Jewish Medical Ethics From Stem Cells to Organ Transplants Aaron H. Chevinsky, MD FACS Chief, Surgical Oncology Morristown Memorial Hospital Co-Director - Carol G. Simon Cancer Center Clinical Professor of Surgery – UMDNJ/NJMS
Jewish Medical Scholars Rav Moshe Feinstein, The Igros Moshe (1895-1986 ) Rav Yosef Kairo, The Bais Yosef , author of the Shulchan Aruch (1488-1575) Rav Moshe Isserles, The Rama (1530-1572) The Rambam, Rabeinu Moshe Ben Maimon (1135-1204) R’ Eliezer Waldenberg, The Tzitz Eliezer (1917-2006) R’ Moshe Tendler Yeshiva University Son-In Law of R’ Feinstein Lord R’ Immanuel Jacobovits Chief Rabbi of Great Britain (1921-1999) Dr. Fred Rosner
You’re very selfish Louis. Those Stem Cell Lines were meant for people who have lost their organs
Each stored embryo is a stem cell debate Updated 1/30/2007 4:22 PM ET What would you do with excess embryos? Guidelines for stem cell research kindle controversy- CNN 8/24/00 Research avenue adds fuel to stem cell controversy July 18, 2001 Posted: 3:15 p.m. EDT (1915 GMT) -CNN A human embryo in its earliest stages of development is made up of undifferentiated stem cells. UConn plans to build stem cell institute By Scott Whipple, Herald Press Staff 02/11/2007 Stem-cell researchers look beyond the embryo By Joyce Howard Price THE WASHINGTON TIMES February 11, 2007
“ mayim b’alma” – mere water. To use a surplus pre-embryo for medical research that will save a life is not halachically prohibited (the Beth Din of America made this point in a ruling on August 21, 2001).
“ Pikuach Nefesh” – We are obligated to save lives
Abortion for the sole purpose of harvesting stem cells is forbidden
Abortion allowed only to “Save” the mother
Abortion generally not allowed for genetic abnormalities
Some Poskim allow abortion up to 40 days for this
Stem Cell Research by Rabbi Yitzchok A. Breitowitz (2005) Stem Cell Research in Jewish Law by Daniel Eisenberg, MD (2001) Stem cells and halacha by Rabbi Raymond Apple
Genetic Screening Causes Controversy by Aaron Klein Dor Yeshorim, an international genetic testing program operating within the Jewish community, was brought to Yeshiva University by YCSC on Tuesday March 10, giving students an opportunity to utilize its services. The program is aimed at couples who wish to get married, and determines their genetic compatibility by screening the blood of each individual and testing for evidence of unexpressed (recessive) genetic diseases.
Man is not permitted to cause needless pain to animals, but man is given dominion over them
This is allowable (Rabbi Dr. Moshe Tendler)
Even from nonkosher animals (Pig Heart Valves)
Artificial or Synthetic Organs
Heart valves, artificial joints, synthetic skin
Dialysis and cardioplumonary bypass
It is a mitzvah to donate organs either when alive or after death ( Midat Chasidut )
Harvard Ad Hoc Committee on Brain Death In 1968, this committee of the Harvard Medical School published a report describing the following characteristics of a permanently nonfunctioning brain, a condition it referred to as "irreversible coma," now known as brain death : Unreceptivity and unresponsitivity- -patient shows total unawareness to external stimuli and unresponsiveness to painful stimuli; No movements or breathing- -all spontaneous muscular movement, spontaneous respiration and response to stimuli are absent; No reflexes--fixed, dilated pupils; lack of eye movement even when hit or turned, or ice water is placed in the ear; lack of response to noxious stimuli; unelicitable tendon reflexes. In addition to these criteria, a flat (EEG) was recommended. The committee also noted that drug intoxication and hypothermia which can both cause reversible loss of brain functions should be excluded as causes. The report was used in determining patient care issues and organ transplants. The condition of irreversible coma, i.e., brain death, needs to be distinguished from the persistent vegetative state , in which clinical presentations are similar but in which patients manifest cycles of sleep and wakefulness. [See President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Defining Death (Washington, DC: U.S. Government Printing Office, 1981)].
Cessation of both respiration and cardiac activity
R’ Immanuel Jacobovits (1968)
“ The classic definition of death as given in the Talmud and Codes is acceptable today and correct. However, this would be set aside in cases where competent medical opinion deems any prospect of resuscitation, however remote, at all feasible.”
Rosner, Fred – Biomedical Ethics and Jewish Law - 2001