The Lander College for Women—The Anna Ruth and Mark Hasten School (LCW), New York Medical College, and Columbia University College of Physicians and Surgeons recently hosted an innovative conference titled “The Future of Reproductive Medicine: A Jewish Perspective.”
The symposium was organized by Dr. John D. Loike of Columbia University and Dr. Ira Bedzow of New York Medical College. By allowing scientists and clinicians to modify the human genetic code, new biotechnologies have the potential to alter our lives in remarkable ways. In the future, these revolutionary technologies may be employed to prevent or correct over 6,000 disease-causing mutations, such as Tay-Sachs disease, cystic fibrosis, Gaucher’s disease, early-onset Alzheimer’s disease, and even some types of cancers.
The welcoming remarks were delivered by Dr. Alan Kadish, president and CEO of the Touro College and University System. Dr. Kadish spoke of recent findings in reproductive medicine, demonstrating that the genetics of a surrogate woman gestating an embryo could influence the genetics of the fetus. He asked, how will halachah view this scientific discovery vis-Ã -vis the ongoing debate whether genetics or gestation confer motherhood?
The complexities of IVF and pre-implantation genetic diagnosis in generating healthy fetuses was illustratively explained by Dr. Susan Lobel of Metropolitan Reproductive Medicine, a leading clinician and expert on IVF. Dr. Lobel introduced several halachic questions, including whether IVF could be used to increase the odds of a successful pregnancy by couples that are not infertile and whether IVF can be used for sex selection in order to fulfill the mitzvah of p’ru u’rvu (i.e. two children, one of each gender). Lastly, Dr. Lobel informed the audience that current IVF procedures do not necessarily require women to come into the physician’s office or hospital on the Shabbat or holidays. Such potential transgressions, Dr. Lobel explained, can be often circumvented by planned scheduling and administration of the various medications involved in IVF.
Dr. Marian Stoltz-Loike, dean of LCW and vice-president of online education, highlighted how the college provides students with the unique opportunity to learn about the interaction of medicine, science, and halachah as it pertains to new technologies. Equally important, because of their education, LCW students are enabled to compete for the best opportunities in their academic and professional pursuits.
In his presentation, Rabbi Tzvi Flaum, mashgiach and professor of Judaic Studies at LCW, emphasized that intervention in reproductive medicine is an option, not a halachic obligation, and should never be used to replace normal marital relations in creating embryos. Rabbi Flaum showed where halachah is permissive in delineating those medical situations where IVF procedures could be performed on Shabbat even though one might think there would be a violation of the laws of Shabbat. Finally, he addressed the issue of sex selection that Dr. Lobel raised, emphasizing that only when there are medical reasons to engage in IVF could sex selection be considered as a halachic option.
The topic of mitochondrial replacement therapy and gene editing was presented by Dr. Dieter Egli, assistant professor of cell and developmental biology at Columbia University and senior research fellow at the New York Stem Cell Foundation. He first provided the audience with a descriptive summary of serious medical symptoms in women who have mutations in their mitochondria. Dr. Egli outlined how mitochondrial replacement therapy has the potential to provide a safe procedure for these women to have healthy children, free of such mutations.
In the second part of his lecture, Dr. Egli presented his thoughts on gene-editing technologies, such as CRISPR, which offer a possible technique for correcting genetic diseases. Dr. Egli stressed that more research must be done to examine the potential side effects of technologies that alter the human genome. He also expressed his concern that our government’s reluctance to fund this research in humans will delay medical applications of these genetic technologies, and stressed the importance of private philanthropy.
Rabbi Dr. Moshe Tendler, shlita, one of the leading poskim and senior roshyeshiva and professor of both biology and of medical ethics at Yeshiva University, reviewed with the audience the many halachic and Jewish philosophical implications of the new technologies that Dr. Egli presented. Rabbi Tendler reiterated that Gâ€‘d instructs human beings to serve as partners in the creation process, which means that new genetic research areas are to be pursued with great vigor and care, given their potentially tremendous medical benefits.
Rabbi Tendler also emphasized the social responsibility of all Jews to contribute to general society and to volunteer for clinical trials for the benefit of humankind. He concluded his presentation with an in-depth explanation of the efficacy of prayer. He stated that the laws of nature are divine and immutable and that people cannot rely on miracles that violate natural law for cures.
Rather, we must understand the importance of prayer as we ask Gâ€‘d for da’as (knowledge) in our ShemonehEsreih. He interpreted the prayer for da’as to mean that we are asking Gâ€‘d to give human beings the knowledge to expand our understanding of medicine, to choose the correct therapy, and to select the most appropriate doctor in treating any critical disease. Throughout his talk, Rabbi Tendler emphasized the need in bioethics to recognize the principle of respecting human sanctity and not allow human autonomy to dominate the other principles of bioethics.
The afternoon panel discussion started with Dr. Theodore Silver from Touro Law Center informing the audience about the secular legal issues surrounding these genetic technologies. He emphasized that, unlike Jewish law, secular legal law focuses on the obligations of a parent to the child and not on the obligations of a child to a parent. In addition, unlike Jewish law, U.S. law does not generally recognize genetics as a criterion of parenthood. He concluded his presentation by quoting the Florida court that two adults who love a child and accept responsibility of the child’s welfare should confer legal parenthood. After Dr. Silver’s presentation, Drs. Lobel, Egli, and Silver as well as Rabbis Tendler and Flaum fielded difficult questions from the audience as they discussed the bioethical and halachic boundaries of genetic technologies.
“The Future of Reproductive Medicine: A Jewish Perspective” was made possible through sponsorship from the Orthodox Union, whose engineers filmed the conference, which will be available online to all interested parties. Other sponsors included The Jewish Press, Gotham Assets Locators, HakirahJournal, Community Synagogue of Monsey, and several private donors.
The scholars at the New York conference emphasized the need for government to further support and fund, rather than limit, research, and that the ethical concerns regarding these technologies are manageable when presented within a Torah framework that highlights the sanctity of human life, the family, and the community.