Overview: Genetic Issues

 

Advances in genetic technology have been among the most startling and controversial scientific developments in recent years. Genetic screening, genetic engineering, and cloning raise essential questions about human nature and power and are thus among the most difficult and exciting issues in bioethics.

 

Screening for genetic diseases can be conducted at various points of human development. Carrier screening can be done to determine whether a person has an unhealthy gene that could be passed on to a child. Pre-implantation screening can be done on a zygote that has been fertilized in vitro, which can then, in theory, be discarded if a genetic malady is discovered. Prenatal testing can detect diseases like Tay Sachs during pregnancy, when abortion is a logistical option.

 

From a Jewish perspective, carrier screening is the most favorable of these options. Two people who test positively for the Tay Sachs gene can be—some say should be—discouraged from marrying. However, it is important that the results of the screening be kept confidential to avoid genetic discrimination. Amniocentesis, in which a small amount of the fluid surrounding a fetus is extracted from a pregnant woman—as well as chorionic villi sampling (CVS), which can be done even earlier in pregnancy—can determine whether a fetus carries a genetic disease like Tay Sachs or is affected with Down syndrome (which cannot be detected through carrier screening).

 

There is no consensus about whether abortion is permissible if such testing does discover an affected fetus. Those like the late Rabbi Moshe Feinstein who reject abortion in such cases also question the permissibility of amniocentesis. However, there are rabbis, such as Eliezer Waldenberg, who permit both amniocentesis and abortion if a terminal disease like Tay Sachs is discovered. For a non-terminal condition, the permissibility of testing and abortion are less clear. Authorities disagree on whether to extend the permissibility of abortion to situations in which a fetal genetic problem is discovered that could cause psychological danger to the mother. Pre-implantation screening, particularly when both man and woman are carriers of a genetic disease, is less objectionable than abortion according to all authorities.

 

Gene therapy is in its early stages, and for the most part, Jewish thinkers have yet to respond to many of the specific questions it raises. Nonetheless, certain broad guidelines characterize Jewish positions to date. In general, genetic engineering for therapeutic purposes is condoned and encouraged by Jewish authorities. Consequently, stem cell research—which supporters say can yield cures for diseases such as Parkinson’s and diabetes—has been endorsed by many rabbis. Stem cells usually come from aborted or discarded embryos, and for this reason many in the “pro-life” camp have rejected this practice. Jewish bioethicists, however, cite the concept of pikuach nefesh—the Jewish value of saving lives—coupled with the idea that an embryo less than 40 days old is traditionally considered “like water,” as reasons for supporting stem cell research.

 

Cloning for therapeutic purposes has also been embraced by most Jewish authorities, though cloning for reproductive purposes (a future possibility) has been rejected by most. Some believe that cloning would create a person in a human’s image, rather than God’s. Others are disturbed by the possible similarity to Nazi experiments aimed at creating a master race. However, some authorities see cloning as a potential option for couples who can’t conceive normally. Michael Broyde, an Orthodox rabbi and professor of law at Emory University, is among those who argue that we should consider cloning in cases where reproduction is otherwise impossible. He believes that cloning may be a mitzvah in such circumstances.

 

Beyond the life and death health issues of genetic screening and engineering, there are other potential and actual ethical and halakhic questions as well. Is it ethical to pre-determine the sex of one’s child through pre-implantation screening of embryos conceived in vitro? Is a pig that’s been genetically engineered to chew its cud kosher? Some of these questions have been answered—a pig is, for now, still a pig, so kosher bacon isn’t on the horizon—but more fascinating and difficult problems are sure to be raised in the coming years.