הלכה על בראשית 2:6

There is some prima facie evidence indicating that lack of respiration and the state of death are, by definition, synonymous. The Sages inform us that the soul departs through the nostrils, thereby causing respiration to cease and death to occur. The Yalkut Shim'oni, Lekh Lekha, no. 77, observes that after sneezing one should give thanks for having been privileged to remain alive.¹⁶Cf. R. Baruch ha-Levi Epstein, Torah Temimah, Gen. 7:22. The Yalkut, noting that the first mention of sickness in Scripture occurs in Genesis 48:1, remarks that prior to the time of Jacob sickness was unknown. It is the view of the Sages that illness became part of man's destiny in answer to Jacob's plea for prior indication of impending death in order that he might make a testament before dying. Before the days of Jacob, according to the Yalkut, an individual simply sneezed and expired without any indication whatsoever that death was about to overtake him. The Yalkut can readily be understood on the basis of the verse "… and He blew into his nostrils the soul of life" (Gen. 2:6). In the narrative concerning the creation of Adam, the soul is described as having entered through the nostrils. According to the Yalkut, the soul departs through the same aperture through which it entered; hence terminal sneezing is associated with the soul's departure from the body. Apparently, then, respiration and life both cease with the departure of the soul.

It would appear that a divergent view is espoused by Hatam Sofer, who indicates that death is synonymous with cessation of respiration. Teshuvot Hatam Sofer, Yoreh De'ah, no. 338, states that the commandment "And if a man have committed a sin worthy of death, and he be put to death … his body shall not remain all night upon the tree, but thou shalt surely bury him the same day …" (Deut. 21:23) implies a clearly defined definition of death. Halakhah deems cessation of respiratory activity to constitute such a definition. This tradition, according to Hatam Sofer, was either (1) received from the scientists of antiquity, even though it has been "forgotten" by contemporary physicians, or (2) received by Moses on Mt. Sinai, or (3) derived from the verse "all which has the breath of the spirit of life in his nostrils" (Gen. 2:6). "This necessarily is the shi'ur [the term shi'ur should in this context be understood as meaning "clinical symptom of death"] received by us with regard to all corpses from the time that the congregation of the Lord became a holy nation." Hatam Sofer, while not spelling out the issue at stake, quite obviously views cessation of respiration as itself constituting death rather than as being merely symptomatic of death. However, in developing this thesis, Hatam Sofer appears to broaden his definition of death by requiring the presence of yet another necessary condition. Hatam Sofer cites the previously mentioned phenomenon described by the Andalusians and accounts for the situation described by them by stating that although in the incident described respiration had ceased, nevertheless the pulse was still detectable either at the temples or at the neck. Without making an explicit statement to this effect, Hatam Sofer here seems nevertheless to amend his definition of death and now appears to state that death occurs only if both pulse beat and respiration have ceased.²⁰Rabbi Moshe Sternbuch, Ba‘ayot ha-Zeman be-Hashkafat ha-Torah, I, 10, asserts that according to Ḥatam Sofer, absence of respiration is sufficient to establish death unless the peron is in a swoon. However, in a state of swoon it is possible for the person to be alive and yet not to breathe. Hence the possibility of a swoon must be ruled out before lack of respiration may be accepted as conclusive evidence that death has occurred. Rabbi Sternbuch evidently interprets Ḥatam Sofer as believing that lack of respiration is merely symptomatic of death rather than constituting death in and of itself. This definition of death is thus compatible with the previously cited view supported by Yoma 85a that death is to be identified with absence of respiration coupled with prior cessation of cardiac activity. Although death occurs only upon the conjunction of both physiological occurrences, cessation of respiration is accepted as the sole operational definition because, in the vast majority of cases, it is indicative of prior cardiac arrest. Hatam Sofer summarizes his position in the statement, "But in any case, once he lies like an inanimate stone, there being no pulse whatsoever, and if subsequently breathing ceases, we have only the words of our holy Torah that he is dead." Accordingly, concludes Hatam Sofer, the corpse must be buried without delay and a kohen dare not defile himself by touching the corpse after these signs of death are in evidence. Cases such as those described in Semaḥot 8 are extremely unusual, to say the least, and are dismissed by Hatam Sofer as being comparable to the celebrated story of Choni the Circle-Drawer (Ta'anit 23a), who slept for seventy years. Oddities such as these occur with such great rarity that Halakhah need not take cognizance of such contingencies.²¹Rabbi I. J. Unterman, “Ba‘ayot Hashtalat ha-Lev le-Or ha-Halakhah,” Torah She-be-‘al Peh (5729), p. 13 and No‘am, XIII (5730), p. 3, points out that Ḥatam Sofer is speaking specifically of a patient suffering from a lingering illness and whose condition has steadily deteriorated. These symptoms, declares R. Unterman, cannot be regarded as definitive signs of death with regard to one who has experienced a sudden seizure. In such cases, all resources of medical science must be employed to save human life. Although he does not elaborate, R. Unterman presumably means that we may not accept our inability to detect these signs of life as conclusive evidence of their absence. R. Waldenberg, Ẓiẓ. Eli‘ezer, X, no. 25, chap. 4, no. 5, quite obviously disagrees with this view. Ẓiẓ Eli‘ezer cites the symptoms advanced by Ḥatam Sofer as reliable criteria of death in all instances. R. Waldenberg explains the numerous cases in which the patient has been restored to life following cessation of respiration as instances wherein respiration was indeed present but not perceived. The physician may, nevertheless, rely upon his determination that respiration has ceased in pronouncing death. Nevertheless, “if it is possible for him to conduct further tests in the anticipation that he may perhaps find life, certainly it is incumbent upon him to do so; however, as to the primary determining factor, with regard to this we have only the words of our Torah and the tradition of our fathers …” In the same vein, R. Chaim Yosef David Azulai, Teshuvot Hayyim Sha'al, II, no. 25, declares that when the statutory signs of death are present, it is incumbent upon us to execute burial without delay, "and if in one of many tens of thousands of cases it happens that he is alive, there does not [devolve] upon us the slightest transgression, for so has it been decreed upon us … and if we err in these signs [of death], such was His decree, may He be blessed."