Cedarhurst, N.Y. — In the 18th century, when Edward Jenner successfully tested the world’s first vaccine, rabbis pondered the halachic (Jewish legal) permissibility of this discovery.
While smallpox was decimating Europe’s population, and Jenner’s vaccine against it was viewed by many as a miracle, it nevertheless posed halachic issues. The vaccine was injected into healthy individuals to prevent a possible illness, yet the healthy individuals could potentially die from the vaccination.
Despite the enormous potential health benefits, some rabbis initially rejected the vaccine. Others cautiously accepted it.
Rabbis of today find themselves in a similar position. We stand on the cusp of possibly the most extraordinary advances in the history of medicine — cures for diabetes and Alzheimer’s, an endless supply of organs for transplantation. The focus of all this excitement is one microscopic cell, called a stem cell.
The mere hope, or even realization of a cure, despite the global ramifications, does not obviate the need for rigorous halachic analysis, nor does it pave a fast and easy path to halachic approval. The same rigorous analysis must be applied here, irrespective of the results. As to whether halachic approval equals good public policy, that is another matter.
There are a number of possible sources for this pleuripotent (i.e., having potential to grow into many different kinds of cells) stem cell, each being explored for its research potential. Two sources, adult stem cells and umbilical cord blood stem cells, present no halachic problems as a source of research. Two other sources, however, require independent analyses.
Stem cells can be derived from aborted fetal tissue. A study in a recent issue of Science magazine shows that human fetal stem cells injected into the brain of a monkey while in its mother’s womb can become integrated into the fetal brain, raising the possibility of repairing brain abnormalities in human fetuses.
The use of fetal tissue for medical research is not new, and when the concept was initially introduced, it was immediately addressed by rabbinic authorities. While halacha generally opposes abortion, there is no intrinsic halachic prohibition to use already aborted tissue if intended for a potentially life-saving purpose.
Nevertheless, a policy allowing such use may induce a rise in halachically objectionable abortions. Therefore, in this case, halachic approbation is not necessarily equated with good public policy.
Another contentious source of stem cells are those derived from fertilized embryos. Scientists generally believe that this source of stem cells has the greatest research potential.
Other religions oppose any research on embryos, considering the in-vitro embryo to have a legal status of life, no different than that of an embryo in-utero or a living human being. According this position, such embryos cannot be used for research, cannot be destroyed, and should, if possible, be implanted in women for gestation and birth.
The preponderance of halachic opinion does not concur with this position and does not accord a fertilized embryo the status of a living human being.
The varying legal status of the different stages of the developing embryo is best highlighted by a case in which saving the embryo conflicts with the observance of the Sabbath. The Sabbath laws can and must be violated to save a human life. What about to save the life of a developing embryo?
The rabbis of the Middle Ages debated this, and we, today, would indeed violate the Sabbath in such a case due to the potential life of the fetus. Does this logic extend to the fertilized embryo in a petrie dish?
According to majority rabbinic opinion, the so-called pre-embryo does not have the legal status of even potential life. Consequently, the Sabbath cannot be violated to save it. Moreover, no violation is incurred with the embryo’s destruction. It therefore follows logically that there would be no objection to using an embryo for research purposes.
Creating embryos for the explicit purpose of stem cell research, as recently performed by the Jones Institute, presents unique Jewish legal concerns, and requires further analysis. However, the use of existing surplus embryos from in-vitro fertilization procedures, many of which are destined for destruction, and of which thousands currently exist, poses no intrinsic legal problem (consent issues notwithstanding).
Moreover, whereas the use of aborted fetal tissue raises concerns about increasing illicit abortions, the use of surplus embryos yields no such concern. The excess embryos are so plentiful that inducements to create embryos explicitly for research would be minimal, at best.
Therefore, given the extraordinary medical potential for stem cell research on surplus embryos, coupled with the absence of any major halachic objections, it appears that, in this case, halachic imprimatur does in fact beget good public policy. We should support research with stem cells derived from existing fertilized embryos and oppose research on aborted fetal tissue.
Throughout, caution should be exercised to prevent the devaluation of human life. In this vein, we should also encourage support for research on adult and umbilical cord stem cells, which poses no ethical problems whatsoever, and does not potentially erode the status of human life.
Former Milwaukeean Rabbi Edward Reichman, M.D., is assistant professor of emergency medicine and assistant professor of philosophy and history of medicine at the Albert Einstein College of Medicine at Yeshiva University, where he teaches Jewish medical ethics.
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