In this teshuva from 1968, Rav Moshe Feinstein offers an in-depth analysis of the issues involved with heart transplants. Bear in mind, as mentioned in the last teshuva, that this was written in the early days of heart transplants, when success was not assured.
Rav Moshe begins by flatly prohibiting heart transplants on the grounds that it involves the murder of two people - the donor and the recipient. The donor is deemed a murder victim since his heart was still beating when it was removed from him, and the recipient is deemed a victim since he is sure to die soon as a result of the transplant and he is condemned to a brief life of pain and suffering in the interim.
The bulk of the teshuva is divided into four sections, in which Rav Moshe makes the following main points:
1) It is forbidden to shorted someone's life by even the smallest amount, and thus so long as someone's heart is beating, removing it in order to give it to someone else constitutes killing that individual.
2) We are not experts in determining the exact time of death, and even once breathing has stopped it is still possible for someone to be alive.
3) Giving someone a heart transplant does not qualify as healing the recipient per se, but rather as prolonging his life. Since that life is likely to be one of suffering, it is forbidden to inflict such a situation on another person. [ed note - does anyone know Rav Moshe's opinion about hooking someone up to a life support machine? Wouldn't that seem to be the same thing?]
4) Rav Moshe's final point discusses the limits of the requirement of לא תעמד על דם רעך - that we are not required to actually cut off a limb in order to save another individual. Certainly in this case, where we are asking someone to give up a major organ for the purpose of possibly saving someone else for a small amount of time there is no requirement to do so.
[My hope is to continue to find teshuvot on this topic that were written as the medical science continued to advance. Stay tuned.]
Sunday, January 30, 2011
Wednesday, January 26, 2011
Determining death - Igrot Moshe Yoreh Deah 2:146
[ed note - this teshuva has been in the news recently due to the recent discussions concerning the RCA's paper about brain death. I am not an expert in the issues involved, nor am I seeking to contribute to the overall discussion. However, I do feel that in any overheated debate, it is important to actually check the sources that are the source of the issue.]
In a teshuva from 1970, Rav Moshe Feinstein was asked to rule on the medical notion of brain death. He begins by stating that life is determined by breathing, and cessation of brain activity does not necessarily mean cessation of respiratory activity. As such, brain death would not be considered death [ed note - Rav Moshe's son-in-law, Rabbi Dr. Moshe Tendler, has drawn a distinction with regard to this teshuva between brain death and cerebral death - see here]. So long as the doctors are able to detect some signs of life, even if they require sensitive high-tech equipment to do so, they should treat the patient to the utmost degree in order to save him.
[Rav Moshe pauses at this point to note that we generally are not concerned with things that can only be detected via microscopes and other instruments which perceive that which we cannot perceive with our senses. The case of a patient whose heartbeat can only be detected via electric radiogram is an exception to this rule.]
The next extensive part of this teshuva deals with the various parts of the body that are discussed in sections of the Gemara that discuss determining death, such as the nose and the navel. Rav Moshe concludes that neither one is actually responsible for life, but rather are merely locations on the body where we can perceive whether or not life functions are continuing, and ultimately he leans towards the view of the Chacham Tzvi that the heart is the major determinant of life.
At the very end of the teshuva, Rav Moshe discusses the issue of heart transplants, which had been done for the first time in 1967, and was still exceedingly rare at the time of this teshuva (see here for more history). Rav Moshe feels that the removal of the heart from the recipient is tantamount to murder, and that doctors are not trustworthy that the transplant will work both because who knows whether the new heart will work any better than the old one, and because past recipients have lived only a short time. It would be interesting to see more recent literature on this topic as medical knowledge in this field has improved vastly over the past four decades. Readers are encouraged to send in references.
In a teshuva from 1970, Rav Moshe Feinstein was asked to rule on the medical notion of brain death. He begins by stating that life is determined by breathing, and cessation of brain activity does not necessarily mean cessation of respiratory activity. As such, brain death would not be considered death [ed note - Rav Moshe's son-in-law, Rabbi Dr. Moshe Tendler, has drawn a distinction with regard to this teshuva between brain death and cerebral death - see here]. So long as the doctors are able to detect some signs of life, even if they require sensitive high-tech equipment to do so, they should treat the patient to the utmost degree in order to save him.
[Rav Moshe pauses at this point to note that we generally are not concerned with things that can only be detected via microscopes and other instruments which perceive that which we cannot perceive with our senses. The case of a patient whose heartbeat can only be detected via electric radiogram is an exception to this rule.]
The next extensive part of this teshuva deals with the various parts of the body that are discussed in sections of the Gemara that discuss determining death, such as the nose and the navel. Rav Moshe concludes that neither one is actually responsible for life, but rather are merely locations on the body where we can perceive whether or not life functions are continuing, and ultimately he leans towards the view of the Chacham Tzvi that the heart is the major determinant of life.
At the very end of the teshuva, Rav Moshe discusses the issue of heart transplants, which had been done for the first time in 1967, and was still exceedingly rare at the time of this teshuva (see here for more history). Rav Moshe feels that the removal of the heart from the recipient is tantamount to murder, and that doctors are not trustworthy that the transplant will work both because who knows whether the new heart will work any better than the old one, and because past recipients have lived only a short time. It would be interesting to see more recent literature on this topic as medical knowledge in this field has improved vastly over the past four decades. Readers are encouraged to send in references.
Mikveh in a bad neighborhood - Igrot Moshe Yoreh Deah 2:91
In a strange case brought to Rav Moshe Feinstein in 1964, the question was asked about the status of a mikveh in a non-Jewish neighborhood which apparently had windows that allowed passers-by to look into the mikveh. Rav Moshe begins by decrying this as a major breach of tzniut, and then notes that the טבילה that the women do may not be good, as they might be so self-conscious as to not be careful with what they are doing. He further exhorts the community to take whatever measures necessary to construct a mikveh that is not compromised.
Rav Moshe then addresses the issue of how the new mikveh is to be built. Apparently, the community wanted to destroy the existing mikveh in order to build the new one. However, Rav Moshe notes that this would leave the community without a functioning mikveh for the intervening period, and that would be an untenable situation.
An additional issue raised was whether or not the community should be worried that a non-Jew would climb up on the roof of the new mikveh and pour water into the pit that was collecting rain water for the mikveh, thus invalidating the mikveh. Rav Moshe ruled that we do not worry that a non-Jew would do something like this, which involves a certain degree of effort, if he stands to gain nothing.
Finally, the questioner asked as well about a community who wanted to construct a shul so that the Aron and bima could be automatically lowered out of sight in the event that a wedding would take place in the shul. Rav Moshe rules unequivocally that such a move would be forbidden, as it would not be respectful to the Torah for it to be below the floor while people are celebrating above (and not necessarily celebrating in a halachically acceptable fashion). Furthermore, Rav Moshe points out that the Chatam Sofer and others do not approve of using shuls as venues for weddings.
Rav Moshe then addresses the issue of how the new mikveh is to be built. Apparently, the community wanted to destroy the existing mikveh in order to build the new one. However, Rav Moshe notes that this would leave the community without a functioning mikveh for the intervening period, and that would be an untenable situation.
An additional issue raised was whether or not the community should be worried that a non-Jew would climb up on the roof of the new mikveh and pour water into the pit that was collecting rain water for the mikveh, thus invalidating the mikveh. Rav Moshe ruled that we do not worry that a non-Jew would do something like this, which involves a certain degree of effort, if he stands to gain nothing.
Finally, the questioner asked as well about a community who wanted to construct a shul so that the Aron and bima could be automatically lowered out of sight in the event that a wedding would take place in the shul. Rav Moshe rules unequivocally that such a move would be forbidden, as it would not be respectful to the Torah for it to be below the floor while people are celebrating above (and not necessarily celebrating in a halachically acceptable fashion). Furthermore, Rav Moshe points out that the Chatam Sofer and others do not approve of using shuls as venues for weddings.
Dental stiches and mikveh - Igrot Moshe Yoreh Deah 2:87
With regard to whether or not stitches as a result of oral surgery present a problem of chatzitza for a woman who has to go to the mikveh, Rav Moshe rules that since the stitches cannot be seen and can only be manipulated via a fine instrument they are considered to be in a מקום בלוע and thus do not need to have the water reach them and thus are not considered to be a chatzitza.
Listening to Gentile music - Igrot Moshe Yoreh Deah 2:56
In this brief teshuva, Rav Moshe rules that it is forbidden to listen to non-Jewish religious music, even on the radio or a recording. This applies not only to current songs, but to ones from the past as well [ed. note - this can be an issue when taking music courses in college and Gregorian chants are part of the curriculum]. Even if the song uses psukim from Tehillim (or elsewhere in Tanach, e.g. The Hallelujah Chorus), it is forbidden. However, if the song is written and/or song by a non-Jew but has no religious purpose, then there is technically no prohibition.
Rav Moshe considers the case of Acheir, who the Gemara claims left Jewish religious life as a result of his constantly singing Greek songs. After some discussion as to whether this could really be the reason that he abandoned his religious life, Rav Moshe cites the Maharsha who says that he was singing songs that had connections to idolatry that led him to heresy. Rav Moshe also notes that a potential issue is the mentioning of the names of other gods, as that would violate the prohibition of ושם אלהים אחרים...לא ישמע על פיך.
[ed. - Does that last point present a problem from songs such as "Let it Be" or "Walking in Memphis"? Discuss.]
Rav Moshe considers the case of Acheir, who the Gemara claims left Jewish religious life as a result of his constantly singing Greek songs. After some discussion as to whether this could really be the reason that he abandoned his religious life, Rav Moshe cites the Maharsha who says that he was singing songs that had connections to idolatry that led him to heresy. Rav Moshe also notes that a potential issue is the mentioning of the names of other gods, as that would violate the prohibition of ושם אלהים אחרים...לא ישמע על פיך.
[ed. - Does that last point present a problem from songs such as "Let it Be" or "Walking in Memphis"? Discuss.]
Wednesday, January 12, 2011
Hunting for sport - Noda BiYehuda Yoreh Deah 2:10
The Noda BiYehuda was famously asked if it is permissible for a Jew to hunt animals for sport. He begins by considering two obvious objections, and rejects them both.
First, he discusses whether hunting would fall under the category of צער בעלי חיים, causing unnecessary pain to the animal. He rejects this objection on two grounds: (1) This rule only applies when there is no benefit for humans, but since when one hunts he stands to get some benefit (perhaps the skins), then there is no consideration of צער בעלי חיים, and (2) this principle only applies when the goal is to apply pain. However, since when one hunts he aims to kill the animal quickly, and to actually put it out of pain, then there is no issue.
The second likely objection is that of בל תשחית, loosely defined as wasting some part of this world. Again, the Noda BiYehuda rejects this problem, as the hunter does stand to gain something once he shoots the animal, and thus there is no wasting involved.
However, the Noda BiYehuda still rejects the permissibility of hunting. He begins the second part of his teshuva by noting that hunting is something that is associated in Tanach with Nimrod and Esav, and thus is not something connected to the character of the descendants of Avraham, Yitzchak, and Yaakov. As to the defense that one should hunt in order to get the skins of the animals, the Noda BiYehuda points out that plenty of animals die on their own and thus there is a readily available supply of such skins without resorting to hunting.
As to the defense that the mishna in Sanhedrin 2a allows for the killing of wild and potentially dangerous animals, the Noda BiYehuda notes that this likely only applies once they have attacked someone and have shown themselves to be actually dangerous, if it applies at all. If anything, hunting for sport is merely revelatory of a cruel nature.
Furthermore, he points out that there may be a specific prohibition involved, namely a violation of ונשמרתם מאד לנפשותיכם - that we are enjoined to take care of ourselves physically. Once who willingly enters a wooded area or some other spot where he is expecting there to be wild and vicious animals is taking his life into his hands (even if he is a relatively good shot), and thus would be violating this mitzva. Even further, the Noda BiYehuda notes that the mishna in the 4th perek of Brachot provides a special prayer that one should recite when entering into a dangerous place, and he reasons that going hunting qualifies as such (based on the fact that even the great hunter Esav said הנה אנכי הולך למות - and the simple explanation is that he expected to eventually die in a hunting accident).
First, he discusses whether hunting would fall under the category of צער בעלי חיים, causing unnecessary pain to the animal. He rejects this objection on two grounds: (1) This rule only applies when there is no benefit for humans, but since when one hunts he stands to get some benefit (perhaps the skins), then there is no consideration of צער בעלי חיים, and (2) this principle only applies when the goal is to apply pain. However, since when one hunts he aims to kill the animal quickly, and to actually put it out of pain, then there is no issue.
The second likely objection is that of בל תשחית, loosely defined as wasting some part of this world. Again, the Noda BiYehuda rejects this problem, as the hunter does stand to gain something once he shoots the animal, and thus there is no wasting involved.
However, the Noda BiYehuda still rejects the permissibility of hunting. He begins the second part of his teshuva by noting that hunting is something that is associated in Tanach with Nimrod and Esav, and thus is not something connected to the character of the descendants of Avraham, Yitzchak, and Yaakov. As to the defense that one should hunt in order to get the skins of the animals, the Noda BiYehuda points out that plenty of animals die on their own and thus there is a readily available supply of such skins without resorting to hunting.
As to the defense that the mishna in Sanhedrin 2a allows for the killing of wild and potentially dangerous animals, the Noda BiYehuda notes that this likely only applies once they have attacked someone and have shown themselves to be actually dangerous, if it applies at all. If anything, hunting for sport is merely revelatory of a cruel nature.
Furthermore, he points out that there may be a specific prohibition involved, namely a violation of ונשמרתם מאד לנפשותיכם - that we are enjoined to take care of ourselves physically. Once who willingly enters a wooded area or some other spot where he is expecting there to be wild and vicious animals is taking his life into his hands (even if he is a relatively good shot), and thus would be violating this mitzva. Even further, the Noda BiYehuda notes that the mishna in the 4th perek of Brachot provides a special prayer that one should recite when entering into a dangerous place, and he reasons that going hunting qualifies as such (based on the fact that even the great hunter Esav said הנה אנכי הולך למות - and the simple explanation is that he expected to eventually die in a hunting accident).
Tuesday, January 4, 2011
Getting remarried - how soon is too soon? - Igrot Moshe Even HaEzer 4:48-51
In this run of teshuvot from a variety of years spanning several decades, Rav Moshe Feinstein deals with issues pertaining to how soon a woman can get remarried. The issues are generally those surrounding children, both those unborn as well as those recently born.
In general, the rule is that a woman has to wait for three months after the end of her previous marriage before entering a new one so that if she becomes pregnant it will be clear who the father is. In this case, asked by Rabbi Ephraim Greenblatt of Memphis, TN, the woman had been separated from her husband for several years yet only now became officially divorced. Rav Moshe ruled that she nevertheless had to wait three months from the time of the actual divorce.
In the second teshuva, Rav Moshe's grandson-in-law Rabbi Shabtai Rappaport asked about a woman whose husband was killed in war (presumably in the Lebanon War, as the question was asked in late 1983). The woman had an infant from that husband (born after his death) and had stopped nursing the child for normal reasons. The woman now met a man and wanted to marry him. Despite the fact that in halacha 24 months are allotted for nursing, with the fear that if a woman becomes pregnant before that she will starve the baby, the fact is that since the baby had stopped nursing on its own (well before 24 months) and since the presence of a husband would provide a stable household for this woman and her children, Rav Moshe permitted her to get married without having to wait until the end of 24 months.
Rav Moshe takes a different approach when it comes to a divorcee. In a case posed to him by Rav Moshe Dovid Tendler, the woman was divorced with an infant, and wanted to remarry before the child turned 2 years old. Since the husband in this case was particularly difficult with regard to paying alimony, and the courts were fairly ineffective in forcing him to do so, Rav Moshe found it difficult to consider this child as being supported by his father (the presumption is that the new husband will not want to support the children of the old one - obviously that can vary from case to case). Rav Moshe ultimately permits her to remarry once the child is 18 months provided that she sees to it that the child is financially provided for and provided that she feels an overwhelming need to get married at that point in time.
In a teshuva written one year later to Rav Shalom Tendler, Rav Moshe addressed a case of a divorcee who had a very young infant and had stopped nursing already so that she could return to work (not far remarriage purposes) and now had met someone interested in marrying her. Rav Moshe permitted her to marry the man, provided that she saw to it that the child would be fully provided for until age 2. The fact that the man was considered to be a positive development for the child played a role in this decision as well.
In general, the rule is that a woman has to wait for three months after the end of her previous marriage before entering a new one so that if she becomes pregnant it will be clear who the father is. In this case, asked by Rabbi Ephraim Greenblatt of Memphis, TN, the woman had been separated from her husband for several years yet only now became officially divorced. Rav Moshe ruled that she nevertheless had to wait three months from the time of the actual divorce.
In the second teshuva, Rav Moshe's grandson-in-law Rabbi Shabtai Rappaport asked about a woman whose husband was killed in war (presumably in the Lebanon War, as the question was asked in late 1983). The woman had an infant from that husband (born after his death) and had stopped nursing the child for normal reasons. The woman now met a man and wanted to marry him. Despite the fact that in halacha 24 months are allotted for nursing, with the fear that if a woman becomes pregnant before that she will starve the baby, the fact is that since the baby had stopped nursing on its own (well before 24 months) and since the presence of a husband would provide a stable household for this woman and her children, Rav Moshe permitted her to get married without having to wait until the end of 24 months.
Rav Moshe takes a different approach when it comes to a divorcee. In a case posed to him by Rav Moshe Dovid Tendler, the woman was divorced with an infant, and wanted to remarry before the child turned 2 years old. Since the husband in this case was particularly difficult with regard to paying alimony, and the courts were fairly ineffective in forcing him to do so, Rav Moshe found it difficult to consider this child as being supported by his father (the presumption is that the new husband will not want to support the children of the old one - obviously that can vary from case to case). Rav Moshe ultimately permits her to remarry once the child is 18 months provided that she sees to it that the child is financially provided for and provided that she feels an overwhelming need to get married at that point in time.
In a teshuva written one year later to Rav Shalom Tendler, Rav Moshe addressed a case of a divorcee who had a very young infant and had stopped nursing already so that she could return to work (not far remarriage purposes) and now had met someone interested in marrying her. Rav Moshe permitted her to marry the man, provided that she saw to it that the child would be fully provided for until age 2. The fact that the man was considered to be a positive development for the child played a role in this decision as well.
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