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Defining the Moment: Understanding Brain Death in Halakhah Paperback – February 9, 2012
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About the Author
Rabbi David Shabtai, MD is a fellow of the Wexner Kollel Elyon at the Rabbi Isaac Elchanan Theological Seminary (RIETS). He received his medical doctorate from NYU School of Medicine and rabbinic ordination from RIETS. Rabbi Dr. Shabtai teaches Jewish Medical Ethics at Yeshiva University and RIETS and lectures on various topics in Jewish law. He is particularly interested in the interface between science, medicine, and Jewish law. He has authored numerous articles on a wide range of topics published in The Journal of Halacha and Contemporary Society, Hakirah, Assia, Journal of Jewish Medical Ethics, and Beit Yitzhak. He is also a contributor and editor of Verapo Yerape.
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One looks in vain for a rabbinic consideration of modern medical science informing Hallachik decision making. And as doctors this is very disconcerting, as practicing clinicians we need a way to be ethical, JEWISH doctors. Neither are we donkeys carrying books. I find it hurtful and insulting that we should be regarded as making ethical decisions in the best interests of all our patients. According to Shabtai's book only non-medical society in the person of rabbonim and lawyers are equipped to make ethical decisions or define philosophical positions like the moment of death!
This sounds like a power grab into our profession. I disagree that it is a religious or philosophical issue, it is a matter of scientific information. We can debate this endlessly, but in the moment at the bedside, we have to make the decisions according to what we know.
There is no discussion of the Harvard Criteria or its evolution, no comparative discussion of how other religious traditions approach the problem, no discussion of current philosophical or legal thinking and omissions of contrary orthodox positions. I did not see much discussion of Rosen's model of anencephalics as anatomical absence of the brain versus brain death as its physiological absence.
Now for the positives. This is an excellent, thorough and in depth review of the Orthodox approach through the ages. It does seem a bit repetitive and there are some real differences between the authorities, however when it comes to clinical decision making they do not impact the issues much.
This is a book worth reading by any doctor who seeks to practice ethically as a Jewish medical practitioner, it will give you insight into the Hallachik position on brain death. As such it may make decisions more difficult and disappoint many patients on transplant lists and extend the suffering of ICU patients and their families.
This book need not have been written by a medical doctor and as such I was disappointed in my expectations.