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Bioethics

Answer By: 
Rabbi Larry Sernovitz

Dear Rabbi,
We are planning our wedding. We are not convinced of the need to get tested for Jewish Genetic Diseases before we get married. We have too much to do before the wedding anyway and we just don't have time to get it done. Whatever our carrier status happens to be, it isn't going to prevent us from getting married so why should we get tested anyway?


Planning for a wedding can be a very time consuming process, especially for a young couple. All of this can be extremely overwhelming. However, genetic testing should not be tossed off the list just because there are so many other things to be done. Getting a simple blood test can make all the difference. If one partner is a carrier of any of the 19 Jewish genetic diseases, the other partner should be screened as well. If both partners are carriers, there is a 25% chance the couple will give birth to an affected child. Once you have this knowledge, you can make intelligent decisions regarding the future. This can include in-vitro fertilization, virtually eliminating the chances of having an affected child, or having a natural pregnancy with the knowledge that a tough decision might have to be made down the road. If this is the chosen route, having a CVS test (Chorionic villus sampling , a prenatal test that detects chromosomal abnormalities such as Down syndrome as well as genetic diseases) completed around 11-12 weeks can identity genetic diseases in the fetus and give you the knowledge to make an informed decision.

Here is what you can do:

Get in touch with the Victor Center for Jewish Genetic Diseases. They have centers in Philadelphia, Boston, and Miami. Their website is filled with useful information. They will give you all the information you need to make informed decisions and to get tested.

Additionally, for information about genetic counselors nationwide, you can visit the National Society of Genetic Counselors website for a listing of genetic counselors and screening centers nationwide. All counselors are accredited and are excellent resources for you.

Rabbi Larry Sernovitz serves Temple Emanuel in Cherry Hill, NJ.

Topic: Bioethics, Birth
Answer By: 
Rabbi Billy Dreskin
A person wearing a doctor's coat and holding a heart made of felt

Jewish law does, in fact, permit organ donation! Whatever you have heard, whatever you thought you learned, set that all aside. Jewish law permits us to sign our donor cards and, when someone we love dies, to use their body to save other lives.

Why then the persistent misperception that Jewish law opposes organ donation? There are four legal concerns Judaism confronts in determining whether or not to permit organ donation. Each concern, on the surface, appears to take a position of opposition. This is probably why so many of us conclude – even as Reform Jews – that we cannot sign donor cards. But follow the discussions to their conclusions and you will understand that, even among Orthodox Jews, organ donation is permissible.

  1. The first area of concern is how one treats the body of someone who has died. Judaism views the human being in life as having been created b’tzelem Elohim, in the image of God. Does it desecrate the human body to make incisions in it after a person has died? The Talmud makes it clear1 that to do so unnecessarily and for no good purpose would violate the principle of k’vod ha’met, honoring the dead. But if such a post-mortem examination might save a life, the Talmud teaches us that we should indeed examine that body by all means available.
     
  2. The second area of concern is what responsibility we have for burying a person’s entire body. This area constitutes the Orthodox community’s primary concern regarding both autopsy and organ donation. Traditional authorities that discuss the burial of a person’s entire body indicate that it is done only to prevent the ritual contamination of kohanim, members of the Jewish community’s priestly class, the group that in Temple times was in charge of all the sacred rituals. In the twelfth century, Moses Maimonides, one of the all-time greatest authorities of Jewish law, differentiated between parts of the body that render the kohen impure, and parts of the body that do not.2 Maimonides determined that internal organs do not transmit ritual impurity, and therefore, while we should not frivolously remove any internal organs, we have no obligation to bury them with the body.Further, with the innovation of organ donation, Orthodox Jewish authorities of this century have determined “that when a part of a body is taken by a surgeon and put into a living body, it becomes part of that living body. Its status as part of the dead which needs to be buried is now void.”3 The kohen need not worry about contamination.
     
  3. The third area of concern is a general principle that the body of the dead may not be used for the benefit of the living.4 It would certainly seem clear to us that organ donation would be in direct violation of such a principle; removing part of a body from someone who has died and giving it to someone who is still living certainly appears to be for the benefit of the living. But upon close examination of the word hana’ah, benefit, we find that the Talmud is, in fact, discussing cannibalism, which clearly is off-limits in our tradition. To save a human life by way of surgical transplantation, all Jewish authorities agree, does not fall into this category.
     
  4. The final area of concern is in defining the precise moment of death. This has been an important issue in Jewish tradition because, as I mentioned earlier, we are required to bury our dead as quickly as possible. For thousands of years, Jewish law has understood the moment of death as being when breathing and heartbeat have stopped.5 These are understandable criteria for past generations who, in the absence of modern technology, were limited in the resources available to them for determining when death had occurred. Today however, in an age when bodies continue to breathe and hearts continue to beat because of artificial respirators, death is now defined by the cessation of all brain activity.

What it all comes down to is this. By and large, the Jewish legal tradition has never opposed organ donation. For nearly 2,000 years, it has laid the groundwork in favor of such actions. The Orthodox community is in the final stages of sanctioning it altogether. And the Conservative, Reconstructionist and Reform movements have supported and encouraged it for many years now.

Sign your donor card. And let your family know about it.

  1. Hullin 11b.
  2. Yad, Hil. Tumat Hamen 2.3.
  3. American Reform Responsa (CCAR), page 295.
  4. Sanhedrin 47b.
  5. M. Yoma 8.5; Yad, Hil. Shab. 2.19; Shulkhan Arukh, Orah Hayim 329.4.

Rabbi Billy Dreskin, Woodlands Community Temple, White Plains, NY.

Topic: Bioethics
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