Sunday, January 16, 2011

Chazal, Brain Death, and Rabbi Natan Slifkin

At the request of R' Herschel Maryles (Emes Ve-Emunah), I wrote a guest post commenting on Rabbi Slifkin's take on the resurrected brain death controversy.

The post is at:

I have been replying to comments on the post there, ayain sham.

Rabbi Slifkin's comments are at:

I have already addressed many of them on Emes Ve-Emunah.

As some Hebrew was omitted from my guest post, I am reposting it here. I will also repost, separately, my essay from the first round of the controversy, in - IIRC - the early 90's.

This past Thursday, my friend Rabbi Natan Slifkin posted on his blog (, a “Summary of the Life/Death Issue.”

Rabbi Slifkin's post is an important one, as it goes to the heart of what many of us find unacceptable with our colleague's approach.

I will try to be as brief as is possible without sacrificing clarity. I therefore will limit myself for now to the opening section of Reb Natan's posting. If there is need for further clarification, I will address the rest of his statements.


RNS writes:
The overall point of this discussion is to show that Chazal's views and rulings on life and death were fundamentally related both to the mistaken beliefs of the era about physiology as well as the limited medical possibilities. Thus, any halachic analysis of this topic must take this into account in order to be valid. Furthermore, our own understanding of physiology, together with the medical possibilities available to us, mean that brain death should be defined as halachic death.

This paragraph really cuts to the heart (no pun intended) of the matter.

When Rabbi Moshe D. Tendler proposed that “brain stem death” be the criterion by which halachic death be established, he staked out a controversial position (see the details of the current re-opening of the controversy at Nevertheless, his position was at no time and under no circumstances predicated on an assumption that Chazal's views and rulings on life and death were fundamentally related both to the mistaken beliefs of the era about physiology as well as the limited medical possibilities. Rabbi Tendler based his argument on a Mishnah in Ohalos and other sources (see my “The Determination of Death: Halachic Considerations,” available at, p.251). His position took for granted the inviolability of the Halachic system and of Chazal's unquestioned and unquestionable authority in the determination and definition of that system and its parameters. Rabbi Tendler's arguments were within the system – they inhered in its sources and rulings, and were completely internal and intrinsic.

Rabbi Slifkin, on the other hand, reveals his cards right at the outset. He is here setting out to demonstrate the “flaws” in the system, and on that basis to suggest that it is outmoded and only partially relevant to contemporary issues. His arguments are from without the system, and extrinsic thereto.

This point of view underlies much of my friend and colleague's writings and is the basis of the uneasiness with which many of us regard his perspective. We are accustomed to assume that Chazal are the final arbiters of Halachah regardless of whatever thought process under-girded their rulings. We assume that those thought processes are those of human beings far greater than ourselves – of rishonim k'malachim – and are very reticent to second-guess them, ever.


RNS writes:
1. Chazal believed that the heart and kidneys are the seat of the mind and free will.

At least some of Chazal - probably most or all - believed that the heart and kidneys are used as the mind and for making decisions (free will). Prooftexts are as follows:

The Rabbis taught: The kidneys advise, the heart considers, the tongue articulates, the mouth finishes, the esophagus brings in all kinds of food, the windpipe gives sound, the lungs absorb all kinds of fluids, the liver causes anger, the gallbladder secretes a drop into it and calms it, the spleen laughs, the gizzard grinds, the stomach [causes] sleep, the nose [causes] wakefulness. (Berachos 61a; similarly in Midrash Vayikra Rabbah 4:4)

This is not an aggadic legend intended to be understood metaphorically. The descriptions of the functions of the tongue, mouth, esophagus, windpipe, lungs, stomach and nose are all clearly scientific descriptions intended to be interpreted literally. The account of the liver causing anger is also consistent with standard belief in the ancient world. Thus, the account of the function of the kidneys and heart are thus also clearly intended to be literal descriptions - and there is no important role ascribed to the brain. This, too, is consistent with standard Aristotelian belief in the ancient world. The Rishonim and Acharonim agree that Chazal were speaking literally, as discussed in my monograph, The Question of the Kidneys' Counsel. Elsewhere, the Gemara relates halachos pertaining to the kidneys of animal offerings to the kidneys' function in man of providing counsel. Other Midrashim likewise echo this understanding of the role of the various organs:

" 'And God said to Moshe: Pharaoh's heart has become heavy (kaveid)' - He was angry. Just as the liver is angry, so too the heart of this one became a liver (kaveid), without understanding, as a fool. (Midrash Shemos Rabbah)

"That is to say, the heart of Pharaoh was turned into a liver (kaveid) -- just as a liver has no understanding to understand and comprehend, so too there was no understanding in his heart to understand and comprehend. Therefore, his heart was hardened and was stubborn for him." (Midrash Lekach Tov)

Like everyone else in the ancient world, Chazal thus likewise interpreted all Scriptural references to the heart (which most people today take as referring to the mind and thus the brain) literally. Scriptural references to the heart having various emotional states, to it housing wisdom and cognition, and to God judging a person based on examining his heart and kidneys, were all taken literally by Chazal.

Rabbi Slifkin is quite bold in his assertions. He purports to know – and to tell us – when an aggadic legend intended to be understood metaphorically. And he informs us categorically that these prooftexts are (notwithstanding their Midrashic sourcing!) not metaphorical.

But who designated my friend the arbiter of these matters? One of my favorite obscure seforim is HaTalmud U'Mada'ei HaTeivel by Rabbi Yekusiel Aryeh Kamelhar (Lvov, 1928, Rabbi Slifkin is familiar with this work as well, as he quotes it in “Messianic Wonders and Skeptical Rationalists” in the Hakirah Torah journal,, p. 203). It is therefore curious that Rabbi Slifkin neglects to inform us of Rabbi Kamelhar's detailed explanation (loc. Cit. ,p. 30ff.) of the metaphorical meaning of the Gemara in Berachos, including the references to the “counseling kidneys,” etc. This omission is even more remarkable considering Rabbi Kamelhar's explanation of the metaphors based on modern medical knowledge!

Reb Natan's “rush to judgment” continues to be manifest in his citation of the Midrashim concerning the metamorphosis of Pharaoh’s heart into a liver. A simple computer search would have revealed to him, as it did to me, the august Chasam Sofer's metaphorical understanding of the Midrash:

חתם סופר עה"ת שמות ז יד
כבד לב פרעה - במדרש לבו נעשה כבד ומייתי על זה משל ע"ש. ולפע"ד אמר כן במכת דם, ע"ד דאחז"ל גיטין ס"ט האי דמא דאתי מפומא אי מכבדא אתי לית לי' תקנתא ע"ש, והכא רמז דהאי מכת דם אתא מכבדא כי כבד לב פרעה ואין לו תקנה. תקצ"ד

ספר חתם סופר על מסכת פסחים דף ז/ב
ואומר בהקדים יישוב מדרש חז"ל בפ' כבד לב פרעה מייתי משל לארי שגזר מיתה על החמור שמרד בו והשועל היה שר הטבחים הוא אכל לב החמור בעת נתחו לנתחים וכששאל הארי איה לבו השיב השועל לא היה לו כ"א כבד דאל"כ לא היה מורד בך ה"נ אמר הקב"ה כבד לב פרעה פי' שגם לבו הוא כמו הכבד מש"ה אמר מי ה' עי' ברבה פ' וארא. והכונה הפשוטה בזה לפע"ד כי בכח נפש האדם ג' כחות הצומחת ובזה משתתף להצמחים ומשכנה בכבד ורוח החיוני בלב והיא המתאוה ומשתתף בזה עם הבהמה ג"כ ונשמת אלקים בקרבו במוח והוא השכל המיוחד לאדם ובו נפרד מהבהמות והוא השכל הנכבד המולך על הגוף להנהיגו והרמז מלך על כל בני שחץ מלך ר"ת ידוע מוח לב כבד שחץ ר"ת שכלית חיונית צומחת ובאשר החמור לא הכיר מלכו הארי מה שדרך הבהמות להכיר ע"כ שב למדריגה פחותה והיה רק כצומח ולזה יפה אמר השועל שלבו הוא כבד פי' שנפל במדרגת הצומח המתואר בכבד. והנה כי כן פרעה שלא הכיר בוראו מאין וניהג עצמו בתאות לבו ונתפתה אחריו הוא גם הוא ירד ממדרגת האדם ונפל לבהמיות ואין לו מוח משכן השכל כ"א לב וכבד וזהו כבד לב פרעה פי' שגדר פרעה הוא לב וכבד לא זולת. והנה בסוף הכביד ה' לבו שלא ברצונו וניטלה ממנו תאותו ולא יכול להלוך אחריה שהיה רוצה לשלח את ישראל ולא יכול הנה כי כן כבר נפל למדרגה יותר פחותה שלא פעל לבו פעולתו המיוחדת ונעשה ממש רק ככבד ולזה אמר אני הכבדתי את לבו פי' עשיתי מלבו כבד ע"ד המדרש הנ"ל. והנה משל הנשמה בשכל בהנהיגה את הלב והכבד כמנהיג המרכבה שהאדם המדבר מנהיג החי הסוסים והרכש והם ינהגו הצומח העגלה ואופניו כן תנהג הנשמה הלב והלב את הכבד אמנם על צד הזרות נמצא שהבהמות מנהיגים העגלה לרוע מנהגם וינצחו האדם בעל העגלה כן ימצא שהלב המתאוה יגבר על השכל אבל זה לא תמצא לעולם שהעגלה תגבר עליהם וינהיגם שלא ברצונם אמנם ברשעים כפרעה וחבריו תמצא שהקב"ה מכביד לבם כנ"ל שמתנהג ע"י הכבד הצומח ועד"ז פרע לו הקב"ה בהסרת אופן מרכבותיו וינהגהו בכבדות כנ"ל שהעגלה משכה את המנהיג ולזה רמז בא אל פרעה כי אנו הכבדתי את לבו וגו' למען שתי אותתי אלה בקרבו ובעה"ט כתב שתי חסר כתיב רמז על ב' מכות ע"ש ולפי דרכנו אומר שהוא ית' הכביד לבו שהפך לבו להעשות כבד למען שיהיו שתי אותות האלו בעצמם בקרב פרעה פי' שיתהפך הענין שהעגלה ימשוך הסוסים והמה האדם הפך משתי דברים במנהג העולם כנ"ל ולזהו אמר מזרה רשעים מלך חכם שמזרה הרשעים אשר לא יחפצו במלכם השכל והולכים אחרי לבם לסוף ויהפך עליהם אופן הוא הכבד כח הצומח הנמשל באופן המרכבה מהפך עליהם להכביד לבם ויחתרו לשוב ולא יכולו ומפרש כי נ"ה נשמת אדם ולה המלוכה ועליה לחפוש כל חדרי בטן חדרי בטן העליון והתחתון הלב והכבד ואילי תיבת כל מרמז בר"ת כבד לב כנ"ל ודוק

or, the Agra d'Kalla:

ספר אגרא דכלה - דף קפד/ב
ויתפרש עוד כבד לב פרעה מאן לשלח העם (שמות ז יד). היינו יש לו טבע הכב"ד, כי כל מין בשר מתגדל על ידי האור ומתעבה, דהיינו כל שהוא גדול כזית, על ידי בישול האור יוצא חוץ מגבולו ומשטחו, ומתגדל ומתעבה ביותר והוא לפי שמתרכך. מה שאין כן בשר הכבד אדרבא על ידי האור מתקשה ביותר ממה שהיה חי, (ועיין במדרש בפרשת בא (שמו"ר פי"ג ג') ככבד הזה שהיא מתבשלת שנית וארטסית נכנס בתוכה וכו', היינו קושי כמ"ש המתנות כהונה). וירצה לפי זה כבד לב פרעה, נעשה ככבד שלא נתרכך על ידי האור, ודברי הקב"ה הם כה דברי כאש נאום ד' (ירמיה כג כט), והוא נעשה ככבד שלא נתרכך, על כן מאן לשלח העם ככבד שאינו יוצא משטחו רק נשאר על מעמדו, כי זה טבעו ביצירה להגביל הדם, כך פרעה מאן לשלח וכו' ומגבילם בגבולו לבל ישלחם

These are results that I came to in a very quick search. At the very least, it is intellectually dishonest to not disclose that one's position is by no means definitive. To respond that one has not done the research is even more inexcusable.

Thus, it is untenable to assert – unilaterally and unequivocally! – on the basis of such questionable sources that Chazal believed in a certain medical system and that their positions are hence faulty.


2. Chazal were mistaken in this regard.

That should be self-evident. We now know that it is the brain that is used for all cognitive processes and for making decisions. The heart and kidneys have no such role. In fact, the heart can be replaced by an artificial pump, and the kidneys can be replaced by a dialysis machine. Doing this does not impair a person's mind in any detectable, significant way.

3. There is a fundamental connection between the mind/ free will, the soul, and the presence of a live person - and thus the mistaken belief that the heart and kidneys house the mind has fundamental ramifications on the question of determining death.

As we have demonstrated, Rabbi Slifkin's foundation is far from firm. There is no definite evidence that Chazal believed that the heart and kidneys house the mind. My colleague has built a house of cards upon which he then continues to be dan dinei nefashos. Were I not to know that he is a soft-spoken and humble person, my mind (the one in my brain...) would be boggled by the arrogant and flippant regard towards Chazal implicit in his approach. I therefore am dan l'kaf zechus that erroneous per-conceived notions, traumatic experiences and harsh treatment have boxed Reb Natan into a weltanschauung and an approach from which it is hard for him to budge, regardless of its flaws.


  1. ...This discussion only relates to whether the donor via a proxy, or his or her relatives, may authorize harvesting; and to whether a physician who is shomer mitzvos may harvest organs from such a donor. If, as is most often the case, the organ is harvested anyway from a "willing" donor by a willing physician, there may be no issur to receive the donated organ.

    If I understand correctly, holding by cardiac death is likely to lead to a situation in which observant Jews may receive donated organs, but are unlikely to become donors, at least of some organs.

    This asymmetry would become public knowledge in the world of people waiting for transplants, transplant medical teams, the Emergency Medical Services world. It would not lead to a favorable impression of halacha, or of observant Jews.

    IIUC, if a halachic approach which permits holding more by the current medical criteria for death were viable, it would make the donor/receiver situation more symmetrical.

    That being said, the transplant industry, for such it is, has its own agendas, some of which are not pretty.

  2. Do poskim have any Torah-derived authority to rule formally based in whole or in part on extraneous concepts such as symmetry? Is the supreme good that others should respect us, regardless of our adherence or non-adherence to the straight halacha?

  3. R. Bechoffer - I think you would be assisted in your understanding of this topic if you read the following:

  4. It's a great essay. Thanks for bringing it to my attention.

  5. In response to Bob Miller, a number of rabbinic enactments have among their reasons "mshum eiva", because of the hatred that doing otherwise would cause. Among other places, this reason is used to permit violating Shabbat to save the life of a non-Jew.

  6. Zevabe, I'm aware of that, but would that approach be admissible in this specific type of life-or-death matter?