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A Survey of Multidenominational Rabbis on Death by Neurologic Criteria

  • Ethical Matters
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Neurocritical Care Aims and scope Submit manuscript

A Response to a Letter to the Editor to this article was published on 05 August 2019

The Original Article was published on 05 August 2019

Abstract

Objective

(1) Determine the pervasiveness of the belief that brain death/death by neurologic criteria (BD/DNC) is not death among rabbis. (2) Examine rabbinic beliefs about management after BD/DNC.

Methods

An electronic anonymous survey about BD/DNC determination and management after BD/DNC was created and distributed to members of the Central Conference of American Rabbis (the Reform Rabbinic leadership organization), the Rabbinic Council of America (an Orthodox organization), the Rabbinic Assembly (a Conservative organization), and the Reconstructionist Rabbinic Association.

Results

Ninety-nine rabbis (40 Reform, 32 Orthodox, 22 Conservative, and 5 Reconstructionist) completed the survey. Awareness of the requirements for BD/DNC was poor (median of 33% of the requirements correctly identified [interquartile range of 22–66%]), but 81% of rabbis knew that absence of heartbeat is not required for BD/DNC. Although only 5% of all rabbis believed a person who is brain dead could recover, 22% did not believe BD/DNC is death, and 18% believed mechanical ventilation should be continued after BD/DNC. There was a significant relationship between denomination and belief that: (1) a person who is brain dead can recover (p = 0.04); (2) a person who is brain dead is dead (p < 0.001); (3) mechanical ventilation should be continued after BD/DNC (p < 0.001); (4) hydration should be continued after BD/DNC (p = 0.002); (5) nutrition should be continued after BD/DNC (p < 0.001); (6) medications to support blood pressure should be continued after BD/DNC (p < 0.001); and (7) cardiopulmonary resuscitation should be performed when a brain dead person’s heart stops (p = 0.006).

Conclusions

Rabbinic knowledge about the intricacies of BD determination is poor. Rabbinic perspectives on management after BD/DNC vary. These empirical data on rabbinic perspectives about BD/DNC may be helpful when considering accommodation of religious objections to BD/DNC.

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Acknowledgements

The author would like to thank (1) Rabbi Steve Goodman for his help designing this survey, (2) Rabbis Mark Dratch, Linda Henry Goodman, Leonard Sharzer, and Elyse Wechterman for distributing this survey, and (3) all of the rabbis who completed this survey.

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Authors and Affiliations

  1. Division of Neurocritical Care, Departments of Neurology and Neurosurgery, NYU Langone Medical Center, 530 First Avenue, HCC-5A, New York, NY, 10016, USA

    Ariane Lewis

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AL was responsible for conception and design, analysis, and interpretation of data, drafting the manuscript, statistical analysis, and final approval of the manuscript.

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Correspondence to Ariane Lewis.

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Ariane Lewis has no disclosures or conflicts of interest.

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Ariane Lewis takes responsibility for the data and accuracy of data analysis.

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Lewis, A. A Survey of Multidenominational Rabbis on Death by Neurologic Criteria. Neurocrit Care 31, 411–418 (2019). https://doi.org/10.1007/s12028-019-00742-3

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