A legal showdown over the meaning of death pits an ultra-Orthodox Jewish couple who believe there is life while the heart still beats against the Washington, D.C., hospital which wants to remove their brain-dead son from life support.

The Uniform Determination of Death Act adopted by the District of Columbia and all 50 states defines death as “the irreversible cessation of all functions of the entire brain, including the brain stem.” That, says Children's National Medical Center, describes the condition of Motl Brody, 12, who was declared brain-dead last week after succumbing to brain cancer.

The northwest Washington hospital filed suit Nov. 4 for a court order allowing it to stop treating Motl. “This child has ceased to exist by every medical definition,” one of his doctors has said.

But Motl's parents, who are Hasidic Jews from Brooklyn, N.Y., believe that life does not end until the heart stops beating. “Under Jewish law and their faith, there is no such thing as brain death,” their attorney, Jeffrey I. Zuckerman, told the Washington Post. “Their religious beliefs are entitled to respect.”

Children's has received hundreds of e-mails and phone calls, mostly from New York residents, pleading to keep Motl on the ventilator and the intravenous drugs that are powering his respiratory and circulatory systems.

D.C. Superior Court Judge William M. Jackson was scheduled to hear the case today, but Children's asked for a continuance until Nov. 12 so doctors could have a last chance to speak directly with the Brodys.

“The issue in this case is whether the Hospital has the authority to follow the stated procedure when a patient is considered brain dead, or whether the parents' wishes take precedent [sic] over hospital procedure in this case,” the hospital's complaint says.

In New York, a hospital's policy for determining death “shall include ... a procedure for the reasonable accommodation of the individual's religious or moral objection to the determination as expressed by the individual, or by the next of kin or other person closest to the individual.”

But the District of Columbia, along with the other 49 states, does not make an exception for religious belief -- which appears to leave Judge Jackson with no statutory basis to accommodate the Brodys' objections.

Moreover, experts in Orthodox Jewish law –- or “halacha” -- differ over whether brain death fits the law's definition of death. A scholarly article entitled “The Brain Death Controversy in Jewish Law” lists six major schools of thought on the issue.

“Whether [brain death] comports with 'halacha' is a matter of great controversy among rabbinic authorities,” the author says.

Motl Brody was admitted to Children's National about six months ago. According to the hospital, other facilities have refused to take him and keeping him at Children's puts other children in intensive care at risk because of the diversion of resources.

“Continuing any support to this child eliminates any dignity this child has left,” Kenneth H. Rosenau, an attorney for Children's, argued in court papers. “There is no religious principle at issue in this case, but a clash on the definition of death.”

In 2006, a similar end-of-life battle involved the family of a Buddhist man and doctors at a Boston hospital who had declared him brain dead. The case became moot when the family agreed to let his drugs run out so his heart would stop beating naturally.

By Matthew Heller
11/10/08