To the Editor:
In their discussion of infertility counseling for Orthodox Jews, Haimov-Kochman et al. (1) note with regard to multi-fetal pregnancy reduction that one soul cannot be put aside for the sake of another and that discussion of the number of embryos to be transferred to the womb should include the religious obstacle to reduce the number of embryos later during early pregnancy.
As we have reported (2,3), senior religious authorities such as Rabbi Mordecai Eliyahu, former Chief Rabbi of Israel, and Rabbi Haim David Halevi, late Chief Rabbi of Tel Aviv, allow reducing the pregnancy to the extent necessary to ensure a good prognosis for the remaining fetuses.
Similarly, there is a spectrum of views in halakhic Judaism concerning abortion. All agree that abortion is moral and required to save the life of the mother, and all agree that abortion on demand for the simple convenience of the mother is anathema. But there is a strong position allowing abortion for “serious” considerations, especially when the resulting pregnancy will impact on the mental health of the mother who must cope with a seriously compromised child. Thus some halakhists will allow the abortion of a Taye-Sachs fetus.
Of course, good current medical practice demands making every effort to avoid the necessity of a multi-fetal reduction. Nevertheless, patients must be advised of the real possibilities, and the doctor should be available to consult with the patient’s halakhic authority in advance so that informed decisions can be made. When there is a spectrum of opinion in halakhic matters, individuals usually defer to the judgment of their local authority.
Richard V. Grazi, M.D.
Genesis Fertility & Reproductive Medicine
Brooklyn, New York
Joel B. Wolowelsky Ph.D.
Yeshivah of Flatbush
Brooklyn, New York
1. Haimov-Kochman R. Rosenak D. Orvieto R. Hurwitz A. Infertility counseling for Orthodox Jewish couples. Fertil Steril 2010;93:1816-9.
2. Grazi RV and Wolowelsky JB. Multi-fetal pregnancy reduction and disposal of untransplanted embryos in contemporary Jewish law and ethics. Am J Obstet Gynecol 1991; 165: 1268-71.
3. Grazi RV and Wolowelsky JB. New Ethical Issues. . In Grazi RV.(ed.) Overcoming Infertility: A Guide for Jewish Couples. Toby Press. New Milford, Ct. 2005.
Published online in Fertility and Sterility doi:10.1016/j.fertnstert.2010.06.055
The Authors Declined to Respond