Rabbinate accepts bill equating brain death with the end of life

Rabbinical figures around the world were astonished by the Chief Rabbinate Council's decision Tuesday, which stated that a Knesset bill equating brain death with the end of life "is in line with halakha [Jewish law]."The bill would allow organs to be taken from a deceased person before his heart has stopped beating - an essential condition for removing vital organs such as the heart, lungs and liver for transplant.

The council's decision represents the first time the state's official rabbinical body has expressed unanimous approval for such a sensitive law, slated to be enacted in the near future.

Tuesday's council meeting was dedicated to the bill initiated by MK Otniel Schneller (Kadima), which states that a person should be considered dead the moment brainstem activity has ceased.

Questions on how to determine the moment an individual dies have long been disputed by both rabbinical and ethical authorities, but this decision is unusual in that the Chief Rabbinate Council - the rabbinate's "government" authorized to set its policy on a range of issues - concluded unanimously that the bill is in line with Jewish law.

The bill would have far-reaching consequences. From a legal perspective, the bill would allow disconnecting a patient from a life-support machine if he is determined to be brain-dead. From a halakhic perspective, a woman whose husband is brain-dead would be considered a widow, and would be permitted to marry again.

A decades-long dispute

The Rabbinate's decision follows a drawn-out dispute between the rabbinical and medical establishments. Thirty years ago, the Rabbinate ruled that it would accept a patient's death only at the moment of clinical death. That decision, however, was never implemented due to a disagreement over the Rabbinate's demand that a representative be appointed to the committee on determining moment of death.

Recently, however, both Sephardic Chief Rabbi Shlomo Amar and Shas Party spiritual leader Rabbi Ovadia Yosef have issued halakhic rulings recognizing brain death as the end of life. Their rulings came in contrast with the position held by Rabbi Yosef Shalom Elyashiv, head of the "Lithuanian" Degel Hatorah faction - that as long as a patient's heart continues beating, he may not be disconnected from life-support devices, and that organs should not be removed from bodies under any circumstances.

The Rabbinate's approval of the Knesset bill came after Schneller agreed that the bill would allow family members to reject doctors' determination of death in the event that their loved ones suffered brain death.

The council said it would devote a separate meeting to the issue of organ transplants.

Officials at the Health Ministry's National Transplant Center yesterday praised the Rabbinate's decision as "revolutionary." "This is a huge achievement in the matter of organ donation," said one official.

"The Rabbinate has already announced in the past that organ donation is [tantamount to] saving the entire world, and that it is even greater than a mitzvah," he said. He added, however, that now, "the Rabbinate intends to continue discussing the matter and to encourage organ donation."

A course on the halakhic implications of organ donation and how to determine moment of death will begin soon, in order to help rabbis assist families with hospitalized loved ones who are seeking rabbinical advice on the matter.

Holding on

Today, fewer than half of the families of patients pronounced brain-dead in Israel agree to donate their organs. Some 35 percent of those who refuse donation do so on religious grounds, and an equal portion because of a desire to keep the body of the deceased intact. Other motives against organ donation include personal beliefs and what they believe the deceased himself would have wanted.

A recent National Transplant Center document indicated that Israel ranks higher than all but two European Union countries in refusal to donate organs, at 57.9 percent of the population.