May I Choose My Baby's Gender? Challenges and Opportunities of Reproductive Technology Today
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Fertility Centers of New England, Preimplantation Genetic Diagnosis (PGD)

Preimplantation genetic diagnosis (PGD) involves screening single cells from embryos for genetic diseases and chromosomal disorders. This testing is performed with in-vitro fertilization (IVF) and occurs prior to embryo transfer, before a pregnancy is established. PGD offers at-risk couples the opportunity to select embryos for transfer based on their genetic and chromosomal status. The goal of PGD is to identify abnormal embryos so they will not be transferred, leaving unaffected embryos to be selected for transfer that are more likely to make healthy, disease-free babies.

PGD can identify the presence of chromosomal translocations (rearrangements of parts of chromosomes) and single-gene disorders (genetic diseases that are the result of a single mutated gene). There are over 4,000 single-gene disorders. The most common diseases tested for are Cystic Fibrosis, Tay Sachs, Fragile X, Myotonic Dystrophy and Thalassemia.

PGD technology can also be used to determine the sex of the embryo prior to the transfer into the uterus. Sex selection is offered to couples interested in family balancing who already have at least one child.

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National Institute of Health

What are genome editing and CRISPR-Cas9?

Genome editing (also called gene editing) is a group of technologies that give scientists the ability to change an organism's DNA. These technologies allow genetic material to be added, removed, or altered at particular locations in the genome. Several approaches to genome editing have been developed. A recent one is known as CRISPR-Cas9, which is short for clustered regularly interspaced short palindromic repeats and CRISPR-associated protein 9. The CRISPR-Cas9 system has generated a lot of excitement in the scientific community because it is faster, cheaper, more accurate, and more efficient than other existing genome editing methods.

Genome editing is of great interest in the prevention and treatment of human diseases. Currently, most research on genome editing is done to understand diseases using cells and animal models. Scientists are still working to determine whether this approach is safe and effective for use in people. It is being explored in research on a wide variety of diseases, including single-gene disorders such as cystic fibrosis, hemophilia, and sickle cell disease. It also holds promise for the treatment and prevention of more complex diseases, such as cancer, heart disease, mental illness, and human immunodeficiency virus (HIV) infection.

4ד

Human Cloning: Position Paper of the Catholic Medical Association, reprinted in Issues of Law & Medicine 15:323, pp. 323-324 (2000)

The cloning of human beings would be a violation of the natural moral law. Research in cloning as it applies to man is degrading. It destroys the dignity of human nature by treating the human person as a material commodity to be manipulated according to whim and fancy.

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The BMJ. 2001 Nov 24, 323 (7323): 1240–1243.

Ethics of using preimplantation genetic diagnosis to select a stem cell donor for an existing person, Robert J Boyle

Who is harmed by allowing PGD to be performed solely for the benefit of a relative? Not the couple who wish to produce an embryo. Nor the child who would not otherwise have existed. Nor the person who receives the stem cell transplant that might save his or her life. We must avoid the trap of interfering with individual liberty by preventing such procedures for no good reason, simply out of the “genophobia” that grips much of society today. Some people object to using PGD along with in vitro fertilisation for any indication. But if these procedures are acceptable, as they are in many countries, it is reasonable to use them to both bring a new person into the world and to help save an existing life.

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Wolowelsky, J.B. and Grazi, R.V. (2007). Sex Selection and Halachic Ethics: A Contemporary Discussion. Tradition 40:1

R. Yitzhak Zilberstein, who regularly contributes responsa to the Israeli Medical Halakha Group, rejects IVF for sex selection: “[Normally] God joins with man and wife [in creating a child],” he writes “but here it is the doctor’s hand [instead].” It is simply absurd, he maintains, to consider putting aside the general halakhic concerns to allow one to bring into the world an infant which, according to some halakhic authorities has doubtful halakhic status as the father’s legal child, has doubtful status as the legal heir, and whose only certain status is that of a male or female baby. That notwithstanding, he continues, “one cannot close the door in the face of despondent people who suffer mental anguish in fear of giving birth to sick children, pressure which can drive the mother mad. Therefore, in the case of a serious genetic disease which affects the couple, it is difficult to forbid the suggestion [for genetic screening through PGD]...”

The medical use of sperm sorting for sex selection in cases of sex-linked genetic diseases such as hemophilia was confirmed by R. Shlomo Zalman Auerbach. He opposed sex selection for family balancing. Rabbinic aversion to sex selection for non-medical purposes was confirmed recently when the Israeli Ministry of Health would allow sex selection for family balancing for a couple with four children of the same sex if an ethics committee including a psychiatrist concludes that withholding such approval would cause damage to the metal health of at least one of the parents or the future child. Rabbinic authorities were quoted as condemning sex selection for personal parental satisfaction as antithetical to traditional Jewish values.

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Wolowelsky, J.B. and Grazi, R.V., Ibid.

Two idiosyncratic cases regarding sex selection offer examples of when Halakha would take a more lenient approach than the secular medical society. Both concern cases of donor sperm and each emerged from the fact that the social father is not considered the halakhic father of the child.

One case concerned the halakhic consideration of yihud, which prohibits unrelated men and women from being alone together in a closed room unobserved by a third party. Adopted children are halakhically unrelated to their social parents, and therefore some halakhists consider the prohibitions of yihud as applicable to them. For this reason, some halakhists discourage adoption in general. Other authorities argue that the deep psychological sexual taboos that exist in normal families are to be found in those families where the child was adopted at birth and therefore waive yihud considerations in such families.

In the case of donor sperm, the child is halakhically related to the mother but not to the social father. The mother has no yichud prohibitions with either a male of female child. But those who apply yihud prohibitions to adoptive families would impose them on living relationships between the social father and a female child—but not a male one. The halakhic authority who had allowed the donor sperm also insisted on sex selection for a male child to avoid yihud problems and allow for the regular social interaction common to biological families.

The second case concerned a child would not have the same status as a Kohen that the social father had. A Kohen has special public duties and rights in the synagogue. Within a religious community, it is obvious who is a Kohen and who is not. The social father here was concerned that every member of the community would thereby know that the child was not his genetic son, destroying his privacy in the matter. He therefore requested PGD to guarantee a daughter...

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Rav Soloveitchik, The Lonely Man of Faith

"The brute's existence is an undignified one because it is a helpless one... Man of old who could not fight disease and succumbed in multitudes to yellow fever or any other plague with degrading helplessness could not lay claim to dignity. Only the man who builds hospitals, discovers therapeutic techniques and saves lives is blessed with dignity." (pp.16-17)

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אמר רבא אי בעו צדיקי ברו עלמא שנאמר כי עונותיכם היו מבדילים וגו' רבא ברא גברא

שדריה לקמיה דר' זירא הוה קא משתעי בהדיה ולא הוה קא מהדר ליה אמר ליה מן חבריא את הדר לעפריך

רב חנינא ורב אושעיא הוו יתבי כל מעלי שבתא ועסקי בספר יצירה ומיברו להו עיגלא תילתא ואכלי ליה

Rava says: If the righteous wish to do so, they can create a world, as it is stated: “But your iniquities have separated between you and your God.” Indeed, Rava created a man, a golem, using forces of sanctity.

Rava sent his creation before Rabbi Zeira. Rabbi Zeira would speak to him but he would not reply. Rabbi Zeira said to him: You were created by one of the members of the group. Return to your dust.

Rav Ḥanina and Rav Oshaya would sit every Shabbat eve and engage in the study of Sefer Yetzira, and a third-born calf [igla tilta] would be created for them, and they would eat it in honor of Shabbat.

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כל דיין שדן דין אמת לאמיתו אפילו שעה אחת מעלה עליו הכתוב כאילו נעשה שותף להקדוש ברוך הוא במעשה בראשית.

Any judge who judges a true judgment truthfully, even if he sits in judgment only one hour, the verse ascribes to him as if he became a partner to the Holy One, Blessed be He, in the act of Creation.

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אמר רבא ואיתימא רבי יהושע בן לוי אפילו יחיד המתפלל בערב שבת צריך לומר ויכולו דאמר רב המנונא כל המתפלל בערב שבת ואומר ויכולו מעלה עליו הכתוב כאילו נעשה שותף להקדוש ברוך הוא במעשה בראשית שנאמר ויכולו אל תקרי ויכולו אלא ויכלו

Rava said, and some say it was Rabbi Yehoshua ben Levi who said: Even an individual who prays on Shabbat evening must recite the passage: “And the heavens and the earth were finished [vaykhullu]” (Genesis 2:1–3), as Rav Hamnuna said: Anyone who prays on Shabbat evening and recites the passage of vaykhullu, the verse ascribed him credit as if he became a partner with the Holy One, Blessed be He, in the act of Creation. As it is stated: “And the heavens and the earth were finished [vaykhullu].” Do not read it as: Were finished [vaykhullu]; rather, as: They finished [vaykhallu].

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א"ל למה אתם מולים, א"ל אף אני הייתי יודע שאתה עתיד לומר לי כן, לכך הקדמתי ואמרתי לך מעשה בשר ודם הם נאים משל הקב"ה, הביאו לי שבולים וגלוסקאות, [אמר לו אלו מעשה הקב"ה ואלו מעשה בשר ודם אין אלו נאים, הביאו לי] אנוצי פשתן וכלים מבית שאן, א"ל אלו מעשה הקב"ה ואלו מעשה בשר ודם. אין אלו נאים?

[Turnus Rufus] said to [Rabbi Akiva]: Why do you circumcise? He said to him: I also knew that you were going to say this to me. I therefore anticipated when I said to you: A work of flesh and blood is more beautiful than one of the Holy One? Bring me wheat spikes and white bread. [He said to him: The former is the work of the Holy One, and the latter is the work of flesh and blood. Is not the latter more beautiful. Bring me] bundles of flax and garments of Beth-shean. He said to him: The former are the work of the Holy One, and the latter are the work of flesh and blood. Are not the latter more beautiful?

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וכן בדין ששלשתן שותפין בו ת"ר שלשה שותפין הן באדם הקב"ה ואביו ואמו בזמן שאדם מכבד את אביו ואת אמו אמר הקב"ה מעלה אני עליהם כאילו דרתי ביניהם וכבדוני.

And so too, the equating of one’s attitude toward his parents to his attitude toward God is a logical derivation, as the three of them are partners in his creation. As the Sages taught: There are three partners in the forming of a person: The Holy One, Blessed be He, who provides the soul, and his father and his mother. When a person honors his father and mother, the Holy One, Blessed be He, says: I ascribe credit to them as if I dwelt between them and they honor Me as well.

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