"From Machon Puah"

Designer Babies

In 2004, American author Jodi Picoult’s novel “My Sister’s Keeper” became a bestseller (it has since become a major motion picture). The main character of the novel was born to her parents in their attempt to provide umbilical cord blood for the treatment of an older sister who was suffering from leukemia. Incredibly, the story is based on true scientific realities; Pre-implantation Genetic Diagnosis (or “PGD”), the technology for the creation of such a child exists and is in regular use today. For example, we recently participated in Shaarei Tzedek hospital’s celebration of the birth of their 100th child conceived through PGD in their PGD lab.

We have previously discussed ethical, moral and halachic issues pertaining to the appropriate use of this technology. With this specific use of PGD, the deliberate engineering of a child to be used as a source of donor materials to save another person’s life, additional halachic issues arise.

In the 10th Annual Puah Conference on Medicine and Halacha held in Jerusalem last month, Rav Yaakov Ariel, the Chief Rabbi of Ramat Gan discussed this issue and raised a number of questions, both from the perspective of the mother/parents of the children as well as that of the unborn child.

In normative situations, couples conceive and bear children for the purpose of having a family under the framework of the mitzva of P’RU URVU (procreation). As such, each pregnancy, be it natural or physician assisted, is undergone with the goal of having a child as a member of the family. The establishment of families in this framework is the reason that women are permitted to put themselves in the danger of childbirth, which does have medical risks (albeit less so in today’s age).

In this case, the pregnancy and childbirth is being undergone not for the purpose of procreation, but rather for the purpose of saving the life of the older sibling. The treatment requires injections to stimulate egg production, the extraction of eggs and other invasive actions that entail some measure of risk. Is the mother halachically permitted to endanger herself with this pregnancy for a purpose other than procreation?

Furthermore, as regards the unborn child, although the initial treatments may consist of utilizing umbilical cord blood, there is no guarantee that they will be limited to such. In the fictional case of the book, the initial treatments failed and the sibling was thrust into serving as a repository of organs and materials for the treatment of her sister’s illness. Are we permitted to put a child under the age of adulthood (bar/bat mitzva) in danger in order to save someone else’s life?
As regards the parents, Rav Ariel noted that although mitzvot are generally fulfilled only when there is a clear intention to fulfill the mitzva, this may not apply in this situation. When discussing the mitzva of procreation, many opinions, such as the Minchat Chinuch, maintain that conceiving, bearing and giving birth to the child are not the requirements of the mitzva. They maintain that the mitzva is not in the action of creation, but rather in the result, the existence of the child.

As such, the motivation of the parents for creating the child are irrelevant halachically. Although they are acting primarily to save their sick child, the future existence of the sibling would fulfill the mitzva of procreation. Accordingly, the same dispensation that allows any woman to become pregnant and deliver a child (with or without fertility treatments) applies in this case and the pregnancy is permitted halachically.

Next week, we will discuss the ethical and halachic ramifications of forcing a newborn infant or minor child to serve as a donor in medical treatments used to save another person’s life.

The Puah Institute is based in Jerusalem and helps couples from all over the world who are experiencing fertility problems. Puah offers free counseling in five languages, halachic supervision, and educational programs. Offices in Jerusalem, New York, Los Angeles and Paris. Contact: (02) 6515050, (Isr) - 718-336-0603 (US) puahonline.org

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