Letters to the Editor	Print

To the Editor:

I found Rabbi Bleich's statements on brain death (Jewish Review, Vol. 3, No. 2) quite interesting. However, I'm afraid that he's guilty of a few serious misconceptions.

He states that the push towards adoption of neurophysiological criteria for determination of death came solely as a result of a need to salvage organs for transplant. While this is partially true it is not the main part of the story. After all, none of those who accept brain death criteria accept that it is all right to kill one person to save another. The fact is that there has been a growing acceptance of the belief that what makes a person a person,is not his body or his bodily functions such as breathing, blood circulation and so forth, but rather his mental functions and personality. A person's mental functions are dependent upon that person having a functioning brain. Without a functioning brain, he is like a chicken without a head.

The clearest example to show this is the brain transplant example discussed by Rabbi Bleich in the interview. If Reuven's brain were destroyed and Shimon's brain were put into Reuven's body, the resulting person would be Shimon. If you woke him after the surgery and asked him who he was and what had happened, he would, without a doubt, reply, "I am Shimon, and I've just received a body transplant." Contrary to what Rabbi Bleich says, the case is not analogous to that of the dybbuk. A dybbuk doesn't destroy its victim's brain and personality. It simply takes control of him. After the dybbuk leaves, Reuven's personality would reemerge. On the other hand, with a brain transplant Reuven's personality is destroyed with his brain. To give another example of why heart function and respiration are not significant as criteria for determining Reuven's life, if Reuven's heart and lungs were removed from his body and kept functioning with medical technology, that beating heart and breathing lungs contained in a jar would certainly not be Reuven.

Rabbi Bleich says that if there is no heart beat and no breathing he is willing to accept that a person is dead even if that person has brain waves. He thinks nothing important follows from this and that there are no such patients, but that is false. There are many such patients. When a health care provider does cardiopulmonary resuscitation (CPR), it is usually because the patient has no heart beat or respiration. Does Rabbi Bleich believe that the health care provider who does CPR is bringing a dead person back to life?

Why is all of this important? First the feasibility of developing mechanical organs that will allow persons to live normally is very slight. We have already seen the tragedies of the Jarvis mechanical heart. Further, there is a desperate need for donated organs. These organs must be kept in the donor as long as possible. No one is suggesting that we kill an innocent person to ?harvest? his organs. What many reasonable individuals are saying, is that, at the very least, it is a mitzvah for a person to save another, not by giving up his own life, but by bequesting his organs to be used after he is dead.

J. Cantor Ph.D

New York University Medical Center