even a kind of kefirah!

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  40. "There is no malice, there is no intent to do harm, and they are helping other people by saving lives."

    Agreed. As is someone who agrees to be an organ donor.

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  41. Minor detail: Thou shalt not murder
    Does this blogger, and the people that he consulted, really and truly believe that this argument could work?

    According to such a argument, people should be able to give up their life in many cases. For example, an elderly man could choose to die so his organs would save 3 young adults.

    One, doesn't need to reject this argument for lack of "sounding frum", since its nonsense. One case involves murder, the other does not. You cannot just focus on the end-results without looking at the means.

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  42. Okay, I guess a clarification is needed.

    Usually, you can't assess the value of human life and give it up as a result. "Whose blood is redder" etc.

    The only case of heroic sacrifice that I personally advocated here was in the case of brain death, where the person cannot even think any thoughts.

    I was saying that for those who do believe that a year of their life can and should be given up for a Gadol, there should be a kal v'chomer to the case of brain death.

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  43. Dovid aid: 'I wonder if rationalists find this statement at all problematic'.

    Why should this be problematic? Rambam explains in Hakdoma Leperek Chelek that the world was created for the people to pursue chocma. Most of the people exist to provide a society for the few seekers of wisdom. This is also the meaning of the Gemorah in Brochos.

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  44. " For example, an elderly man could choose to die so his organs would save 3 young adults."

    How about a young soldier falling on a grenade to save the rest of his squad. In the US armed forces, soldiers who do that get the Medal of Honor. Is this really "nonsense"?

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  45. There's always this fear...: "Toddler Accidentally Shot by Cousin NOT Brain Dead Afterall, Doctor Apologizes for Mistake"

    http://www.hispanicallyspeakingnews.com/notitas-de-noticias/details/toddler-accidentally-shot-by-cousin-not-brain-dead-afterall-doctor-apologiz/12980/

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  46. "I was saying that for those who do believe that a year of their life can and should be given up for a Gadol, there should be a kal v'chomer to the case of brain death."

    Yes, but the corollary would be praying to Hashem to remove the organ and transfer it to the other person. After all, that's what the avrech did. If you equate the two we get back to my original question: is hiring a hit man to shoot someone the same as praying for the person's death.

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  47. "Or is it just something to make himself feel good and/or inspire others? "

    This is precisely what I thought. The fellow was distraught, so his rabbi gave a decision to make him feel better.

    I have another problem with the story. Could making such and exchange be a violation of תמים תהיה? This idea that one can give up a year of his life for someone else strikes me as superstitious. Is this assur?

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  48. There is another aspect which has not been addressed. This avreich seems to be believe that the wellbeing, even the survival, of Klal Yisrael depends on R. Elyashiv's survival. If so, his offer is attempt at hatzalat klal Yisrael, which is a different proposition from one person giving up his life for another. Indeed, in one of his shiurim, R. Soloveitchik said that the main halakhic lesson of Megillat Esther is that one may sacrifice his life for the community. Of course, I think the avreich is barking, based on his assumptions, it makes sense.

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  49. "There's always this fear...:"

    New York State requires two independent neurological exams before a brain dead individual can be allowed to have organs transplanted. In a recent study of 1311 individuals who had been declared brain dead after a neurological examination in New York State, the number who were determined not to be brain dead on the second neurological examination
    was zero.

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  50. Hershel -
    Avrech did not pray for God to transfer a year to Gadol. He simply gave a year of his life. period. you r confusing praying to G-d and actually doing something.

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  51. David,
    How? I just gave you a dollar. Do you owe me a thank you?

    Obviously he meant that he was asking Hashem to do this.

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  52. "New York State requires two independent neurological exams before a brain dead individual can be allowed to have organs transplanted. In a recent study of 1311 individuals who had been declared brain dead after a neurological examination in New York State, the number who were determined not to be brain dead on the second neurological examination
    was zero."

    Well, since mistakes have happened, this survey is suspect.

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  53. Ametour- Of course mistakes can happen. However, if one is very careful, the likelihood of a mistake can be greatly minimized. I am amazed that you are willing to cast doubt on a study based solely on your preconceived notions with no knowledge of the topic. Why dont you read it first and then comment? This is the reference: Lustbader D, O'Hara D, Wijdicks EFM, et al. Repeat brain death examinations may negatively affect organ donation. Neurology 2010; E-pub 2010 Dec. 15.(unfortunately it is not available for free on-line. If you truly are interested feel free to email me noamstadlan at gmail)

    The truth is that 'mistakes' in determining brain death are the sloppy kind: the protocols are not followed with precision, assumptions are made that shouldn't be, and frequently people are not precise with their language and throw around the term brain death without meaning precisely 'he has fulfilled all the criteria for determining irreversible cessation of specific neurological functions.'

    When you throw out all of those 'mistakes', the fact is that no one has ever regained any function after fulfilling the criteria put forth by the American Academy of Neurology(paper in 1995 and reviewed in 2010). Just for completeness, there were 3 cases published last year where there were questions if the patients did in fact regain function. When you examine the facts, the patients did not fulfill the criteria to begin with, and shouldn't have been identified as dead. The criteria work when applied with dedication and precision.

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  54. Hershel.
    So r we having a debate about facts of the story?
    Let me ask you a question - lets say avrech did not ask G-d to give a year of his life. He just gave period. Is it considered giving according to you?
    If you will say no, then we are arguing about different cases.
    I assume that by giving a year of his life it is a done deal. Unlike a dollar case.

    And even in dollar case, mere dibbur also works - if i say that i own u a dollar, then I halachicly own u money.

    Also if you hire someone to kill someone else - u are exempt, since there is no shliach ledvar aveira.

    There are many case in halacha were dibbur constitutes a maase. But all of this is irrelevant here.

    PS in final analysis even if transfer of year does work, God ultimately decides what to do with that year, He can shorten it.

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  55. Although reb hershel probably many to write in jest, her came across as serious.
    The obvious difference is, that anyone would give a kidney to elyashiv, why?
    Because there is no nivull hames. By giving a year to reb elyashiv he did not do anything wrong, but donating organs, is a problem.
    Small difference?

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  56. Although reb hershel probably many to write in jest, he came across as serious.
    The obvious difference is, that anyone would give a kidney to elyashiv, why?
    Because there is no nivull hames. By giving a year to reb elyashiv he did not do anything wrong, but donating organs from a dead body, is a problem.
    Small difference?
    However, this donor of one year, I wonder had he known her only had another five years to live, would he still give away one of those years?
    Its for this reason it can be assumed he really does not think it works, or he thinks that hashem will give him his year back as a reward for donating a year to a godol.

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  57. In the book "All for the Boss" by Mrs. Ruchama Shain, she mentions that a certain relative was dying. His father asked the Chofetz Chaim ZT"L if he could give his remaining years to this son and was told that he could. The son recovered and the father passed away shortly afterwards.

    I read, in another book, that when this same son passed away, a very old man came to pay a shiva call. He said that he was the doctor who had attended the niftar 30 years ago, and there was no way in nature that he could have recovered, never mind live for thirty years!

    I apologize for not providing more specific sites.

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