By Rabbi Yerachmiel D. Fried
Since this question was submitted, the subject of the question has been disconnected from life support and passed on. We, nevertheless, present the question in the merit of the ethical lessons therein.
I am sure you have heard of the situation of the woman, Marlise Muñoz, in Fort Worth who is brain dead, but the hospital is keeping her alive since she is pregnant. Key facts in the situation are:
Mrs. Muñoz suffered what the doctors believe was a pulmonary embolism in November.
The doctors say she is brain dead.
Mr. Muñoz said his wife was clear that she would not want to be kept alive in those circumstances.
In November, when the event occurred, she was 14 weeks pregnant. The fetus still has a beating heart at 20 weeks old.
It is possible that when the woman stopped breathing and suffered oxygen deprivation, the fetus did too. The fetus could be in poor health, and if the baby is born alive, then it may have suffered debilitating brain damage which would lead to severe mental retardation and other physical problems.
The hospital claims the Texas Advance Directives Act is requiring them to keep the woman’s body alive since she is pregnant, others disagree and claim they are misinterpreting Texas law since she is already dead by legal definition.
My questions are:
What is the halachic position on this?
Can a body be kept on life support to keep a fetus alive?
Is there a point in the life of the fetus when the body must be kept alive (from 2 weeks of the first sign of pregnancy to term at 38 weeks)?
Can the family intervene and at what point does one party overrule the other: hospital, family, legislature and even the deceased person’s medical power of authority?
— Steve F.
The halachic position on this question is complicated for a variety of reasons. I subscribe to the position of my mentors that brain death does not constitute death; rather the cessation of cardio-pulmonary activity (This is unlike the official position of the Chief Rabbinate in Israel, and is a major debate in the halachic world). According to this, the existence of a fetus is a moot point; she would not be allowed to be detached from the ventilator by virtue of her own life.
The same mentors, however, concur that although they feel brain stem death is not the definition of death for a Jew; the gentile world is free to define the time of death as they see fit (for reasons out of the scope of this discussion). Therefore the question becomes relevant for a gentile under Torah law even given my halachic worldview. This is because Texas law defines brain stem death as a definition of death even when cardio-pulmonary activity continues artificially. (This is assuming the situation of brain death could be determined absolutely, something which is very questionable).
The Talmud states that if the death penalty is meted out to a pregnant woman, the court need not wait until she gives birth to carry out the penalty. (Arachin 7a, based upon a verse that the fetus, until birth, is considered “part” of the mother). The halachic authorities derive from this that one need not withhold the death of the mother in order to preserve the fetus. This leaves room for debate that although we do not need to keep her alive for the sake of the fetus, would we be allowed to do so? This needs much thought and a ruling, but it would seem that it is improper to do so since this would probably cause undue continued stress and pain to the mother. (The medical world recognizes the existence of pain to a brain-dead patient in many situations, and calls for the administering of anesthesia while harvesting the organs, something which, to me, casts aspersions on the concept of brain death).
Your final question is quite complicated to answer. The rule of thumb in halachah is that nobody has any say in allowing an act which would constitute, according to Jewish law, the cessation of life; this would be considered an act of murder. Whether to continue to artificially cause life to go on, or the delaying of death, is a different question which depends upon the situation and whether this can be accomplished by the lack of acting rather than performing an act.
Rabbi Yerachmiel D. Fried, noted scholar and author of numerous works on Jewish law, philosophy and Talmud, is founder and dean of DATA, the Dallas Kollel. Questions can be sent to him at email@example.com.