All summaries below are done to the best of my abilities and are for the purpose of informing and not paskening. In all cases, a posek should be consulted.

Sunday, February 27, 2011

Using Church Candles - Chatam Sofer Orach Chaim 42

I came across this teshuva while preparing my weekly shiur on Ramban - it is based in part on a Ramban from parashat Vayakhel.

The Chatam Sofer was asked whether one is allowed to use candles from a house of idolatry (which I am going to assume is referring to a church), and whether they could be used in a shul. He split the question between candles that belonged to the church but had not been used, and those that had been used, then extinguished.

In terms of candles that were merely owned by the church, the Chatam Sofer ruled that they could definitely be used in a shul, since the mere designation of the candles as church candles was not sufficient to make it forbidden. Furthermore, since it would only be used for decorative purposes, and since the selling of the candles by the church would constitute a nullification of their idolatrous nature, they certainly could be used in shul.

However, would it be permissible to take a half-used church candle, melt it down, and then reconstitute it and use it in a shul? The Chatam Sofer begins by noting that according to the Shulchan Aruch one should not take the clothes of a priest and turn them into a tallit, as that small amount of tailoring would constitute a sufficient shinui to allow the sacramental clothing to be used for a mitzva. However, he feels that the melting down of a candle and subsequent re-rendering of it as a new candle would be a sufficient shinui and such a thing would be allowed.

However, he wonders if the Ramban in parashat Vayakhel militates against this. In discussing the kiyor (laver), the Midrash states that Moshe did not want to accept the women's mirrors to be used in its construction, since they were used for vanity purposes and thus had no place in the Mishkan. However, Hashem noted that they were in fact tools of shalom bayit and thus should be accepted (see Rashi on Shemot 38:8 for further detail). Ramban wonders why this was such a problem - after all, Moshe had no problem in accepting other jewelry from the women, but notable the kumaz, which according to the Midrash was an accessory worn on a woman's genitals! Why was Moshe not repulsed by accepting such an object!?

According to Ramban, since the kumaz was given along with many other types of jewelry, it was batel (nullified) in the mixture with the other accessories. The Chatam Sofer notes that the more logical explanation would be to say that since the jewelry was all melted down, the kumaz was not a problem, whereas the mirrors, which were not melted down, remained troublesome to Moshe. However, Ramban does not take that approach, and the Chatam Sofer reasons that according to Ramban, merely melting down something does not eradicate its repulsive nature. Applied to our question, that would mean that melting down the candles would not eliminate their stigma of having come from a church.

However, the Chatam Sofer disagrees with this approach (and a Gemara in Avoda Zara 52b which seems to make a similar point), and he permits using such candles under such circumstances. However, he notes that one who wants to be strict and not use such candles will be blessed from steering clear of objects that once were a part of foreign worship.

Wednesday, February 16, 2011

Heart Transplants continued - Tzitz Eliezer 5:25.6

In this teshuva that is the next subsection of the compendium that included the previous teshuva on heart transplants, Rav Waldenberg considers the case of assisting in the death of someone who is a goseis (is close to death) and would be better served by being put out of his misery, and perhaps is even requesting to be put out of his misery.

On a simple level, Rav Waldenberg rules that we may not do so, based on the Gemara in Shabbat mentioned in the previous teshuva and as codified by the Aruch HaShulchan, with the logic that we are not masters of our own bodies, and therefore none of us have the right to request the death of another, or even of ourselves.

Rav Waldenberg cites two cases that prove this. The first is the death of Rabi Chanina ben Teradyon, who was burned alive by the Romans while wrapped in a Torah, and with wet wool put over his heart to slow his death. Rather than let his students remove the wool to hasten the death, Rabi Chanina had the Roman officer remove it, since his students were not allowed to do anything to speed up his death, even though doing so would shorten his agony. The second case brought is that of David HaMelech killing the Amaleki who had killed Shaul HaMelech. Even though Shaul had requested that the Amaleki kill him so as to bring his death about quickly, nevertheless David held the Amaleki (who according to several commentaries was actually Jewish – see Shmuel Bet 1) liable for the murder.

Furthermore, based on a Gemara in Sotah we learn that prolonging someone’s life is considered to be meritorious, even if that life is a difficult and painful one. As such, no one has the right to take his own life or allow someone to do so in order to put himself out of his misery.

Heart Transplants - Tzitz Eliezer 5:25.5

In this teshuva from 1967 (even earlier than those from Rav Moshe Feinstein), the Tzitz Eliezer begins by stating that removing a heart that is still beating in order to transplant it into someone else is tantamount to murder, based on the Gemara in Shabbat 151b that rules that any action which hastens death is considered to be murder.

However, Rav Waldenberg then raises the possibility that the donor is considered to be a treifah, since he is unlikely to live, and perhaps this avenue needs to be explored in terms of potential room to permit taking the heart from someone who is not yet clinically deceased. However, he rejects this position on the grounds that while a court cannot condemn someone as a murder for killing a treifah, that person nevertheless has the status of being a murderer. Furthermore, Rambam in Hilchot Yesodei HaTorah rules that one may not kill another Jew for the purpose of healing another, which would seem in modern times to apply to such a case.

However, the Minchat Chinuch comments on that Rambam that if non-Jews are threatening to kill a group of Jews unless they hand someone over, they are allowed to hand over someone who is a treifah in order to save the rest of the group. While this seems to be another avenue that could lead to permitting taking a live heart to save someone else, Rav Waldenberg rejects this for three reasons. First, as stated before and as pointed out by the Noda BiYehuda, we may not actively kill a treifah, and thus the inference of the Minchat Chinuch is incorrect. Second, it could be that only the person who is himself a treifah is allowed to hand himself over, but no one else is allowed to do so. Finally, whereas Rambam is discussing a case where the non-Jews specifically asked for someone to kill, in this case the doctor is not looking for this particular person per se, but rather for anyone who could serve as a donor, and thus the logic of “whose blood is redder” kicks in.

In terms of the recipient there is a problem as well, since the chances of survival with the new heart are not guaranteed, and thus there is the potential problem that removing his diseased heart and replacing it with someone else’s heart will result in the death of the recipient. Even though every surgery carries with it the potential of danger to the patient, such surgeries are permitted so long as the chances of death are minimal. However, since in the case of heart transplant surgery the chances are death are quite great, it is not permitted under the general heter that is given to surgery.

Rav Waldenberg concludes by speculating whether such a surgery, the likes of which was never envisioned in earlier times, should even fall under the rubric of ורפא ירפא, which is the source allowing physicians to practice their craft. [ed. Note – I am not sure what he means by this, since taken to its logical conclusion, this reasoning would forbid using any innovation in medicine. If anyone can shed light on this, I would be most appreciative.]

Wednesday, February 2, 2011

Heart Transplants - Rabbanut HaRashit - Techumin 7

In what amounts to a policy paper published in volume 7 of Techumin (1987), the Chief Rabbinate of Israel outlined their position on heart transplants. They begin by acknowledging the position of Rav Moshe Feinstein and Rav Isser Yehuda Unterman, who forbade the practice when it was still relatively new. They then note that over the decade and a half since heart transplants first came on the medical scene, the science had progressed so significantly that now roughly 70% of recipients were living at least five years. They noted as well as letter from Rav Moshe Dovid Tendler, son-in-law of Rav Moshe Feinstein, stating that Rav Moshe had changed his views on heart transplants in light of the advances made in science since the time of his original teshuva.

As such, the Chief Rabbinate was willing to allow heart transplants to take place in hospitals in Israel provided that certain criteria were met. With regard to the donor, there had to be a clear establishment of the death of the donor, as determined by confirmation of brain stem death and cessation of respiratory activity. There also had to be written consent from the donor's family as well as the presence of an agent of the Chief Rabbinate present as part of the team that determined death. Note that there is no longer a concern that the transplant would qualify as killing the recipient, as most recipients did succeed in living somewhat normal lives after the procedure.

The article concludes with a list of clinical indicators that brain stem death has, in fact, taken place.