Originally published 1/30/11, 9:11 pm.
Even those who completely accept the position that Brain Stem Death [BSD] = respiratory death = Halachic death STILL must exercise caution.
[For the record, currently it appears to me that BSD has a strong "yeish al mi lismoch". But let's defer that to another day]
Meanwhile there is a poignant true story. I've been given permission to share this as a warning, BUT I have altered some identifying facts to protect the family
Here goes from Rabbi "Sholom"
«Several years ago I was involved in a tragic situation of a Teenage boy who had a bleed in the brain. Medically, the situation was hopeless. Aware that there were different opinions on the matter, the parents were adamant about wanting to donate their son's organs.
Given the machloket haposkim on the matter, I felt I could not deny them their
wish. I called Rabbi Tendler, and he was extremely helpful in guiding me
through the protocol and the tests that had to be done to establish brain death.
What was most disturbing was that I felt - as far as the doctors were concerned - that I was slowing things down. They clearly wanted to move
things along, given the utter hopelessness of the situation. As a result of their eagerness, I could not afford to leave the boy's side, for fear that they would skip steps and not do what. was necessary even for their own protocols.»
I hesitated to share this, nevertheless, I felt obligated to do so.
"Let the families beware"
Shalom
RRW
2 comments:
This story has a flaw.
The boy appears to have been brain dead but not brain stem dead.
Therefore this is not a problem with halachic definition of life but with doctors ignoring that definition. Big difference.
I have admired your blog and coments on Avodah and elsewhere.
It is well known, and in fact documented in the medical literature that the criteria to determine death by neurological criteria(brain death)vary from hospital to hospital, and indeed sometimes physician to physician. A number of recent papers have advocated for only one exam and no confirmatory studies. (there are other papers that call for more confirmatory studies). This reality does not impugn the halachic validity of the concept of brain death. It does underscore the fact that halachic medical ethics and secular medical ethics are not the same, and it is sometimes necessary to have someone make sure that the patient's wishes are known to the treating team. I think the overwhelming number of physicians respect the desires of the patients, and when push comes to shove do not substitute their value judgements for the patient's. However, this issue relates not just to brain death, but to almost every situation where a determination is needed as to how aggressive the medical care should or should not be. As a side note, 2 years ago I made an offer to Rabbi Bush(the author of the RCA paper) to organize orthodox neurologists and neurosurgeons who would be under the direction of halachic authorities and would be able to act as intermediaries in situations such as you describe. In this way we would be able to make sure that the medicine matched up to the halacha. The offer was met with silence.
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