Baby On Board

Approximately one in every five Ashkenazi Jews is a carrier for one of 10 debilitating genetic disorders. The knowledge base in genetics and genetic technology has grown exponentially in last few years, and it is now possible to screen for 10 disorders that occur with higher frequency in the Ashkenazi Jewish community.

Almost all segments of the Jewish community support carrier screening to prevent the birth of affected children. The increase in the number of genetic tests now being offered is bound to identify more carrier couples, who can choose not to give birth to a child with one of these debilitating if not fatal disorders. But where does halachah (Jewish law) stand on the issue of high-tech reproductive technologies?

In an article published by the Rabbinical Council of America, Rabbi Michael J. Broyde writes that “Jewish law insists that new technologies—and particularly new reproductive technologies—are neither categorically prohibited nor categorically permissible.

“Rather, they are subject to a case-by-case, method-by-method analysis of the consequences of the new technology as well as the methodology employed, and both need to be permissible for new technology to be proper in the eyes of Jewish law.”

According to Jewish tradition, once a medical treatment is proven to be effective, its use to heal the sick and save lives is mandatory. Jewish law and ethics permits “cutting edge” medical treatments to be used if they are designed to benefit patients, although it is not mandatory to do so.

Furthermore, even if there is the possibility of abuse of a new treatment or technology, in the absence of clear evidence of harm, improving the human condition through medical care takes precedence and such treatments should be used.

For couples found to be carriers of a genetic disorder, the halachic implications of reproductive technology may become very real. Those implications vary, however, depending on the reproductive options under consideration by carrier couples.

What carrier couples concerned about Jewish law should understand, first and foremost, is that choosing not to have children is not an option according to halachah.

These couples must, then, consider the reproductive technologies available to them that are sanctioned by Jewish law. Couples should remember that many of the questions they face can be answered only on a case-by-case basis, and thus they should consult with a competent rabbinic authority when facing these very personal, very controversial issues.

If any of these reproductive technologies are not effective for any reason, then adoption is a possible option.

One of these controversial issues involves the efficacy of prenatal testing for carrier couples who are concerned that their child may be affected with a very debilitating or even fatal Jewish genetic disorder.

These couples can opt for chorionic villus sampling (CVS), where a placental cell sample is obtained between 10-12 weeks of gestation, or amniocentesis, which involves taking a sample of the amniotic fluid after the 16th week of pregnancy.

Halachic authorities disagree on the permissibility of these tests if the intended outcome is the therapeutic abortion of an affected child.

For example, Rabbi Gedalia Dov Schwartz stated that “According to Rav Eliezer Waldenburg, prenatal testing such as amniocentesis is permissible to clarify if the fetus has some major genetic disease. He takes into very serious consideration the mental anguish of the mother if such a diagnosis is made. He is of the opinion that an abortion is permissible before the seventh month of gestation. However, this opinion is opposed by Rav Moshe Feinstein, who writes that it is not permitted although the child born will be afflicted with a genetic disease that will be fatal after a year or two.”

According to Jewish law, it is relatively clear that pre-embryos are not considered to be human life forms. As Rabbi Gedalia Dov Schwartz noted, an embryo does not warrant protection as a form of human life until 40 days after conception.

Because preimplantation genetic diagnosis (PGD) takes place before embryos are implanted in the womb, consensus within the halachic community is that not all embryos tested by PGD need be implanted.

Assisted reproductive technologies such as artificial insemination, egg donation, and surrogate motherhood may bring into question the Jewish identity of the child being conceived through these methods.

Therefore, couples considering these or any alternative methods of conception should consult a competent halachic authority while they are exploring their reproductive options.

Rabbi Gedalia Dov Schwartz, of the Chicago Rabbinical Council, reviewed this article.

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