Selected Reform Responsa 129

In the last years, it has been suggested that Jews accept the criteria of death set by the ad hoc committee of the Harvard Medical School which examined the definition of brain death I 1978(Journal of American Medical Association, Vol. 205, pp. 337 ff). They recommend three criteria:(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, a flat or isoelectric electroencephalogram. They 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. Mosheh Feinstein felt they could be accepted along with turning off the respirator briefly to see whether independent breathing was continuing(Igrot Mosheh Yoreh Deah II,#174). Moses Tendler has gone somewhat further and has accepted the Harvard criteria(Journal of American Medical Association, Vol. 328,#15, pp. 165.1 ff). Although David Bleich (Hapardes, Tevet 57.37; Jacob Levy, Hadarom, Nisan 57.31, Tishri 57.30; Noam 5.30) vigorously rejected those criteria, we can see that though 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 include those of the older tradition and comply with our concern that life has ended. Therefore, when circulation and respiration continue only through mechanical means as established by the above mentioned tests, then the suffering of the patient and his family may be permitted to cease, as no“natural independent life” functions have been sustained.

1. Acceptance of total cessation of brain-stem function as a criterion of death in keeping with halakhic standards for determining death, provided the Harvard Criteria are met.