Defining Death in Jewish Law

Traditional sources point to the cessation of breathing as the moment of death.

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The talmudic sages did not intend to imply that the nostrils determine life, for the nostrils are not an organ upon which human life depends. The teaching of the sages is that breathing is a sign of life, and that absence of breathing is a sign of death. It is incumbent upon us to identify the organ that controls breathing. The current state of scientific knowledge indicates that it is the brain, and not the heart, that controls breathing.

It follows from the text in Yoma and the commentaries thereon that death occurs when breathing totally and irreversibly ceases. The talmudic and post‑talmudic sources do not require the cessation of the heartbeat for the determination of the moment of death. Under normal conditions, the time between the cessation of breathing and the cessation of the heartbeat is minimal—a matter of minutes. If there is any possibility of reversing the cessation of respiration and reestablishing independent breathing, one is obligated to attempt to do so by all medical means possible. Under extreme conditions, however, when it is clear that independent breathing can never return because of the irreversible death of the brainstem, the patient can be regarded as dead from the moment that brainstem death is established, even if the patient’s heart is still beating.

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Dr. Abraham Steinberg

Abraham Steinberg is a pediatric neurologist at Shaare Zedek Hospital in Israel and head of the medical ethics department of the Hebrew University-Hadassah School of Medicine. He is a recipient of the prestigious Israel Prize.