‘Give me children or I shall die,” said Rachel to her husband Jacob, speaking for many women of the Bible who struggled to have children, and figured out how to do it. [Genesis 30:1]
Rachel ordered Jacob to sleep with her servant; Sarah did likewise to Abraham. Tamar became pregnant by pretending to be a prostitute. And Hannah promised her son to the priesthood, if only God would give her one.
Today, these texts have special significance to the many American Jewish women who similarly do what is necessary to build a family. These days, that often means the latest reproductive technology, said Paul Root Wolpe, a bioethicist at Emory University. Yet even among American Jews, there is a small group sounding a warning about the risks of these technologies, and they root their work in their Judaism.
“There probably are connections to our Jewish identities and values for me, and I think for some others,” said Marcy Darnovsky, executive director of the Center for Genetics and Society, a nonprofit think tank near San Francisco. “I got into this work out of concern that new reproductive technology could be used to produce enhanced human beings.”
Darnovsky started to study the ethics of reproductive technology in part because when she realized they could be used for eugenics, the science of breeding to improve human populations, she remembered a terrifying film about the Holocaust she saw in the 1960s.
Most recently, Darnovsky, has written on the risks of a new procedure that would create an embryo with genetic material from one man and two women in order to try to prevent certain diseases passed down through the mother. Unlike all other existing reproductive technologies, she writes, this one doesn’t just create a child, it modifies that child’s genes — and those of any descendants — and creates the possibility of parents selecting for preferences like hair color.
“Just because we can do something doesn’t mean we should,” she has written.
Darnovsky’s critique is one that American Jews, predisposed as they are to use reproductive technology, don’t often hear.
Going back again to the Bible, there’s pru u’rvu, the religious imperative to be fruitful and multiply, which are among the first words God speaks to human beings, Wolpe said.
Unlike other religions, such as Catholicism, for whom an unused embryo is a life with theological significance, Jews have few religious qualms about reproductive technology, he added. Even fervently Orthodox rabbis, who resist many aspects of modernity, sanction reproductive technology.
Also, because American Jewish women who are not Orthodox marry and try to bear children later than the general population, they have more need of reproductive technology, which makes them less likely to criticize it.
Miriam Zoll underwent years of fertility treatments for exactly this reason, an experience she recounts in her book “Cracked Open: Liberty, Fertility and the Pursuit of High-Tech Babies,” published in 2013 by Interlink. Zoll uses her story of trying in vitro fertilization and seeking an egg donor to raise awareness that reproductive technology is a big business whose practitioners’ quest for higher success rates — and profits — can distort their practice of medicine.
Clinics’ statistics are often misleading, said Arthur Caplan. A bioethicist at New York University, Caplan said he sees many benefits to reproductive technology, but criticizes the industry for not breaking its success rates down to give individual women facing a variety of problems a better sense of their chances.
“Money is an issue in terms of infertility programs trying to make money,” Caplan said. “You may not be the world’s best candidate, but you aren’t told, because they want you as a patient.”
Conversely, some practices reject women with harder cases because they want to keep their success rates high.
Too many women don’t realize that their doctors don’t pay adequate attention to the mental health risks of fertility treatments or the effects of premature and multiple births on children, women and families, Zoll said.
“There’s scientific fervor,” she said. “These doctors are legitimately excited with regard to helping couples who are infertile, but what they don’t take into account is a full picture of their child who may be born, or the family after they leave the clinic.”
Jewish culture appreciates scientific fervor, said several experts, which is another reason why Jews need to know that reproductive technology can have a downside.
“Judaism is a very science-positive and medicine-positive religion,” Wolpe said, invoking Maimonides, who was a court physician and the author of several canonical medical and religious texts, in addition to the “Physician’s Daily Prayer” a gilt-lettered copy of which can be found hanging today in so many doctor’s offices.
Jews are also more able as a group than many others to afford fertility treatments: They are expensive, often not covered by insurance and largely unregulated by the government.
These factors create another ethical issue, which is that the women who are selling their eggs or serving as surrogates are at risk of exploitation, said Jeremy Gruber, the president of the Council for Responsible Genetics.
More regulation is needed to protect those who provide eggs and wombs, as well as for many other reasons, Gruber said.
“We think technology can be a great benefit, but we think it should be used responsibly,” he said. “Ethical issues should be addressed. The process should be transparent. With assisted reproductive technology, there’s no transparency, because there’s no regulation, and no requirement to be transparent.”