Question:
Should parents or other close relatives of soldiers or ex-soldiers who have died in a veterans' hospital consent to the request of the hospital authorities to permit autopsy?
Answer:
There are certain principles in the Talmud which are used by Rabbinic authorities in discussing the question of autopsy. First of all, it is prohibited unnecessarily to delay the burial of the dead; and also, it is forbidden to deface or to shame the dead ("nivvul" or "bizayon"). On the other hand, there is the general principle that saving a life voids all the prohibitons in the law except those of idolatry, adultery or murder. There is one specific case in the Talmud in b. Chullin IIb in which there is discussion of whether a body should be cut up for the benefit of the living, as in a case where a man is accused of murder and it is a question whether the victim was not dying anyhow. The Talmud takes for granted that to save the life of the accused it would be permitted to cut the body and investigate.
However, the Talmud does not specifically deal with the question of autopsy for the benefit of medical science which may save the lives of others, and the Shulchan Aruch does not mention at all any prohibition of autopsy.
Later authorities, beginning with Ezekiel Landau (1713-1793), deal with this question to a considerable extent. There is no doubt that the overwhelming body of rabbinical opinion would prohibit the turning over of Jewish bodies to medical schools, for there the body would be cut up completely for the sake of teaching anatomy and would never come to burial. But as for an autopsy by physicians in a hospital for the sake of discovering the cause of death in order to help other patients there is some variety of opinion. The strictest of all in this matter is Jacob Ettlinger of Altona (1798-1871) who would prohibit it entirely unless a man, before his death, agreed to turn over his body for autopsy. (Binyan Zion #170-171.) But the two classic authorities, Ezekiel Landau (in "Noda bi'Yehuda", II, Yore Deah #210) and Moses Sofer (in "Chatham Sofer", Yore Deah #336) both agree that while autopsy would not be permitted for the general advancement of medical science, merely upon the general expectation that something might be learned from the autopsy, nevertheless if there were an invalid present with that same disease who therefore might be benefited by the autopsy, then it would be permitted, for then the principle that the saving of a life voids the other commandments would definitely and specifically apply.
The Committee of the CANRA makes no general decision on this question to be applicable to civilian life, but the military situation in veterans' hospitals is somewhat different from civil life. First of all, military hospitals are very large and a vast number of patients are present in the building. Secondly, many of these patients suffer from diseases and wounds caused by the war, and, therefore, there is a great similarity in the sicknesses encountered. Hence the probabilities are very great in a veterans' hospital that there is actually present more than one patient with the same sickness as that of which this patient has died. On that basis it would seem that the conditions set by Ezekiel Landau and Moses Sofer would apply affirmatively to the veterans' hospitals. It is, of course, to be understood that the body should not be defaced more than absolutely essential and that the burial be not unduly delayed.
Inasmuch as there are grounds for religious scruples in this matter, the request coming from the hospital authorities should make it clear that they are asking for an autopsy, and instead of merely saying "scientific examination of the body is requested" they should say "scientific examination (autopsy) of the body is requested."
We are informed that the Chief Rabbinate of Palestine has entered into an agreement with the Rothschild University Hospital of the Hadassah permitting autopsy upon a number of grounds, some of which go beyond those mentioned above. It permits autopsy as does the above responsum for the purpose of saving the life of a patient, need not be within the hospital but may be outside of the hospital. Other grounds for autopsy in accordance with this agreement are when the physicians are unable to state the cause of death without an autopsy, or in the case of hereditary diseases where it is necessary to guide the families as to methods of protective caution.
The Chief Rabbinate requires a certificate from the physicians as to the reasons for the autopsy and also consultation with the rabbinate in cases of hereditary disease.
The ground for autopsy given in our responsum is that in the large veterans' hospitals where most of the sicknesses are war-caused sicknesses there is strong likelihood of a patient being present with the same disease as the deceased. This reasoning is strengthened by the broader opinion given by the Chief Rabbinate of Palestine.