SELECTED REFORM RESPONSA
The modern development of medicine has brought wonderful cures and provides additional years of life even to those in advanced years. On the other hand, its technology may leave us in a permanent coma or a persistent vegetative state in which we are neither alive nor dead. Such individuals may be completely dependent upon life support machinery. While this is acceptable during periods of recovery, we fear a permanent coma when the mind has ceased to respond and a plateau of mere existence has been reached.
When the Harvard criteria of death have been satisfied, life support machinery may be removed. This state of“brain dead” has been defined by an ad hoc committee of the Harvard Medical School in 1968(Journal of the American Medical Association, Vol. 205, pp 337ff). It recommended three tests:(1) Lack of response
to external stimuli or to 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
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