Rabbi Billet: “Rabbinic Community Should Embrace Brain Death as Criterion for Death”

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rabbi-heshie-billetRabbi Heshie Billet of Woodmere, L.I. writes in The Jewish Week: For the record, I wish to clarify my position on the halachic definition of death as pertains to the Dec. 3 story on the Rabbinical Council of America report on brain death and the manner in which my views were cited (“RCA Backs Off Stand On Brain Death For Transplants”).I never suggested that the RCA report might lead to the death of anyone. The RCA issued a study on the definition of death in which it presented all of the halachic alternatives. The report was carefully done in an objective manner by excellent rabbinic scholars who had no agenda in doing their study.

They presented a majority opinion that rejected brain death and instead advocated for other alternatives. They presented brain death, as well, as a minority opinion. The consequence of the majority opinion would be the inability of Orthodox Jews to donate organs for transplants.

Therefore, I said that in my opinion, the minority opinion, which accepts brain death as the criterion for death, should be embraced by the rabbinic community. It is becoming increasingly more difficult to allow people of a particular group to receive vital organ transplants if they will not donate organs as well. Failure of the Orthodox community to donate organs could have dire consequences for that community if there is a backlash in the medical community to such a trend.

This is important in both the diaspora and Israel. In fact, in Israel the majority of rabbinic authorities as well as doctors in the religious Zionist Torah-educated community use brain death as the criterion for death. You cannot have a viable state today that denies its citizens the lifesaving possibility of organ donation.

At the same time, it is important in my view not to impose any definition of death as a matter of public policy. The religious rights of citizens of all halachic points of view should be respected and protected.

{The Jewish Week/Matzav.com}


31 COMMENTS

  1. all those who got very excited with quoting R’ Moshe (incorrectly) about thanksgiving, will hopefully get it right here, R’ Moshe agrees with this he held Death is defined as “cessation of breathing” ie brain stem death
    so ben torah et al, you no doubt agree with Rabbi billet right?

  2. You mean they say openly that the opinion is driven not by the issue itself but by the worry of “consequences”… and they call themself “Rabbis”!…

  3. The gedolei Israel have poskened on this subject a long time ago. Rabbi Heshie Billet can keep his and the RCA’s pesak for thier own.

  4. I’m at a loss to understand Rabbi Billet’s position. According to the majority opinion, harvesting organs from a brain dead person is akin to murder. The patient is still alive. Why is the dire need for organs a basis for the rabbinical community to adopt the minority opinion, which accepts brain death as the criterion for death? In matters of life and death is there any justification for adopting a minority opinion? May one murder a healthy person for his organs? Strange.

  5. Rabbi Billet says that we should “embrace a minority opinion” about the definition of death, because of convenience. After we have agreed that the majority disagrees, and the Torah says that we follow the majority, to do so is nothing short of murder!

  6. Once that happnes, r”l, then we become like every other murderous, cruel, barbaric “civilization” (sic) out there. If the Modern Orthodox want to be like Episcopalians in this area, let them.

  7. There is a disagreement as to what Reb Moshe said. One Rav quotes him as saying he allowed the brain-death criterion. Everybody else quotes him as saying that brain death was absolutely not a valid criterion.

    Cessation of breathing is most assuredly NOT brain-stem death in this context. The problem arises when a person is on a respirator; otherwise there would be no issues at all.

  8. Ben torah he has R” Moshe on his side (did you forget how much you like R’ Moshe or is it only when he says what you want to hear). and keep in mind it is R’ Moshe who holds you can argue on the gedolei hadar, even in their own town, (written to a Rav moving to benei brak who was afraid to argue with the chazon ish)
    #5, i have no idea what you are talking about, who cares who the picture is of, Rabbi Billet holds the same as R” Moshe

  9. It is not clear what R’ Moshe said. The source of his statement is not so clear. What is clear is that R’ Elyashev holds time of death is when the heart stops beating.

  10. The criteria for pronouncing someone dead is an exact science formulated by Chazal and handed down through our holy Mesorah. The mere suggestion that contemporary consequences might somehow change that determination is a an unmitigated Chutzpah and literally spitting in the face of Chazal. With all due respect, Rabbi Billet sounds like he has joined the Conservative movement and has negated the divinity of our holy Torah.

  11. R’ Moshe’s position is clear if you can read hebrew, he held cessation of breathing (ie brain stem death) is death. If you cant read hebrew but can understand english, search “Rabbi Dovid Feinstein” on youtube it is the first video that pops up he explains his father’s shita

  12. This Rabbi is Mechusar Emunah.

    If a person is supposed to die, R”L, he will die even if he gets a transplant. If a person is not supposed to die, he will not die even if he doesn’t get a transplant.

    Our job is to do our hishtadlus within the bounds of halachah. If that means we will not be able to receive transplants because we cannot be cadaveric donors, then so be it. Hashem has other ways of allowing us to survive.

    Hani kavshi deRachmono lama lach?

  13. When my family was faced with this question, Rav Dovid Feinstein,shlita was emphatic that death is determined only when the heart stops beating and NOT when the brain ceases all functions.

  14. Reb Dovid Feinstein said b’feirush at the Agudah Convention a number of years ago that Reb Moshe ztl’s shitta was death occurs at cessation of breath. Enough said, end of discussion.

  15. Therefore, I said that in my opinion, the minority opinion, which accepts brain death as the criterion for death, should be embraced by the rabbinic community.

    Is he greater than a bas kol? When R’ Eliezer ben Hyrcanus summoned one, the majority did not change.

  16. I fail to undrstand the logic. This ordained Rabbi is suggesting that people who explored the halcha objectively change their postion to make it easier for Orthodox Jews to get transplants.

    In my simplicty I fail to understand this. If we as Jew are commited to observing halacha as the Divine guide to life why should we disregard halacha because of an abstant undocumented socail concern?

    Can someone help me?

  17. 1- Brain death and brain stem death are not the same.
    2- We have 2 children of Reb Moshe who agree on what he said. They are both major Poskim. One is considered probably the greatest posek in USA. Can there still be a machlokes as to what Reb Moshe held??
    3- Rabbi Billet is a wonderful Rabbi….. but from whom did he get shimush in Psak to enable him to issue an opinion when gedolei haposkim have been through this so many times.
    4- Can our need for organs to save lives be a svara to , acc, to some , kill in order to get them??
    5- Dr. Abraham has often said- If there is a machlokes between poskim as to when death halachically occurs and neither side gives in tot he other, how can you be lenient. By matters of life and death we are implored to be stringent. This is not availus…….. yet!

  18. because of consequenses we change halacha?huh?is he orthodox?regardless of what one holds defines death his reasoning is really screwey.btw totally maskim to matzav for prominently displaying his form of head covering for all to know that hes not mishelanu.maybe he can count rabbah horowitz shita to get a majority.lol!

  19. Um #25 cessation of breathing IS brain stem death (the brain stem, specificly the medulla is the center of breathing control)! Rabbi Billet is pushing to follow Rav Moshe’s psak although it isnt the majority. thank you for providing this important link, which hopefully should help correct some misperceptions people have.
    #21 i can explain, now you may disagree but if you pay attention, you should have no trouble understanding. Nobody is saying to disregard halacha chas vesholem. Halacha is quite often affected by consequences (eg mishum aguna hikilu, hefsed miruba, shas hadchak etc) Of course this doesnt mean we go against halacha chas vesholem just their are times where we are meikel, or shift it one way, again within the halachik framework, out of a dire neccesity. Rabbi billet feels thier is a dire neccesity to make lifesaving organs available to frum yidden and therfore the opinion of those who hold brain stem death is death (there are many R’ Moshe being the most famous) should be addopted

  20. a few questions for those who are so sure that brain death isnt death to think about:
    1) A person who while on a ventilator has his head severed, is this diccapatated individual still alive? keep in mind as long as the heart recieves a steady supply of oxygen it will keep beating, the heart has its own pacemaker and doesnt require the brain to maintain its automaticity. Would you consider him alive?
    2) if not, what about somebody who had his spinal cord severed at the c1 level with no messages being transmited from the brain to the body), though from the outside his head is attached , again his heart would still be beating (with O2 supply) is he alive?
    3) if not, what about an indivudal who although his brain stem is physicly intact and connected to his spinal cord, it is physyologicly dead and isnt transmiting any impulses to the body, alive, again his heart would still be beating Is he alive? This is what is known as brain stem death.

    If you answered all 3 are dead, you have accepted brain stem death as death as per R’ Moshe and others
    If you said all 3 are alive you are on your own, there is no shita i am awre of that holds that. (and so much for psik reishe vlo yamos…)
    If you chose a combination of either #1 or #1 and 2 as dead but #3 alive, what is the difference?

    My only point is its not pashut at all, so try not to have such srong opinions until being meayin/thinking about the ugya at least a little

  21. To #25

    Once there is brain stem death it is impossible for the repiratory system to function. In other words, if there is brain stem death then there is no breathing. So Reb Dovid shlita and Rabbi Tendler shlita are in full agreement as to what Reb Moshe ztl held: Death occurs when the repiratory system fails a/k/a cessation of breath a/k/a brain stem death.

  22. Yankel and Anonymous,

    Despite your statements that brain stem death is tantamount to cessation of breathing, the criteria for death is cessation of breathing as noted by a human being and not the indication of brain death on a monitor.

    What you’re saying may be true, but according to Rav Dovid shlit”a the cessation of breathing must be witnessed.

  23. tzoorba,

    Perhaps my words were unclear. I also believe your are slightly inaccurate as well. Reb Dovid shlita states that Reb Moshe ztl’s shitta was death=cessation of breath.

    I am not sure where your comment about indications on a monitor comes from. Reb Dovid acknowledges that if in fact brain stem death=cessation of breath then brain stem death would be a proper criteria. Therefore, if such a thing is proven–I know of no dispute as to whether breathing has ceased once there is brain stem death, but correct me if I am mistaken–then brain stem death is death l’fi Reb Moshe.

    My guess is you’re alluding to how this would be carried out in practice. I am not a doctor but if I recall, Reb Dovid discussed it at the Agudah Convention. Nobody says you can “pull the plug”. However, if it ascertained that there is brain stem death and the ventilator needs to be disconnected for “maintenance” then it need not be plugged back in.

  24. tzoorba, if a person is brain dead he cant breathe, it is a definition of being brain dead. It isnt tantamount to cessation of breathing it equals cessation breathing. Again, a person cant breathe if his brain stem isnt functioning it is that simple.

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