Monday, April 9, 2018

Halacha in a Nutshell: Autopsies

Sure, let's jump right into a hot, emotional topic. Autopsies. 

A strange revelation about myself and my Jewish journey: Jewish death practices are a big part of how I got interested in Judaism. When I was young, my mother became certified to sell burial plots. (Yes, apparently you have to get a particular education and license for that. Given the potential for elder abuse, I assume that's why.) So from a relatively young age (somewhere between 10-12), I knew a lot about American death practices, and they horrified me as a general rule. I assumed we just buried people respectfully in a box and they eventually decomposed into dirt. We don't. In fact, many regulations exist to prevent exactly that: keep our decomposing bodies from mixing with the earth and entering the water table. Given the chemicals we use to preserve the body for several days or weeks before an open casket funeral, that's probably a good idea honestly.

So I began thinking about what I wanted for myself when I one day died. And I became very vocal about these issues with my parents and any time it came up in conversation. I used to tell people "just throw me respectfully into a ditch." Don't tell the government or I might end up in a steel box surrounded by concrete. 

When I first discovered Judaism online at 19, some of the mourning practices were given as part of the introduction to Judaism. And I've found that's common among introductions; at least some death practices are given very early in your exposure to Judaism as a general rule. Those spoke to me, and they reflected the deep feelings about death I had cultivated so many years before. It was the first confirmation that maybe Judaism is where I should be.

But autopsies. Those are complicated. And I continue to have complicated feelings about them. 

In short: autopsies are generally prohibited. This is to respect the person and their body. Routine autopsies are seen as unnecessary and disfiguring for no purpose. And honestly, I agree with that, even though I'd never considered it before. After years of Law & Order, I guess I assumed every body always gets an autopsy and that this is both normal and necessary. But it's not. The family can say no in almost every case. (I'm told there are some states with laws that can mandate an autopsy over objections, which makes sense when you think about how many murders are committed by family and romantic partners.)

But what if foul play is suspected? An unexpected death of someone who seemed healthy? What about when a young person passes away without warning and maybe had a congenital health issue that could also affect siblings still living? What is there's a public health concern, that maybe this person is part of a larger health outbreak like food contamination or tampering? What if you need to rule out suicide under unusual circumstances for the purposes of qualifying for a life insurance policy to care for the person's children? (We can discuss suicide in halacha another day.) These are very complicated questions, and families have to make decisions quickly and under intense emotional circumstances. Many families say no to autopsies far beyond a line that I'm personally comfortable with. And that is their right. I imagine that different rabbis could come to somewhat different conclusions too, if presented with a specific shailah. But we all agree that the overarching concern should be that we must remember this is a person and they should be treated with the utmost respect. All questions should be viewed from that perspective. Seek out a posek to discuss your case if you're ever in this situation. Preferably, seek out one you know and trust already, but you can always call the rabbinical associations and they will help you.

How does this affect you? Please please please draw up a living will (also called an advance directive or advance health care directive). This is an important idea for so many reasons. Only you can answer the questions of what your priorities are at the end of life or when you're incapacitated. Jewish law impacts almost all these questions. You can learn more about them from the orthodox perspective at this PDF from the OU, and it has links to sample living wills you can model your own on. Everyone old enough to be reading this blog post and understand it should consider these questions and consider making a living will. That's not just me talking as a lawyer (and you can do this with no lawyer needed - just a notary usually). I'm saying this as a child who has had to make these decisions for a parent who could not communicate with me. This is one of the best gifts you can give your family, and Gdwilling, you should be 120 years old before they realize what an awesome gift it was.

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