Permitting or Encouraging Autopsies for Orthodox Jews in Some Circumstances
Opening the Conversation
In honor of Barbara Gelnick who used to host the police on Succos every year and did a lot of bridging between law enforcement and the Jewish community
This has been on my mind for a while. I hope that this opens the door for conversation and that Rabbis, poskim, Orthodox Jewish pathologists, and anyone who has stakes in this will contribute to the conversation. The sheet on Sefaria is the same information with slightly better/worse aesthetics.
Table of Contents:
Why We Do Not Autopsy: Kavod Hameis
Treat the Body with Dignity
Do Not Mutilate a Body
Bury in Ground, Cases where disinterment of body is allowed
Bury Same Day as quickly as possible
Fear of missing organs in techiyas hameisim
Yechezkel Dry Bones Nevuah as Counterpoint
The Luz Bone
Burying Organs with the Body
How Far Does Pikuach Nefesh Go and How Immediate Must it be
Cases like my mother-in-law to benefit general science
Cases where there is family history
Less Intrusive Options
Exploration of Halachic support
Exploration of Community Support
Fostering Relationships and Conversations with Medical Examiners
Why We Do Not Autopsy: Kavod Hameis, Honoring the Body of the Dead
Treat Body with Dignity
https://www.sefaria.org/Berakhot.18a.10?lang=bi
תָּנוּ רַבָּנַן: הַמּוֹלִיךְ עֲצָמוֹת מִמָּקוֹם לְמָקוֹם, הֲרֵי זֶה לֹא יִתְּנֵם בְּדִסַקַּיָּא וְיִתְּנֵם עַל גַּבֵּי חֲמוֹר וְיִרְכַּב עֲלֵיהֶם, מִפְּנֵי שֶׁנּוֹהֵג בָּהֶם מִנְהַג בִּזָּיוֹן. וְאִם הָיָה מִתְיָרֵא מִפְּנֵי גּוֹיִם וּמִפְּנֵי לִסְטִים — מוּתָּר. וּכְדֶרֶךְ שֶׁאָמְרוּ בַּעֲצָמוֹת כָּךְ אָמְרוּ בְּסֵפֶר תּוֹרָה.
The Gemara discusses other issues concerning the dignity of the deceased. The Sages taught: One who transports bones from place to place may not place them in a saddlebag [disakaya] and place them on the donkey’s back and ride on them, as in doing so he treats the remains disgracefully. However, if he is afraid of gentiles or highwaymen and therefore must move quickly, he is permitted to do so. And just as they said with regard to bones, so they said with regard to a Torah scroll.
Do not Mutilate a Body
https://www.sefaria.org/Chullin.11b.7?lang=bi&with=all&lang2=en
דלמא טרפה הוה אלא לאו משום דאמרינן זיל בתר רובא
And let us be concerned that perhaps the person that he killed was a tereifa, one who has a wound or condition that will lead to his death within twelve months. One who kills a tereifa is exempt from capital punishment because in that sense, the halakhic status of a tereifa is that of a dead person. Rather, is the reason we are not concerned for this not due to the fact that we say: Follow the majority of people, who are not tereifot?
וכי תימא דבדקינן ליה הא קא מינוול וכי תימא משום איבוד נשמה דהאי נינווליה וניחוש שמא במקום סייף נקב הוה
And if you would seek to reject that proof and say that we examine the corpse to determine whether he was a tereifa, wouldn’t the corpse be mutilated through that examination? And if you would say that due to concern for the possibility of an unjustified loss of life of that murderer, we will mutilate the corpse to determine whether the victim was a tereifa, it would remain necessary to rely on the majority, as let us be concerned that perhaps there was a perforation in the place that he stabbed the victim with the sword.
Bury in Ground, Cases where disinterment of body is allowed
https://www.sefaria.org/Shulchan_Arukh%2C_Yoreh_De'ah.348.3?lang=bi
אפילו מי שאין לו ממון שצוה ואמר אל תקברוהו אין שומעין לו:
Even one who has no money, who gave instructions [that when he dies] he should not be buried [in order not to become a public charge], is not to be obeyed.
https://www.sefaria.org/Shulchan_Arukh%2C_Yoreh_De'ah.362.1?lang=bi
לקבור בקרקע ואם קוברין שני מתים יחד. ובו ו' סעיפים:
הנותן מתו בארון ולא קברו בקרקע עובר משום מלין את המת ואם נתנו בארון וקברו בקרקע אינו עובר עליו ומכל מקום יפה לקברו בקרקע ממש אפילו בח"ל:
One who places his dead in a coffin and did not bury it in the earth, transgresses thereby a [negative command] because he keeps the dead over night [unburied]. If he placed him in a coffin and buried it in the earth, he does not transgress [a negative command] on his account. Nevertheless, it is [more] appropriate to bury him in the earth proper even [when he is buried] outside the Land [of Israel].
https://www.sefaria.org/Shulchan_Arukh%2C_Yoreh_De'ah.363.1?lang=bi&with=all&lang2=en
איסור פנוי המת והעצמות ממקומן. ובו ז' סעיפים:
אין מפנין המת והעצמות לא מקבר מכובד לקבר מכובד ולא מקבר בזוי לקבר בזוי ולא מבזוי למכובד ואצ"ל ממכובד לבזוי ובתוך שלו אפילו ממכובד לבזוי מותר שערב לאדם שיהא נח אצל אבותיו וכן כדי לקברו בארץ ישראל מותר ואם נתנוהו שם על מנת לפנותו מותר בכל ענין ואם אינו משתמר בזה הקבר שיש לחוש שמא יוציאוהו עובדי כוכבים או שיכנסו בו מים או שהוא קבר הנמצא מצוה לפנותו (יש נוהגין לתת מעפר א"י בקבר) (א"ז) (ויש למנהג זה על מה שיסמוכו) (מדרש תנחומא פ' ויחי):
One should not remove a corpse and bones from a dignified grave to [another] dignified grave, nor from an undignified grave to [another] undignified grave, nor from an undignified one to a dignified one, and needless to say [that it is forbidden] from a dignified one to an undignified one. And [to remove a corpse] into his own, even from a dignified [grave] to an undignified one, is permissible, for it is pleasant for a man that he rest beside his ancestors. And likewise, in order to bury him in the Land of Israel, it is permissible [to remove him]. If they placed him there [originally] with the intention that he be removed [later], it is permissible under all conditions. If he is not safe in this grave, for there is apprehension that heathens may take him out, or that water may enter therein, or that it is a grave that has been found, it is a religious duty to remove him [therefrom]. Some are wont to place some earth from the Land of Israel in the grave; (and this custom has a basis).
אין מוליכין מת מעיר שיש בה קברות לעיר (אחרת) אלא אם כן מחוצה לארץ לארץ: הגה או שמוליכין אותו למקום קברות אבותיו (כן משמע בא"ז) ואם צוה להוליכו ממקום למקום או שצוה לקברו בביתו ולא בבית הקברות שומעין לו (ג"ז שם) ומותר ליתן סיד עליו כדי לעכל הבשר מהר ולהוליכו למקום אשר צוה (רשב"א סימן שס"ט):
They do not convey a corpse from a city wherein there is a cemetery to another city, unless it is from outside the Land into the Land [of Israel], Gloss: Or if they convey him to the place of his ancestral sepulchre. And if he left instructions to convey him from one place to [another] place, or [if] he left instructions to bury him at his home and not in the cemetery, he is obeyed. It is permitted to place lime upon him, in order to decompose the flesh rapidly, and [then] to convey him to the place [concerning] which he left instructions.
אין מלקטין עצמות לא מתוך הארון ולא מתוך הקבר לצד זה לקבור שם מת אחר או לצורך המקום:
One may not collect bones from a coffin, nor [may one gather the bones] from a grave to one side [in order] to bury therein another corpse, nor for the need of the place.
מקום שנוהגין לקבור במהמורות (פי' בשוחות עמוקות מן במהמורות בל יקומו) בלא ארון עד שיתעכל הבשר ואחר כך מלקטין העצמות וקוברין אותן בארון מותר:
[In] a locality where it is customary to bury [the dead first] in depressions, (i.e., deep pits, — derived from, 'into deep pits that they rise not up again',) without a coffin, until the flesh is decomposed, and afterwards one collects the bones and buries them in a coffin, it is permitted.
Bury Same Day as quickly as possible
Devarim 21:23 https://www.sefaria.org/Deuteronomy.21.23?lang=bi&aliyot=0
לֹא־תָלִ֨ין נִבְלָת֜וֹ עַל־הָעֵ֗ץ כִּֽי־קָב֤וֹר תִּקְבְּרֶ֙נּוּ֙ בַּיּ֣וֹם הַה֔וּא כִּֽי־קִלְלַ֥ת אֱלֹקִ֖ים תָּל֑וּי וְלֹ֤א תְטַמֵּא֙ אֶת־אַדְמָ֣תְךָ֔ אֲשֶׁר֙ ה אֱלֹקיךָ נֹתֵ֥ן לְךָ֖ נַחֲלָֽה׃ {ס}
you must not let the corpse remain on the stake overnight, but must bury it the same day. For an impaled body is an affront to God: you shall not defile the land that your God Hashem is giving you to possess.
Fear of missing organs in techiyas hameisim
hunt down source: The Radvaz (VIII 197) instructs exhumers to be careful not to leave even one part of the body in its previous grave, because the deceased cannot arise without every single part of its body. If a body part remains in another grave, the entire body cannot be resurrected until that part rolls to Emek Yehoshafat, causing delay and suffering to the deceased. The Shevet Halevi stresses this, in light of a professional opinion stating that most times graves are not cleared entirely.
https://www.sefaria.org/Ketubot.111a.22?lang=bi
וּלְרַבִּי אֶלְעָזָר, צַדִּיקִים שֶׁבְּחוּץ לָאָרֶץ אֵינָם חַיִּים?! אָמַר רַבִּי אִילְעָא: עַל יְדֵי גִּלְגּוּל. מַתְקֵיף לַהּ רַבִּי אַבָּא סַלָּא רַבָּא: גִּלְגּוּל לְצַדִּיקִים צַעַר הוּא! אָמַר אַבָּיֵי: מְחִילּוֹת נַעֲשׂוֹת לָהֶם בַּקַּרְקַע.
The Gemara asks: And according to the opinion of Rabbi Elazar, will the righteous outside of Eretz Yisrael not come alive at the time of the resurrection of the dead? Rabbi Ile’a said: They will be resurrected by means of rolling, i.e., they will roll until they reach Eretz Yisrael, where they will be brought back to life. Rabbi Abba Salla Rava strongly objects to this: Rolling is an ordeal that entails suffering for the righteous. Abaye said: Tunnels are prepared for them in the ground, through which they pass to Eretz Yisrael
Yechezkel Dry Bones Nevuah as Counterpoint
https://mg.alhatorah.org/Tanakh/Yechezkel/37.1#m7e3n6
וַיֹּ֣אמֶר אֵלַ֔י בֶּן־אָדָ֕ם הֲתִֽחְיֶ֖ינָה הָעֲצָמ֣וֹת הָאֵ֑לֶּה וָאֹמַ֕ר אדושם ה׳ אַתָּ֥ה יָדָֽעְתָּ׃
וְנָתַתִּי֩ עֲלֵיכֶ֨ם גִּידִ֜ים וְֽהַעֲלֵתִ֧י עֲלֵיכֶ֣ם בָּשָׂ֗ר וְקָרַמְתִּ֤י עֲלֵיכֶם֙ ע֔וֹר וְנָתַתִּ֥י בָכֶ֛ם ר֖וּחַ וִחְיִיתֶ֑ם וִידַעְתֶּ֖ם כִּֽי־אֲנִ֥י הֹ
The Luz Bone
https://www.sefaria.org/Kohelet_Rabbah.12.5.1?lang=bi
שָׁאֵיל אֶת רַבִּי יְהוֹשֻׁעַ בֶּן חֲנַנְיָה אָמַר לֵיהּ מֵהֵיכָן אָדָם מֵנִיץ לֶעָתִיד לָבוֹא, אֲמַר לֵיהּ מִלּוּז שֶׁל שִׁדְרָה. אָמַר לוֹ הַרְאֵנִי, מֶה עָשָׂה הֵבִיא לוּז אֶחָד שֶׁל שִׁדְרָה נְתָנוֹ בְּמַיִם וְלֹא נִמְחָה, בְּאוּר וְלֹא נִשְׂרַף, בְּרֵיחַיִם וְלֹא נִטְחַן. נְתָנוֹ עַל הַסַּדָּן וְהִכָּה עָלָיו בְּפַטִּישׁ, נֶחְלַק הַסַּדָּן וְנִבְקַע הַפַּטִּישׁ, וְלֹא הוֹעִיל כְּלוּם.
“The almond tree will blossom” – Rabbi Levi said: This is the nut-sized bone at the top of the spinal column. Hadrian, may his bones be crushed and his name expunged, asked Rabbi Yehoshua ben Ḥananya; he said to him: ‘From where does a person blossom in the future?’ He said to him: ‘From the nut-sized bone at the top of the spinal column.’ [Hadrian] said to him: ‘Show me.’ What did [Rabbi Yehoshua] do? He brought him the nut-sized bone at the top of the spinal column. He placed it in water, but it did not dissolve; in fire, but it did not burn; in a mill, but it was not ground. He placed in on an anvil and struck it with a hammer. The anvil split, the hammer split, but it was to no avail.
Burying Organs with the Body
Yoreh Deah 362 Pischei Teshuva #1 where it seems amputated organs need not be buried,
https://www.sefaria.org/Ketubot.20b.5?lang=bi
Kesuvos 20b where the custom is to bury amputated organs.
The majority opinion follows Rabbi Yechezkel ben Yehuda Landau (1713 – 1793) opinion at Noda B’Yehuda I, Yoreh Deah (YD) 90, who holds that the mitzvah to bury separated body parts is required only of people who are dead, because it would be a disgrace not to. Rav Moshe Feinstein (1895-1986), however, held that even the body parts of living people must be buried because a kohen could become tamei from contact with those parts. Igros Moshe, YD I, 231, citing Nazir 43b. See also, Rambam (Rabbi Moshe ben Maimon, aka Maimonedes (1135-1204)), Tumas Mes 2:3. In Berachos 5b and Baba Basra 116a, Rabbi Yochanan is quoted as saying that he was carrying with him a "bone" of his deceased 10th son. Rashi believes the bone was small enough that it would not convey tumah. The Rashbam (at Baba Basra 116a) argues that Rabbi Yochanan must have been carrying his son's tooth, since that definitely would not convey tumah and does not require burial. But that position is in dispute. Although it is well held that a person may benefit from the tooth of a living person, others question whether one is permitted benefit from the tooth of a deceased person. See, e.g., Ran (Rav Nissim of Gerona, 1320-1376), Chulin 122a; Rabbi Ovadia Yosef (b. 1920), Shlita, Yabia Omer, III, YD 21.
https://www.torahmusings.com/2018/12/amputated-limbs/
https://www.medethics.org.il/ask/halachic%20sources%20for%20treating%20body%20parts/
How Far Does Pikuach Nefesh Go and How Immediate Must it be
hunt down this source
Other rabbinic authorities (e.g., Rabbi I. *Jakobovits), taking modern developments into account, suggest that autopsies, especially in cases of heart disease and cancer, not only belong to the category of pikku'aḥ nefesh in a general way, but are even sometimes imperative, especially in connection with determining the effects of new medicines. "As it is the duty of the rabbi to prevent autopsies where no pikku'aḥ nefesh is involved, so is it his duty to insist on it where there is the slightest possibility of it being of benefit" (R. Isaac Arieli, in: Torah she-be-al Peh (1964), 66).
https://www.jewishvirtuallibrary.org/autopsies-and-dissection
there has been a universal consensus of opinion permitting autopsies in the case of violent or accidental death or where crime is suspected. In such cases the talmudic precedents quoted above would apply. Most of those who oppose autopsies made an exception in the case of corneal transplants which restore sight to a blind person. In this specific instance Rabbi Unterman stated that the deceased would consider it an honor for his eye to be used for such a purpose, thus overcoming the prohibition of nivvul ha-met., In the same responsum, Rabbi Unterman put forward the interesting view that an organ from a deceased person is "revived" when successfully grafted on to a living person and ceases to be regarded as part of a corpse. Though resistance to transplants remains widespread, there has been a tendency to greater leniency, as in the case of heart transplants where the position has shifted from total opposition to conditional consent.
https://www.jewishvirtuallibrary.org/autopsy-in-jewish-law#:~:text=Jewish%20law%20forbids%20the%20despoliation,practice%20makes%20the%20body%20impure.
Case like my mother-in-law to benefit general science
My mother-in-law died suddenly in her sleep the day after heart surgery that “went well.” Cause of death is undetermined. Clot? Stroke? Is this hereditary? Are there things to be medically learned if we know the cause of death in cases like this? Are there prophylactic actions to be taken in higher risk situations. Do autopsies help us determine what these higher risk situations are? Will this help us understand the causes of death and prevent them in the future?
https://pubmed.ncbi.nlm.nih.gov/31715155/
Cases where there is family history
Our friend passed away suddenly with a family history of a mother and aunt who also passed away unexpectedly. In cases of family history of unexpected death, should the children be allowed halachically for their mother to have an autopsy? Is it not a direct risk for those children, not knowing the cause of death? Is this not a preventable future pikuach nefesh case if the family has that information?
Lesser intrusive options
Can frum pathologists suggest/compile cases and methods where non-intrusive options such as CAT scans can be done to determine cause of death in cases that will a) give important information to at-risk relatives or b) give important information to the scientific community to generally prevent sudden unknown cause death.
Exploration of Halachic support
Are there known Rebbeim who specialize in autopsy halacha?
Are there big poskim who are reluctant to allow autopsies in the types of cases discussed here? Are there big poskim who already do allow autopsies in the types of cases discussed here?
Exploration of Community Support
Do frum doctors know the halacha if there are heterim? Does the frum medical community think this is important?
Does there need to be publicity about heterim or correction of misunderstanding of what is allowed and what is forbidden similar to organ donation?
Fostering Relationships and Conversations with Medical Examiners
Is the law willing to work with our halachic preference to not desecrate the body if it is avoidable while still doing less intrusive tests? Are there Rabbis or health care professionals who can explain our concerns while also making sure important medical information about unexpected death can be discovered?
Thanks for bringing this to light - I never thought of autopsies as Pikuach Nefesh for others, but it sounds compelling