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Dec. 1, 2006
Medicine and halachah meet
Fertility expert discusses the fine line of observant treatment.
MOREY ALTMAN
Are fertility doctors playing God? Dr. Richard Grazi is willing
to concede there's some truth to the accusation.
"Doctors always play God to some extent," said Grazi,
who will speak in Vancouver Dec. 10. The very fact that conception
can occur in a laboratory is just one of many areas of potential
conflict between the dividends of reproductive medicine and the
qualifications of halachah (Jewish law).
Grazi will discuss infertility and Judaism as the keynote speaker
at a seminar called Overcoming Jewish Infertility: A Community Approach.
The event is the result of a new initiative between Jewish Family
Service Agency and the Rabbinical Association of Vancouver, to help
Jewish couples address the issue of infertility. The seminar will
also feature a panel discussion between Grazi and Rabbi Don Pacht,
principal of Vancouver Hebrew Academy, Dr. Cirelle Rosenblatt, a
clinical psychologist who has specialized in counselling infertile
Jewish couples, and Yvonne St. Pierre, the financial manager of
Vancouver's Genesis Fertility Clinic. The seminar will examine such
issues as the ways in which new developments in reproductive medicine
affect observant Jewish couples and available resources for couples
affected by infertility.
As an Orthodox Jew and a reproductive specialist for 20 years, Grazi
is uniquely qualified to speak on the subject. He was attracted
to the field when it was still in its infancy. "Reproductive
medicine is a translational science, meaning that advances in science
are rapidly adapted to medical practice," he said in an interview.
"Because it represents the convergence of so many fields –
surgery, embryology, human development and genetics, molecular biology,
to name but a few – it is to my mind the most exciting field
of medicine."
Grazi is currently the director of reproductive endocrinology and
infertility at Maimonides Medical Centre and the founder of the
Genesis Fertility and Reproductive Medicine Centre in Brooklyn,
N.Y. (which is unconnected to the Vancouver Genesis clinic). He
is also the author of two books on infertility and Judaism, including
last year's Overcoming Infertility: A Guide for Jewish Couples.
The book outlines substantial updates on recent technological breakthroughs
and treatments.
"Keeping a book of this type current is very much like hitting
a moving target," said Grazi, adding that the greater challenge
was actually dealing with halachic opinions. "Writing any text
that attempts to present a uniform Jewish viewpoint is fraught with
danger," he observed. "The hazards include being offensive,
overstepping boundaries and just getting it wrong. With this material,
in particular, there are strong viewpoints among halachic authorities
that can be diametrically opposed. The purely medical part, of course,
was easier, because I deal with it every day."
Subjects discussed in the book include the rabbinic understanding
of conception, the rabbinic and medical partnership, and aspects
and treatment of female and male infertility. It also includes an
essay by the late Rabbi Joseph Soloveitchick on adoption.
Infertility can be caused by a number of factors, including physiological
complications, environmental conditions and lifestyle. Statistics
actually suggest that Jewish couples experience a higher than average
level of infertility because of the decision to postpone having
children until later in life, usually to pursue higher education
or for employment reasons. The infertility rate for women appreciably
rises once they're in their 30s.
At one time, the only option for infertile couples was adoption,
but, since 1978, when the first test-tube baby was successfully
brought to term, medical science has offered new alternatives. However,
many of those alternatives raise complex issues that must be considered
by observant Jews, who then must turn to rabbinic authorities on
halachah for guidance.
Although halachah generally supports the use of IVF (in vitro fertilization)
and intra-cytoplasmic sperm injection, there are aspects of medical
procedures that raise many challenging questions. Does obtaining
sperm for IVF through masturbation constitute a violation of the
biblical prohibition against the "spilling of seed"? Does
the use of donor sperm generate a legal debate over the paternity
of the child? Does a donor egg from a non-Jewish woman result in
a non-Jewish child? Can time-sensitive medical procedures be performed
on the Sabbath, even though technically, there is no life in danger?
"At the interface of medicine and halachah, the biggest overall
problem," said Grazi, "is that halachah is neither monolithic
or constant. It is, rather, diverse and constantly evolving. Because
there is no uniform voice in halachah, especially as it relates
to rapidly advancing medical issues such as fertility therapies,
there is often great confusion for Orthodox patients."
In a culture where so much emphasis is placed on family and children,
many Jewish couples experience a sense of shame, loss, anger and
depression when unable to conceive. Many couples find themselves
dealing with their infertility without traditional support networks,
a difficulty that is not lost on Grazi.
"I am impressed," he said, "by the incredible spiritual
strength and emotional fortitude that couples pursuing a solution
to their infertility typically exhibit. It is humbling to be in
the presence of many of my patients."
The seminar takes place from 10:30 a.m.-1 p.m. on Sunday, Dec. 10,
in the Schara Tzedeck Youth Auditorium. To register, call 604-257-5151
or e-mail [email protected].
Morey Altman is a Vancouver freelance writer.
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