22-28 Apr

Q: Does halakha sanction eugenics?

ABSTRACT

Genetic screening, gene therapy, and other applications of genetic engineering for the treatment, cure, or prevention of disease fulfills the bibilical mandate to heal. If Tay-Sachs disease, diabetes, hemophilia, cystic fibrosis, Huntington’s disease, or other genetic diseases can be cured or prevented by “gene surgery,” it is permitted in Jewish law.

Genetic premarital screening is encouraged in Judaism for the purpose of discouraging at-risk marriages for a fatal illness such as Tay-Sachs disease. Neonatal screening for treatable conditions such as phenylketonuria is certainly desirable and perhaps required in Jewish law. Preimplantation screening and the use of only “healthy” zygotes for implantation into the mother’s womb to prevent the birth of an affected child is also probably sanctioned in Jewish law. Whether or not these assisted reproduction techniques can be used to choose the sex of one’s offspring to prevent the birth of a child with a sex-linked disease, such as hemophilia, has not yet been ruled out by modern rabbinic deciders.

Prenatal screening with the specific intent of aborting an affected fetus is not allowed according to most rabbinic authorities, although a minority view permits it “for great need.” Not to have children if both parents are carriers of genetic diseases such as Tay-Sachs is not a Jewish option. Preimplantation screening is preferable. All screening test results must remain confidential. To improve physical traits and characteristics such as height, eye and hair color, facial features, and the like, is frowned upon in Judaism, if it serves no useful medical or psychological purpose. Cloning microorganisms for the benefit of mankind, such as the synthesis of insulin, growth hormone, and a wide variety of therapeutic substances, to treat and cure illnesses is certainly permissible. But to unleash superbacteria into the world for nontherapeutic and perhaps even evil purposes is totally contrary to Jewish ethics.

Rabbi Akiva suggests that we must play an active roll in changing the fate of those challenged. When possible, we should be involved in imitatio Dei and act upon the suffering confronting us. Just as G-d has the power to heal and end suffering, when we have the capacity, we are obligated to do the same. One is forbidden to take a providential view on life to suggest that any person's suffering is G-d's will and thus ordained. In the case of infertility, we are to recognize the opportunities given to us by science, and as agents of G-d, use these opportunities to realize our dreams for overcoming the tragedy of infertility….

While a married couple having difficulty conceiving may use the gifts of science, it is important to recognize the risks. Halakha responds to those risks by not demanding that couples engage in infertility treatments in order to have children. If a couple wishes to forego these difficult procedures, halakha understands and supports such a decision. This is evident from a Tosafot in Pesahim. Tosafot suggests that a male who needs to undergo medical procedures in order to become circumcised is not mandated to do so-even though without the procedure the individual will be unable to participate in several mitsvot (Torah commandments) including the eating of the Paschal lamb).

BIO
Fred Rosner, MD, FACP, is director of the Department of Medicine of the Queens Hospital Center in Jamaica, New York, a major teaching campus of New York's Mt. Sinai School of Medicine, where he serves as professor of medicine. He is a Diplomat of the American Board of Internal Medicine and a Fellow of the American College of Physicians. He is also visiting professor of medicine at his alma mater, the Albert Einstein College of Medicine of Yeshiva University.

Dr. Rosner is the recipient of the American Medical Association's Isaac Hays, MD and John Bell, MD Award for Leadership in Ethics and Professionalism; the Maimonides Award from the Michael Reese Medical Center and Chicago College of Jewish Studies for Notable Contributions to the Field of Medicine and Judaica; the Bernard Revel Memorial Award from the Yeshiva College Alumni Association for Distinguished Achievement in the Arts & Sciences; the Maimonides Award of Wisconsin for Distinguished and Extraordinary Service to Learning & Science; a medal from the Ben-Gurion University in Beersheba; and the Lawrence D. Redway Award for Excellence in Medical Writing from the Medical Society of New York.

Listed in a number of prestigious Who's Who publications, Dr. Rosner is an international authority and lecturer on medical ethics. He has helped found and serves on a number of bioethics committees; he reviews manuscripts for and serves on the editorial board of a number of professional medical journals. He has published thirty-six books, written chapters by invitation in several dozen books; his bibliography has nearly nine hundred items. He is author of six widely acclaimed books on Jewish medical ethics, including Modern Medicine and Jewish Ethics (Ktav, 1991), Medicine and Jewish Law I and II (Jason Aronson, 1990 and 1993), and Pioneers in Jewish Medical Ethics (Jason Aronson, 1997). Other books include: an English translation of Julius Preuss's classical reference work Biblical and Talmudic Medicine (reprinted in 1993); the Encyclopedia of Medicine in the Bible and the Talmud (Jason Aronson, 1999); and many books on the great Torah authority and physician Moses Maimonides, including a Medical Encyclopedia of Moses Maimonides (Jason Aronson, 1998).

rosnerf01@hotmail.com

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