[Dean's World] Ron Coleman: Winter harvest

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Posted by Ron Coleman:
Winter harvest
http://www.deanesmay.com/posts/1165595653.shtml


   Rabbi Avi Shafran passes this along about our increasing numbness
   about life and death, even as advances in science make it increasingly
   clear that we don't know the difference between the two. It's
   reprinted with permission of Am Echad Resources. I've added links.

     In a forthcoming book, [1]Final Exam: A Surgeonâs Reflections on
     Mortality, [2]Dr. Pauline W. Chen [3]writes about the many
     operations she performed on brain-dead patients for the purpose of
     procuring, or âharvesting,â their organs for transplantation. âThey
     all,â she writes, âseemed remarkably alive.â

     This past fall, the prestigious journal Science published a
     [4]report on a young woman who, after a devastating car accident,
     was declared vegetative. For five months, she showed no signs of
     awareness whatsoever. Scientists, though, decided to put her in a
     [5]Functional Magnetic Resonance Imaging scanner, a machine that
     tracks blood flow to different parts of the brain and that was only
     developed a few years ago. When they asked her to imagine things
     like playing tennis and walking through her home, the scan lit up
     with telltale patterns of language, movement and navigation
     indistinguishable from those produced by the brains of healthy,
     conscious people. The reportâs authors, while stressing that the
     patient may still be classified as âunconscious,â conclude
     nonetheless that she has a ârich mental life.â

     Ten years earlier, a patient like the young woman would have been
     assumed, for all practical intents, to be â effectively, if perhaps
     not legally â lifeless. Only the development of a new diagnostic
     technology has now rendered her more obviously alive. Itâs hard not
     to wonder what technologies might one day yet be developed â or
     what aspects of consciousness might forever elude scientific
     instrumentation.

     The acronym DCD might be mistaken for some new medium of music
     reproduction but in fact refers to âdonation after cardiac deathâ â
     the procurement of organs from people whose hearts have stopped,
     even if their brains may still be functioning. Such procedures have
     taken place in many countries, despite the fact that the cessation
     of heartbeat is not necessarily irreversible. Even some patients
     whose hearts did not respond to cardiac resuscitation, it is well
     documented, have âcome back to lifeâ â in one case after the lapse
     of a full seven minutes, certainly sufficient time for harvesting a
     vital organ or two.

     The driving force behind the scramble to define death âto the
     instantâ is clearly the worldwide shortage of organs for
     transplant. This past summer, doctors at the [6]World Transplant
     Congress in Boston were told how the pool of available organs in
     the United States could increase by up to 20% if DCD were adopted
     more widely.

     What does Judaism have to say about all this? Saving a life is a
     most weighty imperative, to be sure, but Jewish religious law, or
     halacha, does not permit one life to be taken to save the life of
     another â no matter how diminished the âqualityâ of the life of the
     former, no matter how great the potential of the life of the
     latter.

     Halacha requires that death be clearly established, and does not
     permit any action that might hasten the death of a person in
     extremis. Harvesting organs after any cessation of heart function
     that might not be permanent would be forbidden.

     Unrelated to DCD is âbrain deathâ â a diagnosis of irreversible
     cessation of all brain function, which modern medicine and secular
     law consider sufficient to permit the âharvestingâ of organs before
     removal of life-support. What does Jewish law have to say about
     âbrain deathâ? Can a patient with no discernable brain activity but
     whose heart continues to beat be considered a corpse?

     Some rabbis vote yea on that question. And a recent New York Times
     [7]8/nyregion/18organs.html?ex=1165726800&en=8d57cf1c7e4ea457&ei=50
     70">article about a conference organized by the âHalachic Organ
     Donor Society
     ,â an organization advocating increased organ donation from
     halacha-observant Jews, referred to ânear unanimity among rabbis on
     the criteria for organ donationâ â presumably referring to the next
     paragraphâs citation of the chief Sephardic rabbi of the Israeli
     city of Tzfat, whose criterion is brain death.

     But many, and considerably more prominent in the world of halachic
     discourse, are the rabbinical authorities who do not agree. They
     include the late [8]Rabbi Shlomo Zalman Auerbach, who was renowned
     as one of our generationâs most [9]authoritative halachic decisors,
     as well as [10]Rabbi Yosef Elyashiv, considered by many Jews to be
     the most authoritative authority of Jewish law today. Some leading
     scholars at Yeshiva University too, like [11]Rabbi Herschel
     Schachter and [12]Rabbi J. David Bleich, concur with those
     decisors.

     In her book, Dr. Chen writes about her â83rd procurementâ when the
     brain-dead body she sliced open for its organs was that of a young
     Asian-American woman like herself, who reminded her vividly, so to
     speak, of herself. She found herself hesitating during the
     procedure, but managed to complete it, although as she cut the vena
     cava and watched the patientâs blood drain into canisters, she felt
     âas if my own life force were draining away.â

     Dr. Chen may intend her account to be simply what the title of her
     book promises, a reflection on mortality. But perhaps another
     thought for consideration lay there on the operating table, the
     idea that despite the inevitability of its end, life is holy â and
     we do well to tread carefully and slowly before considering it
     gone.

     That might explain the feeling she writes she had at the end of
     that 83rd procurement, an exhaustion born not only of âsleep
     deprivation [and] overworkâ but of âan unbearable grief.â

     © 2006 AM ECHAD RESOURCES

References

   1. http://www.amazon.com/Final-Exam-Surgeons-Reflections-Mortality/dp/0307263533
   2. http://www.randomhouse.ca/catalog/display.pperl?isbn=9780307263537
   3. http://www.nytimes.com/2006/12/03/magazine/03lives.html?_r=2&oref=slogin&oref=slogin
   4. http://www.sciencemag.org/cgi/content/abstract/313/5792/1402?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=vegetative+state&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
   5. http://www.neuroguide.com/gregg.html
   6. http://wtc2006.org/
   7. http://www.nytimes.com/2006/11/1<a%20href=
   8. http://en.wikipedia.org/wiki/Shlomo_Zalman_Auerbach
   9. http://www.medethics.org.il/articles/JME/JMEB2/JMEB2.1.asp
  10. http://en.wikipedia.org/wiki/Yosef_Shalom_Eliashiv
  11. http://www.yutorah.org/bio.cfm?teacherID=80153
  12. http://www.yutorah.org/bio.cfm?teacherID=80025