When does life end?

A very sad case is getting some attention in the news these days.

Motl Brody, a twelve-year-old boy, has died because of a brain tumour. But according to his parents’ religion, Motl is still alive:

Doctors at Children’s National Medical Center in Washington say the seventh-grader’s brain has ceased functioning entirely.

But for the past few days, a machine has continued to inflate and deflate his lungs. As of late Friday afternoon [Nov. 7], his heart was still beating with the help of a cocktail of intravenous drugs and adrenaline.

That heartbeat has prompted Motl’s parents, who are Orthodox Jews, to refuse the hospital’s request to remove all artificial life support.

Under some interpretations of Jewish religious law, including the one accepted by the family’s Hasidic sect, death occurs only when the heart and lungs stop functioning.

That means Motl “is alive, and his family has a religious obligation to secure all necessary and appropriate medical treatment to keep him alive,” the family’s attorney wrote in a court filing this week. …

Unlike Terri Schiavo or Karen Ann Quinlan, who became the subjects of right-to-die battles when they suffered brain damage and became unconscious, Motl’s condition has deteriorated beyond a persistent vegetative state, his physicians say. His brain has died entirely, according to an affidavit filed by one of his doctors.

The affidavit was filed because the hospital is seeking the authorization of a court to discontinue care.

Coincidentally, I mentioned this topic only a few days ago in a comment here:

Jews emphasize the text in Genesis 2, “The LORD God blew into Adam’s nostrils the breath of life, and man became a living being.” Jews conclude that a baby becomes a living being when it draws its first breath. Similarly, life is considered to end when a person ceases to breathe.

There’s an exceptionally sensitive discussion of the case at scienceblogs.com. Orac (the blogger) has direct experience with situations like Motl’s, as a resident on the trauma ward:

When a child suffers brain death, it’s incredibly difficult for the parents to accept that the child that they love is dead. After all, the child is still warm, still smells like their child (and smell is a very primal sense), still has a beating heart, and still looks like a child. It doesn’t take religion for parents to go into profound denial over the true situation. However, there is no doubt that religion can be a powerful force that can reinforce such denial. …

Throughout thousands of years of human history, it was obvious when a person is dead. Now it’s possible to be dead and not appear so, thanks to the technology of the last 40 years or so. …

Having had the unfortunate task of disconnecting a child with massive head trauma from the ventilator while the parents held her, I can say that accepting that I wasn’t “killing” the child was far more difficult than it should have been, given my knowledge. It sure felt like it.

The last paragraph quoted brings up an interesting point. It’s tough to be in the position of the doctor who is responsible to switch off the ventilator. Similarly, it’s tough to be in the position of the parents, giving permission to the hospital to switch off the ventilator.

My understanding is that Jews sometimes put ventilating machines on a timer. The machines will switch off automatically when a certain number of hours have passed. As a result, doctors can stop the ventilator merely by being passive — by not intervening to keep the ventilator going.

It’s a rather legalistic way of respecting the biblical prohibition, “Do not kill.”

I don’t have anything profound to say by way of conclusion. I see no reason to find fault with either the parents or their religion in a situation as tragic as this.

I write about it because I find such conflicts between tradition and modernity endlessly fascinating. There’s always another twist that you hadn’t considered. And often, the twists are gut-wrenching.

At least, they are for me. I continue to find the religious perspective profoundly attractive, even though I usually end up siding with science in cases of conflict.

(p.s.:  Motl’s remaining bodily functions ceased on Saturday, Nov. 15, and his funeral was held today. May God grant peace to both the boy and his loved ones.)


1 Comment (+add yours?)

  1. Zayna
    Nov 17, 2008 @ 14:04:55

    See, though we’d love for doctrine to be applied as a general rule, love and understanding of the human condition will always leave exceptions.

    Compassion is the only option.


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