"From Machon Puah"

Uterine Transplants - The Recipient

Last time we concluded discussing the halachic ramifications of uterine transplants for the donor. This procedure was recently reported with two successful transplants by the University of Gothenburg in Sweden. This week we will start to examine the halachic questions related to the recipient.
The first question is the issue of causing damage to the body, similar to the donor, as the procedure involves an operation, incision into the body etc. This can be permitted for two reasons; first, since this operation is done in a hospital setting by doctors it is not destructive and therefore is not included in the prohibition of chabala, damaging the body. Second the reason that the recipient is undergoing this procedure is in order to have children and procreate, therefore it is included within the mitzva of “pru urvu” which overrides the problem of causing damage to the body.
This is similar to the permission given to undergo cosmetic surgery which could also be considered as damaging the body. The reason that the Rabbis were lenient in the case of cosmetic surgery is that the person concerned is embarrassed about the way that they look and this is considered as though they are in actual physical pain. The Tosafot (Shabbat 50b) claims that psychological pain is the greatest pain that there is and can be treated as an illness. This rationale would apply in the case of uterine transplants as well where the recipient is willing to undergo this procedure in order to have the joy of becoming a mother.
The second concern is that of risk. The recipient is under risk for this procedure due to the surgery and the anesthetic given, but also due to the immunosuppressive drugs that need to be given so that the body does not reject the new uterus. This is considerable risk and these drugs would have to be administered for the entire time that the uterus functions in the body of the recipient for fear that the body will reject the organ. While we do give these drugs long term for transplant patients these are usually in cases of an essential organ where the benefit would outweigh the risk. The question is whether it is permitted to face this risk for the purpose of transplanting a uterus.
An expert in kidney transplants told me that he thought that the cost is too high for such a procedure, but obviously there are fertility experts who are performing such procedures and therefore must believe that the benefits are significant enough that they justify prescribing such medication. - More on this next week.

Rabbi Gideon Weitzman

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) 651-5050 (Isr). http://www.puahonline.org

• Other "From Machon Puah"
• What is a Miracle?
• Between Conception and Birth
• The Pregnancy in the Bathtub