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Are there authorities who hold that a stopped heart constitutes halachic death, but yet permit heart transplants? Stopping and taking out the recipient's heart would seem to be technically considered as causing halachic death (i.e. murder). The fact that it ultimately leads to healing or prolonging the life of the recipient (at time T2) should seemingly have no bearing on the prohibition of murder (which occurs at time T1 < T2).

[While there's a precept of violating Shabbos for someone so that he can keep more of them in the future, an analogous "kill someone so that he can live longer" principle doesn't seem to exist.]

So according to these authorities (if there are any), what is their halachic reasoning to permit stopping a recipient's heart?

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  • Wouldn't most open heart surgeries be the same issue? I don't think anyone holds that they are assur. Based on the Gemara shabbos about a person under a fallen wall, the Chacham Zvi says that death can be determined by heartbeat only if there's no breathing as well. Perhaps that's why nobody says great surgery is assur, and by extension, it wouldn't be the issue of transplants either. Reb Moshe says it was assur for other reasons
    – Chatzkel
    Commented Jul 25, 2021 at 22:20
  • If he's halachakly dead, so his children would inherit him. Maybe his wife is also freed from marraige. Bunch of other shailos would come up.
    – Shlomy
    Commented Jul 25, 2021 at 22:24
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    Open heart surgery has an artificial heart lung machine running while the bad heart is removed. Thus, he is still alive even halachically. A person whose heart has stopped and is revived by CPR is not considered halachically dead.
    – sabbahillel
    Commented Jul 25, 2021 at 23:42
  • @Chatzkel Fair point, this question could've also been about open heart surgery. But what happens if there's no breathing also - but only artificial blood oxygenation (or maybe CPR as sabbahilel said). Why should that not be halachic death?
    – user9806
    Commented Jul 26, 2021 at 0:24
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    Jewish Virtual Library points out that part of the definition is irreversible cessation. Similarly, a person on a ventilator (which is artificial oxygenation) cannot be disconnected. Thus someone on a heart lung machine is treated as still alive and must be kept on until the operation is completed and the heart and lungs functional.
    – sabbahillel
    Commented Jul 26, 2021 at 0:32

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As stated above -- halachic death would be when there's irreversible heart cessation.

However, your intuition is somewhat correct. See this related question. Once the patient's heart is removed, there is no longer a chezkas chai -- presumption of living -- and thus the odds of success have to exceed fifty percent to allow heart transplants. (Rabbi Unterman addressed them before they had met this threshold, and from what I understand they fortunately later did.) As heard in a lecture from Dr. Fred Rosner.

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