Friday, March 16, 2012

Defining the Moment: Anachronistic Explanations in Rashi

About a month ago, the launching of the book "Defining the Moment: Understanding brain death in Halakhah" by R. Dr. David Shabtai was  announced on the Hirhurim blog. In the comments section, R. Natan Slifkin asked the following question:
Rabbi Shabtai – I have not yet read your book, but it seems that all those who wrote haskamos, and whose positions you discuss, take the approach of paskening this question directly from the Gemara and earlier poskim. Applying this methodology of psak is in turn is based on two presumptions: that Chazal differentiated between the nervous system, the cardiopulmonary system, and the respiratory system – and that they correctly understood the role of each. Do you discuss the nature and validity of these presumptions in the book?
R. Dr. Shabtai didn't reply to the comment and not to a subsequent comment submitted one day later, although he addressed other questions posed to him in the comments. A few days later, R. Slifkin wrote the following on his blog:
I posed [the] question to the author twice, and despite the fact that he was responding to other comments, he did not respond to my question. My guess is that he'd never thought about it, and is uncomfortable with it. I don't blame him for his discomfort.
In the same post, R. Slifkin also wrote that:
Someone who acknowledges that Chazal only possessed the limited scientific knowledge of their era will (hopefully) take this into account. But if someone believes that Chazal could not have been mistaken about scientific matters ... then they will refuse to consider that brain death cannot be resolved via drawing inferences from the statements of Chazal.
On another, more recent, blogpost on Hirhurim, a commenter named "Ephy" wrote:
Rabbi Slifkin does not just hold brain death is the time of death, but rather we should ignore the Gemara on the topic since it was unaware of the brain housing the intellect. This is at odds with Rabbi Tendler etc (by Rabbi Slifkin’s own admission) who analyze the Gemara. Rabbi Slifkin will quickly reject any Gemara that discusses anything that deals with the body science etc. 
Now, I'm not sure what is it that R. Slifkin meant when he said that Hazal's limited scientific knowledge have to be taken into account when trying to pasken whether brain death is death or not from Hazal. It could be that he meant what Ephy said he meant, namely, that we have to ignore Hazal's statements on this issue. But it could also be - and that's the way I took it to mean - that all R. Slifkin meant to say was that we have to take Hazal's limited scientific knowledge into account when trying to draw inferences about brain death in Halakhah. But of course, it's possible to draw halakhic inferences about the criteria of death from Hazal.

R. Slifkin asked R. Dr. Shabtai whether he took into account Hazal's limited knowledge. But what about Rashi's limited scientific knowledge? I think that this is something that shouldn't make anyone uncomfortable, as per the famous quote from R. Moses Sofer in his Hidushei Hatam Sofer (Niddah 18a) about Rashi's limited medical knowledge. In the example below, it becomes apparent that (at least in one case) R. Dr. Shabtai  assumes Rashi's perfect scientific knowledge. To me, this is quite disturbing. 

In chapter 5 of the book, R. Dr. Shabtai deals with the Mishna and Gemara in tractate Yuma (83a, 85a). The Gemara records a dispute between Tana'im regarding a building that collapsed on a person in Shabbat, and the dispute is whether the rubble may be cleared up to the person's nose where they have to check if the person is alive (if he is, they should continue the excavation; if not they must cease), or up to the person's heart (according to Rashi's text.). According to Rav Papa, the dispute is as follows: in the case that the rubble is being cleared from the person head down, everyone agrees that they must only clear up to his nose and check if the person is alive. The dispute is only in the case that  they clear the rubble from his feet up. Some rabbis say that they may only clear up to his heart, and some rabbis posit that the rubble can be cleared up until that person's nose.

Says Rashi (Yuma 85a s.v. amar Rav Papa):
אמר רב פפא, מחלוקת מלמטה למעלה - מחלוקת דהנך תנאי - דמר אמר עד לבו ומר אמר עד חוטמו - מלמטה למעלה, שמוצאו דרך מרגלותיו תחלה ובודק והולך כלפי ראשו דמר אמר בלבו יש להבחין אם יש בו חיות שנשמתו דופקת שם ומר אמר עד חוטמו דזימנין דאין חיות ניכר בלבו וניכר בחוטמו.
"Said Rav Papa, the dispute is from bottom upward" - the dispute of the Tana'im in which one side said that [they remove the rubble] up to his nose and the other side said that [they remove the rubble] up to his heart, "bottom-up" - it is in a case where they found the person's feet first and the excavate him toward his head. One side says, his heart can be checked whether it has a pulse, and the other side said that there are cases in which the pulse is too weak and there's still a breath in his nose.
According to Dr. Avraham Steinberg, both positions in the Gemara agree that the lack of respiration is the sole requirement to determine death. However, when the victim is found feet-first, some rabbis say that checking for lack of heartbeat is enough since if there's no heartbeat, it's impossible for the person to still be breathing. (As a side note, this is only a viable explanation if you assume that Hazal knew respiration is impossible when the heart isn't beating anymore. If you posit - as R. Slifkin probably does - that Hazal didn't know that, we're forced to say that some tana'im held that both, checking for pulse and for respiration are valid criteria.)

Asks R. Dr. Shabtai (p.75):
If both opinions maintain that cessation of respiration is sufficient criteria to establish death, why doesn't the [nose] opinion rely on cessation of heartbeat, as the [heart] opinion does, when the victim is uncovered feet-first? If there's no heartbeat, the victim cannot be breathing; why then require continued checking until [the nose] if breathing is not physiologically possible? Reading the Talmud as describing the criteria for death invariably leads to this conundrum.

Except, of course, if you believe that Hazal didn't know that. But R. Dr. Shabtai's isn't the only one guilty here of ignoring this possibility. It is Dr. Steinberg - on whose approach R. Dr. Shabtai is asking - that ignored the possibility that Hazal simply weren't aware that cessation of heartbeat invariably means cessation of respiration (although, as we noted earlier. one can take Dr. Steinberg's approach with the slight modification that the "heart" position held that both, lack of respiration AND lack of heartbeat are correct criteria to determine death). But what bothered me is the answer R. Dr. Shabtai gives to this conundrum:

Rashi therefore explains that the Talmud is not debating the actual criteria for death - cessation of heartbeat or respiration - but only the particular tests used to determine whether some previously agreed upon criteria have been met. Both opinions agree that a person cannot breathe without without a heartbeat; the question is only whether a chest exam is sufficiently sensitive to diagnose a heartbeat.
R. Dr. Shabtai then goes on to explain that according to Rashi, both positions in the Gemara agree that the criteria for death is the irreversible cessation of heartbeat. The dispute is only on the tests required to determine that the criteria has been met. According to the "heart" position, checking the heart for a pulse is enough to determine whether the heartbeat has ceased or not. According to the "nose" position, that is not sufficient, and the nose has to be checked for respiration. Only when there's no respiration can we be sure that there is no cardiac function.

Besides for the obvious problem which R. Dr. Shabtai fails to address, which is that checking for respiration is NOT a valid test to determine cardiac function, since the heart can continue beating even when respiration has stopped (and which is, ironically, only a problem for R. Dr. Shabtai who assumes that Hazal were up-to-date with their scientific knowledge), R. Dr. Shabtai's entire presentation of Rashi's approach is based on the mistaken premise that not only did Hazal know that cessation of heartbeat is a sure sign of cessation of breathing, but Rashi knew that as well, and therefore explained the Gemara as as relating to tests that are made to determine criteria not even hinted at in the Gemara!

R. Dr. Shabtai finishes off the passage with the following word:
In summary, Dr. Steinberg maintains that [checking the nose] and [checking the heart] are disparate criteria for death and that R. Papa concludes that both opinions essentially agree that cessation of respiration is the determining factor. Rashi, on the other hand maintains that the Talmud's question relates to the accuracy and sensitivity of different possible tests of cardiac function - assuming that cardiac criteria and cardiac criteria alone determine death.
To me, this is a misrepresentation of what Rashi says, and is based on the assumption that Rashi is aware of the fact that  lack of heartbeat invariably shows on cessation of respiration. Take away this assumption, and there remains almost no basis for explaining Rashi the way R. Dr. Shabtai does. 


  1. First off, I’d like to thank you for carefully reading my book. My purpose in writing it was to increase Talmud Torah and further debate and discussion on this important issue. Yeshar koah to you for furthering that goal.

    I would like to address the point you raised regarding understanding Rashi – which I believe, is indeed a very fair and important question, both regarding a careful reading of the words of Rashi as well as understanding whether this reading requires any scientific assumptions.

    Regarding the particular reading of Rashi, Yeedle succinctly summarizes my explanation of Rashi:

    “according to Rashi, both positions in the Gemara agree that the criteria for death is the irreversible cessation of heartbeat. The dispute is only on the tests required to determine that the criteria has been met. According to the "heart" position, checking the heart for a pulse is enough to determine whether the heartbeat has ceased or not. According to the "nose" position, that is not sufficient, and the nose has to be checked for respiration.”

    I believe that this is an appropriate and correct presentation of Rashi’s position. Rashi explains that when finding the victim feet-first, the hotmo [nose] position requires checking until the nose and is not satisfied with a negative cardiac exam because “sometimes, life-force [hiyyut] is not perceptible in the heart and is perceptible in the hotem [nose].” The assumption is that hiyyut is normally found in the heart and that when it is no longer present, the person is dead. This is what I referred to as _criteria_ for death – which is accepted by both the hotmo [nose] and libbo [heart] positions. The two opinions in the Talmud, according to Rashi, only argue as to the most accurate / precise test to make this determination – what is the optimal assessment to determine that the heart has stopped.

    This is the explanation that Rashi gives for the hotmo [nose] position – that sometimes hiyyut is not perceptible in the heart but is perceptible in the nose. This is a question of actual reality – is the heart still functioning, and Rashi explains that sometimes, the best way to find out, is to check the nose. Rashi does not explain why this should be so, but it is undeniable that he indeed makes this assertion. It is clear (at least to me) that Rashi believed it to be true, and that he similarly believed that without a heartbeat (when hiyyut is objectively not found in the heart) that the person is dead. This is not predicated upon any scientific assertions or historical recreations, but is a simple reading of the actual text.

    In Rashi’s and Hazal’s time, this was demonstrably true (irrespective of any scientific theory). Almost all people found beneath a building collapse and unable to breathe, did not have a heartbeat. Rashi similarly makes clear, that without an actual heartbeat, there is no chance of breathing. The only reason the hotmo [nose] position requires checking past the heart, is because sometimes, the heartbeat is imperceptible. Were the heart objectively found to be stopped, even the hotmo position, would not require checking any further. Putting these two factors together likely led Rashi to explain the hotmo [nose] position as explaining that sometimes a cardiac exam is not sufficiently sensitive to detect a heartbeat in all circumstances and therefore a more accurate test would be to check for signs of respiration – to determine whether or not the heart was beating.

    This is how I understand the words of Rashi and this reading is consistent with the demonstrable reality existing at his time. We can speculate as to why he believed this to be true (and indeed Hakham Tzvi gave a historical / scientific explanation), but the fact that he believed the criterion for death to be the cessation of heartbeat appears to be the logical outcome of what he wrote.

  2. (continued from previous comment - I hit the character limit)

    Please see p. 83-84 where I note that today we know that this is not a valid test and that we have far more sensitive and specific tests to make this determination, which should be followed. Perhaps I should have devoted a longer discussion to this point or placed it earlier in the chapter. I will certainly take this into consideration if and when I publish a second edition. This addresses the test alone, but not the criteria, which I argued (p. 41-42) do not change with advances in science since they reflect value judgments and not scientific realities. This postulate has been accepted by virtually all who have written on this topic, from Dr. Steinberg and R. Tendler, to R. Bleich and R. Elyashiv (the entire spectrum).

  3. Question 1
    If Rabbi Dr Shabtai is willing to explain Rashi that the "nose" opinion thinks that the tests for a heartbeat are inconclusive and insufficient, then why does he have to posit new criteria for death in the first place? Why couldn't he explain Rashi like R. Steinberg (criteria of death being respiratory) and answer his question (how could there be a "nose" opinion if the cessation of a heartbeat means no more breathing) by saying the same thing i.e that sometimes the heartbeat test is inconclusive and there really is a heartbeat and therefore he still might be breathing?

    Question 2
    I don't see how he addressed your problem in his comment. Once you entertain the possibility that chazal weren't aware of the fact that cessation of heartbeat means no breathing, then understanding Rashi the original way works fine.
    He also didn't seem to respond to what you called the "obvious problem", that cessation of breathing doesnt mean no more heartbeat. So if the criteria is heartbeat cessation, why do you only check until the nose?

  4. Thank you for thoughtfully reflecting on some of these issues:

    The way I understand things, Rashi is actually saying explicitly that the hotmo [nose] opinion believes that a heart exam is not sufficiently sensitive to determine death. He is also explicitly saying that the actual criterion for death is cessation of heartbeat. This is the only reason that checking the nose is required. He states quite clearly that "sometimes hiyyut is not perceptible in the chest but is perceptible in the nose." To my mind, this statement has two very important implications:

    1. Even the nose opinion is really trying to ascertain whether or not the heart is beating. This is the only reason why he advocates checking the nose. [I understand that Dr. Steinberg disagrees, but I don't believe that his interpretation is sufficiently faithful to the words of Rashi.]

    2. No heartbeat - in actuality - means no breathing. He explains that the only reason [according to the hotmo opninion] to check for breathing when a heartbeat cannot be detected is because our means of assessing the heartbeat are insufficiently sensitive. The only reason to think that a person might be breathing is because he may still have a heartbeat that we cannot detect. It is clear (at least to me) that Rashi assumed that without an actual heartbeat a person cannot breathe.

    The reasons why Hazal (as interpreted by Rashi) and Rashi may have thought so are not relevant at this moment. What is clear, is that Rashi states it to be true.

    Regarding the "obvious problem" - I do deal with that issue, as I noted in the previous comment, on pages 83-84. Perhaps I should have dealt with it earlier in the chapter to avoid possible confusion.

  5. Thank you R. Dr. Shabtai for your detailed response.

    I didn’t realize while writing the post that you understood the word hiyut in Rashi to mean “life-force”. Thanks for clarifying this important point. While this might be your preferred interpretation of Rashi, this interpretation is debatable. One can say that hiyut simply refers to status of life, and in the heart this refers to heartbeat. Accordingly, all Rashi is saying is that as long as the heartbeat is still perceptible, the person’s living status can be determined by checking the heart. With such an interpretation we can still say that according to Rashi, both positions in the Gemara consider ICSR be a criteria for death, and the dispute is if lack of heartbeat can *also* be considered as a criteria for death.

    Therefore, when you say “it is undeniable that [Rashi] indeed makes this assertion” that the heartbeat can be checked in the nose, this is only so if you assume “hiyut” means “life-force” as I explained.

    Rashi similarly makes clear, that without an actual heartbeat, there is no chance of breathing
    I don’t understand where you see this in Rashi.One can take Rashi to say the exact opposite - that even when there is no perceptible heartbeat, the person might still be breathing (זימנין דאין חיות ניכר בלבו - at times one cannot perceive a heartbeat, וניכר בחוטמו - and hiyut is percievable in the nose, by checking whether he’s breathing or not). Or as Jr put it, "sometimes the heartbeat test is inconclusive and there really is a heartbeat and therefore he still might be breathing".

    Thanks for referring to pp. 83-84. But as I wrote in the post, my point is not that since we now know that checking the nose is not a good test to determine lack of heartbeat, therefore Rashi couldn’t have said that. My point was that from the premise upon which you base your interpretation in Rashi - that Rashi knew that once you determine lack of heartbeat, there’s no need to check for respiration - it should follow that Rashi also knew that checking the nose won’t help determine lack of heartbeat. Your answer that “[almost] all people found beneath a building collapse and unable to breathe, did not have a heartbeat” can be rephrased to say that “ *all* people found beneath a building collapse and with no heartbeat, were unable to breath”. There’s no indication that Rashi knew either of the two to be a verifiable reality in his times.