Ask the Rabbi: The cadaver conundrum

On using the 'image of God' to preserve life.

Q. Does Jewish law allow a person to will their body for scientific research or medical training? - R.B., Haifa A. The permissibility of cadaver research balances different elements of Judaism's sanctification of human life. On the one hand, Judaism asserts that the human body embodies the image of God and therefore prohibits its physical desecration, even when willfully self-inflicted (Rashi Deuteronomy 21:23). Yet for the same reason, Judaism also deeply values medical research and all other attempts at preserving human life. This conflict goes so deep in fact that the opening of Hebrew University's medical school was delayed 22 years until the issue of anatomical dissection was resolved! In antiquity, gentiles, and particularly Christians, eschewed anatomical research as immoral. While medieval doctors (including Leonardo da Vinci) performed rare dissections, only in the 17th and 18th centuries did it become standard for medical training. The first decisor to address the issue, Rabbi Jacob Emden (1697-1776, Germany), forbade this research because it transgressed the prohibition of benefiting from corpses (She'elat Yavetz 1:41). Other rabbis ruled against it since it delays burial (halanat metim) and desecrates the human body (nivul hamet). In theory, however, the obligation to save human life (pikuah nefesh) overrides these (and almost all other) prohibitions. Rabbi Yehezkel Landau (1713-1793, Prague) was asked regarding the propriety of performing an autopsy on a patient who died after unsuccessful bladder surgery to correct the treatment for future cases (Noda Beyehuda Tanina YD 210). He prohibited the dissection, contending that pikuah nefesh only trumps other commandments when there exist immediate life-saving benefits. Potential future benefits remain too remote to permit desecrating the body. He further contended that any leniency might lead to excessive and unjustified dissection by non-Jewish doctors on Jewish corpses. The majority of leading scholars, including Rabbi Moses Sofer, Rabbi Abraham Isaac Kook and Rabbi Moshe Feinstein, adopted this position. Rabbi Benzion Uziel (1880-1953), the first Sephardi chief rabbi of Israel, contended that Landau failed to recognize the immediate benefits of medical research. Firstly, he argued, patients with similar illnesses to the deceased always exist, whether in that specific hospital or somewhere else. Moreover, if doctors never pathologically examine the corpse, then these illnesses will remain incurable. As such, pikuah nefesh definitively permits anatomical research. He contended that Israel must establish medical schools with anatomical training to educate doctors and establish a functioning society. Uziel, however, cautioned that students must handle the corpses with the utmost respect, and meticulously bury all body parts and entrails following the dissection (Mishpetei Uziel YD 1:28). A different permissive approach toward willing one's body to medicine was taken by Rabbi Ya'acov Ettlinger (1798-1871). This German authority affirmed the severity of desecrating a body, and even forbade autopsies when there was an immediate life-saving benefit. He contended, however, that a person may waive (mochel) in his lifetime all regulations aimed to preserve the deceased's dignity. One can choose how to forgo this honor, as long as all body parts are ultimately properly buried (Binyan Zion 170). Based on these opinions, chief rabbi Isaac Herzog in 1947 allowed the Hebrew University medical school to perform anatomical studies. Herzog, along with prominent contemporaries Rabbi Eliezer Waldenburg and Rabbi Tzvi P. Frank, allowed a person to donate their body for medical school training (Encyclopedia of Jewish Medical Ethics, I:82). Like Ettlinger, they ruled that this right remained exclusively with the donor, and contended therefore that the deceased's family or doctors cannot donate the corpse on their own initiative. In cases, however, where the deceased did not will his body, but died from an illness with an unknown cure, they ruled that a special committee of rabbis should determine the propriety of performing an autopsy (Tzitz Eliezer 4:14). Interestingly, these rabbis buttressed their opinion by documenting talmudic stories that indicate rabbinic use of anatomical research. In both cases, the sages examined the remains of death penalty victims to determine biological data with legal implications (Behorot 45a and Tosefta Nida 4:17). The stories, however, remain cryptic and do not present a bona-fide proof to this opinion. Despite these arguments, the vast majority of Orthodox rabbis, as noted above, forbade people from willing their bodies to science. They contended that earlier sages previously rejected many of the arguments for leniency, and saw no reason to abandon these rulings. In repeated incidents throughout the 20th century in Europe, America and Israel, these rabbis forcefully forbade this practice, contending that particularly in our times, Jews must uphold the value of sanctifying human life (Encyclopedia of Jewish Medical Ethics, I:74). Many non-Orthodox rabbis, however, took a more permissive approach. I should point out that many decisors allow autopsies in cases of genetic diseases or for victims of violent crimes. One should consult a rabbinic authority to ascertain the propriety of this action in each specific case. The writer, editor of TraditionOnline.org, teaches at Yeshivat Hakotel and is pursuing a doctorate in Jewish philosophy at the Hebrew University. [email protected]