July 19, 2024
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July 19, 2024
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Touro Symposium Addresses Controversy Over Reproductive Medicine

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 entitled “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 and featured a diverse panel of experts in their respective fields. The conference touched upon a variety of topics including in vitro fertilization (IVF) and newly emerging genetic technologies such as gene editing and mitochondrial replacement therapy. By allowing scientists and clinicians to modify the human genetic code, our holy human grail, these 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.

At this conference, people of all ages and genders heard the legal, medical and halachic experts discuss the benefits and risks of these new reproductive technologies, as well as the ethical barriers that they present. With refreshing contrast to the majority of the public press that raise apprehension over the new genetic technologies, the consensus among the experts at this conference was that the Jewish tradition focuses not on fear but rather on the suffering of infertile couples. Furthermore, Judaism takes a lead position in explicating the positives in promoting basic research in these new biotechnologies to ensure the development, within a halachic framework, of appropriate therapeutic interventions.

The welcoming remarks were delivered by Dr. Alan Kadish, president and chief executive officer of 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 raised a question that, among others, was repeated throughout the conference and set the stage to address other legal and halachic issues of new genetic technologies: How will Halacha view this scientific discovery vis-a-vis the ongoing debate whether genetics or gestation confer motherhood?

The complexities of IVF and preimplantation genetic diagnosis (PGD) 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 who are not infertile and whether IVF can be used for sex selection in order to fulfill the mitzvah of pru u’ruvu (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.

As she introduced Rabbi Tzvi Flaum, mashgiach and professor of Judaic Studies at the Lander College for Women, Dr. Marian Stoltz-Loike, dean of LCW and vice president of Online Education, emphasized the importance of LCW hosting such an innovative, multidisciplinary conference. Dr. Stoltz-Loike highlighted how LCW provides students with the unique opportunity to learn about the interaction of medicine, science and Halacha 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 Flaum emphasized a major principle in Jewish law—that intervention in reproductive medicine is an “option,” not a mandatory halachic “obligation” and should never be used to replace normal marital relations in creating embryos. He also addressed many critical halachic issues that are rarely discussed in reproductive medicine. Rabbi Flaum showed where Halacha 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 suffer from mutations in their mitochondria. Dr. Egli outlined how mitochondrial replacement therapy has the potential of providing 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 technique in 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 human beings 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 rosh yeshiva 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 the important obligation that God 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 tremendous potential 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 the prayer as we ask God for da’at (knowledge) in our shemoneh esrei. He interpreted the prayer of da’at to mean that we are asking God to give human beings the “knowledge” to expand our knowledge 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 Rabbi Tendler and Rabbi Flaum fielded difficult questions from the audience as they discussed the bio-ethical 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, Hakirah Journal, Community Synagogue of Monsey and several private donors.

In conclusion, the tone of this conference differed dramatically from the summit held in Washington, D.C., the previous week on gene editing. At the end of the summit, the organizers in Washington issued clinical and ethical words of caution:

“It would be irresponsible to proceed with any clinical use of germline editing unless and until (i) the relevant safety and efficacy issues have been resolved … and (ii) there is broad societal consensus about the appropriateness of the proposed application.”

In contrast, the scholars at our 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 kedusha, the sanctity, of human life, the family and the community.

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