SELECTED REFORM RESPONSA

internal need;( 2) absence of movement and breathing as observed by physicians over a period of at least one hour;( 3) absence of elicitable reflexes; and a fourth criterion to confirm the other three;( 4) a flat or isoelectric electroencephalogram. The group also suggested that this examination be repeated after an interval of twenty- four hours. Several Orthodox authorities have accepted these criteria while others have rejected them. Moses Feinstein felt that they could be accepted along with shutting off the respirator briefly in order to see whether independent breathing was continuing( Igrot Mosheh Yoreh Deah# 174). Moses Tendler has gone somewhat further and has accepted the Harvard criteria( Journal of American Medical Association Vol 238# 15 pp 165 ff). David Bleich ( Hapardes, Tevet 5737) and Jacob Levy( Hadarom Nisan 5731 Tishri 5730; Noam 5.30) have vigorously rejected these criteria as they feel that life must have ceased entirely with the heart no longer functioning, a condition belatedly established by Hatam Sofer in the eighteenth century( Responsa Hatam Sofer Yoreh Deah# 338). We can see that although the question has not been resolved by our Orthodox colleagues, some of them have certainly accepted the recommendations of the Harvard Medical School committee. We are satisfied that these criteria comply with our concern that life has ended. Therefore, when circulation and respiration only continue through mechanical means, as established by the above- mentioned tests, then the suffering of the patient and his/ her family may be permitted to cease, as no" natural independent life" functions have been sustained. We would permit a physician in good conscience to cease treatment and to remove life giving support systems. The" persistent vegetative state" is more difficult as" brain death" has not yet been reached. Such an individual would be considered a goses who is considered to be a living human being in all respects ( Semahot 1.1; Yad Hil. Evel 4.5; Tur and Shulhan Arukh Yoreh Deah 339.1 ff.). One may desecrate the Sabbath to help him according to Jacob Reischer ( Shevut Yaakov 1:13), though others( Kenesset Hagadol) disagreed.

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