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Friday October 22, 1999

Jews weigh in on reproductive issues at S.F. confab

MARTIN KASSMAN
Bulletin Correspondent

What are the moral implications of cloning?

Should Jewish couples undergo expensive, prolonged fertility procedures when children in need of homes are in foster care?

Do Jewish doctors have a responsibility to keep a very premature infant alive?

Advances in reproductive and neonatal care pose a number of ethical dilemmas. Jewish health professionals, rabbis, lawyers and scientists struggled with some of those issues earlier this month at the Union of American Hebrew Congregations' bioethics conference in San Francisco.

Keeping an extremely tiny premature infant alive "involves committing extraordinary resources, not to mention the extraordinary level of suffering involved for some of these little patients and their families," said Dr. Harvey Gordon, a retired urologist who teaches bioethics at Baylor College of Medicine in Houston.

"The salvage rate may be low," he added. "Those who survive can be severely impaired in many cases."

The panel discussion, titled "P'ru ur'vu: Reproductive Issues and the Jewish Family," took place Sunday, Oct. 10 during the four-day Reform movement conference, "Bio-Ethics & Sacred Decisions: Medical Technology, Liberal Judaism & Our Lives."

Laurie Zoloth-Dorfman, a former neonatal intensive care nurse who now heads Jewish Studies at San Francisco State University, also addressed concerns about extremely premature infants. She said the parents "have to understand that they are involved in a kind of medical experimentation."

If they know "that disaster may lie ahead" and are willing to go forward, they should have that option, she said. But at a time when many Americans lack basic health care, Zoloth-Dorfman also acknowledged the difficult "resource-allocation decision" such a choice entails.

With some 6 billion people on the planet, Rabbi Michael Feshbach of Temple Beth Am in Williamsville, N.Y., said: "This is not just a question in terms of resources for one country. This has implications for adoption, for interrelatedness."

Hard questions about resource allocation were also at the heart of a discussion on infertility. Are infertility treatments an "entitlement" for which society should pay, asked Gordon.

Feshbach, whose previous comments had been relatively lengthy, drew loud laughter with his one-word answer: "Yes."

Earlier, the rabbi mentioned the struggle with infertility in his own marriage, later giving an emotional account during a breakout session following the panel.

Zoloth-Dorfman noted that infertility has solutions other than medical ones. She spoke of the many children in foster care who need adoptive parents. "What percentage of them [are] cared for by Jewish men and women who want children so desperately? The percentage is actually quite low," she said. "They tend to be cared for by religious, devout Christians."

The expensive nature of medical treatment for infertility should not be ignored, "in light of the fact that there's 45 million Americans without access" to treatment for the simplest ailments, Zoloth-Dorfman added. There is "a kind of obscenity" in spending so much money treating infertility in the absence of "basic, decent medical care for all."

Feshbach summed up the dilemma: "Here we have one of those cases where Jewish sensibilities and human ones in general may be in direct conflict with one another." He cited the biblical admonition to "be fruitful and multiply" and the world's diminished Jewish population.

Zoloth-Dorfman, who has five children, said many Jewish women born or raised after the Holocaust feel an obligation "to replace ourselves and the lost children of that generation."

The possibility of humans replicating themselves by way of cloning was the subject of another session. H. Allen Gardner, a geneticist and University of Toronto professor, described the mechanics of cloning and the potential consequences of using the procedure to create human beings.

He spoke enthusiastically about a number of potential benefits from cloning, including advances in agriculture, genetics and pharmaceuticals. But he was less sanguine about human cloning, which is currently illegal in this country.

Among the drawbacks: an increase in social inequities, if only rich people could afford to be cloned; the doubtful legal status of clones, in custody and inheritance cases; and difficult religious questions, such as whether a clone has a soul.

Following the discussion, Gardner said human cloning "may be an egoism." But he expressed deep sympathy for a person raised in abusive or adverse circumstances, who might wish to have a clone accomplish the things he or she could have accomplished in a different environment.

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