Subject: Halachic definition of a physician
Question: Is a third or fourth year medical student (clinical clerk) considered a full-fledged physician for halachic purposes? What is the role of a medical student? What is the halachic definition of a physician?
Answer: A medical student has the same halachic coverage as the graduate physician.
Comment: Although the student has no legal responsibility for patient care and although he may not have adequate knowledge to exercise mature medical judgment, his aid is often necessary and nearly always beneficial. Time is saved by the senior physician because additional hands are available. The halacha does not distinguish between medical student, clinical clerk, intern, resident and attending physician, or even layman insofar as all contribute to the total patient care. The obligation to aid a dangerously ill patient falls not only on the graduate physician but on anyone able to and asked to render assistance. Included in this obligation are first and second year medical students and certainly third and fourth year students who possess considerable medical knowledge and are essential members of the diagnostic and therapeutic team.
The industrious and aggressive medical student may have access to medical literature and information which may be extremely recent and not clearly known to the senior physicians in attendance. The student may be able to devote many hours to an individual patient, thus making him the patient's "primary" doctor. The student's long and detailed history and physical examination may reveal facts and physical findings that might otherwise have been missed. The additional period of questioning may allow the patient to reflect and remember more important information not elicited by the other examiners. By performing many other required tasks, the student enables the physician to render better care to the patient.
For these reasons, a medical student has the same halachic coverage as the graduate physician, including laws pertaining to the Sabbath and Yom Tov.
(Source: Shulchan Aruch, Orach Chayim 328:10)
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt”l.
Subject: Kohen (priest) studying medicine
Question: May a kohen study medicine? What restrictions or permissive rulings, if any, are there regarding this question?
Answer: A kohen in the United States is prohibited from attending medical school.
Comment: Because of the requirement in the United States medical schools that students take anatomy and pathology courses, there is no way that a kohen can attend medical school. Even if the assumption is made that most if not all cadavers are non-Jewish, ritual defilement of a kohen still occurs upon contact with any dead body, although a non-Jewish cadaver does not ritually defile those people present in the same room who are not in physical contact with the deceased.
Although the exemption of pikuach nefesh (danger to life) sets aside all the commandments in the Torah, permissive rulings based on this principle apply only to physicians already in practice who are kohanim. The consideration of potential pikuach nefesh does not, however, sanction a kohen to begin medical school where the above-cited halachic problem cannot be overcome.
The rumored permissive ruling of the late Chief Rabbi Isaac Herzog based on the promise to settle in Israel and contribute to the medical needs of the developing state has never been confirmed in writing and, therefore, cannot be given any credence.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt”l.
Subject: Kohen (priest) studying dentistry
Question: May a kohen become a dentist? What restrictions or permissive rulings, if any, are there regarding this question?
Answer: Under the usual academic conditions, a kohen is not permitted to study dentistry.
Comment: In the previous bulletin, we pointed out that, because of the requirement in United States medical schools that students take anatomy and pathology courses, there is no way that a kohen can attend medical school. Even if the assumption is made that most, if not all, cadavers are non-Jewish, ritual defilement of a kohen still occurs upon contact (maga) or by carrying (massa) any dead body. The halachic distinction between Jew and Gentile concerns ritual defilement on being present in the same room with a cadaver (tumath ohel).
The same objections expressed concerning medical school apply to dental school. The latter curriculum also includes anatomical dissection which is forbidden to a kohen irrespective of whether the cadaver is Jewish or non-Jewish. If, however, the dental student can avoid actual dissection and attend only as an observer, and if his early dentistry training does not include a human skull with its dentition, then there is little halachic objection to a kohen studying dentistry. This restricted permissibility rests upon the fact that in the present era we follow the lenient halachic ruling that a non-Jewish corpse does not convey ritual defilement to people in the same room who have no direct contact with it. Unlike the physician, the dentist is not usually involved with dying patients, death certificates, the mortuary, etc., which pose seemingly insoluble problems to a physician who is a kohen.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt”l.
Subject: A physician or dentist treating his own family, including his parents
Question: Is a physician or dentist permitted to diagnose and treat illness in close members of his own family? Does the ruling apply equally to parent, sibling, spouse, child, aunt, uncle, cousin, nephew, niece etc.? Is a physician permitted to perform a complete physical examination on his close relative? May a physician or dentist draw blood from, or perform surgery on, or administer medication to his parents?
Answer: A physician or dentist should not draw blood, give injections, or perform surgery (even minor) on his parents, but may do so for all other relatives. If a life~threatening medical emergency arises, a physician may treat his parents, if no equally competent physician is available.
Comment: No greater honor can a Jewish physician bestow upon his father and mother than diagnosing and treating their physical ailments, particularly if the parent considers his or her child to be more competent than other physicians. Thus, all diagnostic and therapeutic procedures including history taking, physical examination and prescribing treatment are allowed in the fulfillment of Honor thy father and mother. Because of emotional involvement with family, the advice and cooperation of a colleague should be available.
There is, however, a Biblical prohibition against inflicting a wound upon one’s parent, and therefore, any diagnostic procedure that involves drawing blood, giving injections, lancing boils or other minor or major surgery, all of which are considered to constitute a “wound,” should not be performed by a physician or dentist, unless no equally competent physician or dentist is available.
No such restriction exists for all other relatives, including siblings, cousins, aunts, uncles, nephews, children and spouses!
(Source: Shuichan Aruch, Yoreh De’ah, Rama 241:2)
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt”l.
Questions Pertaining to Procreation and Sexuality < Click here to go back >
Subject: Gynecological diagnostic procedures
Question: Does a pelvic examination or pap smear or endometrial biopsy or I.U.D. insertion with or without resultant bleeding render a woman niddah?
Answer: Bleeding following a pelvic examination does not necessarily render a woman niddah.
Comment:
a) Pelvic examinations
When a gynecologist finds it necessary to perform a pelvic examination
on a Jewish woman patient, any bleeding that may ensue from the physical
irritation of the examination is not considered to be menstrual blood
necessitating abstinence. However, if for any reason, it is necessary
to pass an instrument past the cervical os into the cervical canal,
the Jewish patient must be so advised. If the instrument is 0.7 inches
in diameter (1.75 cm) or more, the patient must consider herself to
be a niddah even if no bleeding ensues. Bleeding from cervical erosions
or the cauterization used to treat these erosions is not considered
niddah blood. If feasible, pelvic examination should be done within
24 hours prior to onset of menses. It is necessary for the patient to
consult with her Rabbi to determine the regulations that she must observe
following pelvic examinations.
b) Pap smear
In the usual procedure no instrument penetrates the cervical
os. The cotton swab and wooden applicator stick are of such dimensions
as to present no halachic concerns.
c) Endometrial biopsy
Although the uterine cavity is entered in endometrial biopsy, the instrument
is usually less than 6 mm in diameter and therefore does not cause psichath
hakever (cervical dilatation). Therefore, the patient is not considered
a niddah.
d) I.U.D. insertion
The cervix is usually dilated to permit insertion of an intrauterine
contraceptive device. Even if no bleeding occurs, the patient becomes
a niddah.
e) Rubins or tubal patency test
Tubal air insufflation is performed to determine if the Fallopian tubes
are free of blockage or adhesions. The instruments used do not present
any halachic problem because the cannula used is always less than 10
mm in diameter. If the tubes are found to be patent, no halachic problem
ensues. If blockage is found, the backward pressure of the carbon dioxide
may be viewed by some as a "dilation" and rabbinic consultation
is necessary.
f)Hysterogram
The radioopaque dye used to infuse the uterus is administered via a
cannula only a few millimeters in diameter. Thus there is no psichath
hakever and the niddah state is not induced.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Contraception
Question: Under what circumstances, if any, may contraceptive methods be employed? Which methods are most preferable in Jewish law?
Answer: Contraceptive methods may be used only for specific medical or psychiatric indications.
Comment: Contraceptive devices cannot be used except for specific
medical indications such as rheumatic heart disease, severe renal disease
and similar situations, where pregnancy would constitute a serious threat
to the health of the mother. Jewish law requires that the marital act
be as normal as possible. When medical indications, which include psychological
factors, necessitate the use of a contraceptive technique, Jewish law
grades methods of contraceptive techniques from least to most objectionable
in the following order: oral contraceptives, chemical spermicidals,
diaphragms and cervical caps to be used by the wife, condoms, and coitus
interruptus. The most objectionable method, and one that is least often
recommended by Jewish law, is the use by the male of the condom or withdrawal.
An intra-uterine contraceptive device (I.U.C.D.) cannot be sanctioned
by Jewish law until and unless there is clear evidence as to its mode
of action. On the basis of the best evidence presently available, these
devices act as early abortifacients. Their propensity for inducing intermenstrual
spotting is also a significant deterrent to their use.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Contraceptive counsel to unmarried girls
Question: Does halacha permit the orthodox Jewish physician to give contraceptive advice to and to prescribe contraceptive devices for unmarried girls?
Answer: Except under very exceptional circumstances, Judaism considers it immoral for the physician to give contraceptive advice to an unmarried girl.
Comment: The doctor must use judicious moral judgment in this sensitive area of human relations. Judaism deems it immoral to give contraceptive counsel to unmarried persons when such advice may serve to remove an important barrier to immoral conduct. When confronted with the mentally retarded patient or with people in whom self-discipline is lacking as determined by previous conduct, consultation with a religious guide should be undertaken to decide the proper course of action.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Sperm procurement and analysis
Question: Is sperm analysis permissible in Jewish law? Under what circumstances? How should one obtain the sperm?
Answer: Sperm analysis is allowed when medically indicated, provided the sperm is obtained as described below.
Comment: During the medical work-up of a sterility problem,
it is occasionally necessary to test the semen of the husband for quantity
and quality of sperm. The least objectionable method is the procurement
of sperm by coitus interruptus, or if this is unsatisfactory for any
reason, a condom (Milex sheath) may be applied on the male membrum prior
to coitus. These two procedures involve the natural sex act and are,
therefore, most acceptable to Jewish law.
Masturbation to obtain sperm is strongly condemned, based upon the following
Talmudic passage:
"... Rabbi Eleazer stated: Who are referred to in the Scriptural
text Your hands are full of blood (Isaiah 1:15)? Those that commit masturbation
with their hands. It was taught at the School of Rabbi Ishmael: Thou
shalt not commit adultery (Exod. 20:13) implies that thou shalt not
practice masturbation either with hand or with foot...."
The use of a mechanical vibrator applied to the anal area to induce
erection and ejaculation to procure semen for examination can also be
approved, if necessary.
To have sexual intercourse in the physician's office so that the physician
can retrieve the sperm from the vagina of the woman is considered licentious
and improper. When it is necessary to evaluate sperm survival in the
vaginal tract, a nearby hotel room must be obtained to enable the wife
to present herself shortly after coitus for such testing. Of course,
the laws of niddah must be observed even under these medical conditions.
Source: Shulchan Aruch, Even Ha'ezer 23:1-3
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Artificial insemination
Question: Is artificial insemination ever allowed in Jewish law? Under what circumstances? Is the ruling different depending upon whether donor sperm or the husband's sperm is used?
Answer: Under most circumstances, artificial insemination using donor sperm is not permitted. Semen from the husband may be used to impregnate his wife if no other method is possible.
Comment: Artificial insemination using the semen of a donor
(A.I.D.) other than the husband is considered by most Rabbinic opinion
to be strictly prohibited for a variety of reasons, including the possibility
of incest, confused genealogy and the problems of inheritance. However,
without a sexual act involved, the woman is not guilty of adultery,
and is not prohibited to cohabit with her husband. The child born from
A.I.D. does not carry any stigma of illegitimacy. The use of semen from
the husband is permissible if no other method is possible for the wife
to become pregnant. If the insemination must be performed during the
wife's period of ritual impurity, consultation with a Rabbinic authority
is indicated.
Since many important legal and moral considerations which cannot be
enunciated in the presentation of these general principles may weigh
heavily upon the verdict in any given situation, it is essential that
each individual case be submitted to Rabbinic judgment which, in turn,
will be based upon expert medical opinion, both physiological and psychological.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Induction of labor
Question: Is there a halachic objection to inducing labor by means of oxytocin or prostaglandins?
Answer and Comment: If induction of labor is undertaken for
clinical indications of major obstetric complications, that is to say
the welfare of the mother or child, it is certainly permissible. Such
situations might include severe pre-eclampsia, diabetes mellitus, bleeding,
overdue babies, blood group incompatibility, or the like, according
to the judgment of the obstetrician.
Any medical or surgical procedure which is carried out for any purpose
other than the benefit of the patient constitutes assault and battery.
Hence, induction of labor undertaken for the social convenience of the
mother and/or obstetrician is contrary to halacha. Halacha clearly forbids
any procedure that carries additional risk to mother or child. Induction
of labor for social convenience may well involve increased risk to the
baby or mother and, hence, would constitute an unethical procedure in
the eyes of Jewish law.
The following is a quotation from an editorial in the prestigious medical
journal Lancet (Nov. 16, 1974, pp. 1183-4):
". . . induction on the grounds of social convenience is a pernicious
practice which has no place in modern obstetrics. The mother's holiday,
the calls of the obstetrician's private practice, must not influence,
for the sake of even a few days, an event which for the child may affect
the outcome of its entire life. Social convenience must be dismissed.
Medical convenience - daylight delivery - is a more difficult problem;
the argument goes as follows: The chances of the occurrence of a major
life-threatening emergency are greater at delivery than at any other
time of life. If one could choose the time of one's road accident, coronary
thrombosis, orgastrointestinal ~aernorrhage, it would be at 10 A.M.
on a Tuesday in October. No-one is asleep, on holiday, or a dozen miles
away. Obstetric complications offer, in principle, a similar choice:
a median delivery-time of 5 P.M. on a weekday could be achieved for
at least half the population. Should this be the aim? The question cannot
be easily answered at present.
Indeed, there is even some evidence that fetal complications, as judged
by the need for incubation or oxygen administration, may be relatively
more common during daylight hours.
Further observations and information are essential if an objective answer
is to be found to the question whether or not induction of labor for
medical convenience is sound clinical practice or meddlesome midwifery.
If it really is more dangerous to be born at night, either we should
make daylight delivery the norm to aim for, or we should ensure that
the same facilities are available by night as during the day."
Halacha requires the latter course; namely to have all the necessary
facilities available at night as well. The possibility of better response
to an emergency situation during daylight hours is no justification
for introducing a procedure (i.e., induction of labor) which, in itself,
may be less than "good medical practice." Induction of labor
should be reserved only for those clinical conditions that demand early
termination of pregnancy so as to benefit mother or child.
Once labor has begun, the judgment of the obstetrician determines the
need for oxytocin for the benefit of mother and/or child.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Assistance of husband during natural childbirth
Question: Is a husband permitted to assist during natural childbirth (as in the Lamaze method)? When is the wife considered a niddah or a yoledeth (parturient woman)? Is the husband's role during natural childbirth an exemption from the usual laws of niddah because of his contribution to his wife's physical and psychological welfare?
Answer: Within certain guidelines (see below) the husband is permitted to be present during natural childbirth and to provide solace and comfort to his wife.
Comment: The wife is considered a niddah or a yoledeth immediately upon the appearance of any blood, the "bloody show," mucus plug tinged with blood, or any active bleeding from the cervical canal. She is also considered to be a yoledeth if there is no bleeding at all but labor has progressed to a point of:
(a) contractions of such frequency and/or severity to make it very
difficult to walk without assistance
(b) the nurse or physicians report that the cervix is fully dilated.
Under the above conditions, the niddah state is established with all
its halachic restrictions.
Prior to that time (i.e., during labor) if no blood has appeared, the
woman is not a niddah and may even have physical contact with her husband.
When she becomes a niddah, however, as defined above, no further physical
contact is permitted.
Although the hospital environment, the presence of the medical team
members, and the preoccupation of both husband and wife with the birth
process minimize the halachic concern, lest physical contact lead to
forbidden intimacies, it is not permitted for the husband to "wipe
her face, rub her back, or support her during contraction." Indeed,
proper preparations for natural childbirth should include the husband's
supportive role - but without physical contact. His presence, encouragement
and reassurances are the sum total of his contributions. Any physical
ministrations can better be performed by hospital personnel.
In the delivery room itself, the husband should not view the act of
birth of the child but should stand near the head of the table and offer
encouragement and reassurance to his wife. He should not even view the
birth process through the mirrors present in most delivery rooms.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Therapeutic abortion
Question: Is therapeutic abortion permitted in Jewish law? If yes, under what circumstances? Is abortion on demand allowed?
Answer: Jewish law sanctions abortions only where a grave hazard to the mother's physical or mental health exists.
Comment: Abortion on demand is prohibited by Jewish law. Jewish
law sanctions abortion only when continuation of pregnancy constitutes
a grave hazard to the mother. Such hazards include psychiatric disturbances
that may be caused or aggravated by the continued pregnancy, if these
disturbances are genuinely feared to lead to risk to life. For example,
if a woman seriously threatens suicide, and if competent psychiatric
opinion agrees with the possibility of danger to the woman's life, then
an abortion not only may but must be carried out to save the mother,
since her life takes precedence over that of her unborn child. A serious
medical threat to the mother's life such as advanced rheumatic heart
disease or serious kidney malfunctioning also constitutes an indication
for abortion permitted by Jewish law.
The fear that a child might be born physically malformed or mentally
deficient, such as following exposure to rubella early in pregnancy
or ingestion of thalidomide, does not in itself justify recourse to
abortion. Both before and after birth, art abnormal child (physically
or mentally) enjoys the same title to life as a healthy child. This
consideration is quite apart from the chance that an abortion might
eliminate a perfectly normal child. The sole indication for terminating
a pregnancy in Jewish law is a threat to the mother's physical or mental
health that endangers her life.
Since many important Jewish legal and moral considerations which cannot
be spelled out in the presentation of general principles may weigh upon
the verdict in any given case, it is essential to submit every case
to Rabbinic judgment.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Assisting at or performing an abortion on a Jewish or non-Jewish woman
Question: May a nurse or anesthesiologist or some other person assist in the performance of an abortion? If they may, under what circumstances? What of a non-Jewish woman who requests an abortion?
Answer: Jewish law sanctions abortions only where a serious hazard exists to the mother's physical or mental health.
Comment: In a previous Halacha Bulletin, we pointed out that
abortion on demand is prohibited. Jewish law sanctions abortion only
when continuation of pregnancy constitutes a grave hazard to the mother.
Such hazards include psychiatric disturbances that may be caused or
aggravated by the continued pregnancy, if these disturbances are genuinely
feared to lead to suicide. For example, if a woman seriously threatens
suicide, and if competent psychiatric opinion agrees with the possibility
of danger to the woman's life, then an abortion must be carried out
to save the mother, since her life takes precedence over that of her
unborn child. A serious medical threat to the mother's life such as
advanced rheumatic heart disease or serious kidney malfunctioning also
constitutes an indication for abortion permitted by Jewish law.
The fear that a child might be born physically malformed or mentally
deficient such as following exposure to rubella early in pregnancy or
ingestion of a teratogenic drug does not in itself justify recourse
to abortion. Both before and after birth, an abnormal child (physically
or mentally) enjoys the same title to life as a healthy child. This
consideration is quite apart from the chance that an abortion might
eliminate a perfectly normal child. The sole indication for terminating
a pregnancy in Jewish law is a threat to the mother's physical or mental
health so that her life is in danger.
Request for abortion by Jewess or non-Jewess in no way removes the prohibitions
involved. Neither the obstetrician-gynecologist or anesthesiologist
or nurse nor any other person may perform or assist in any manner in
such abortions unless the lifesaving considerations for the mother warrant
a halachically approved abortion. The prohibition of performing abortion
is a Noachian law and is therefore equally applicable to non-Jewish
physicians, based on the scriptural verse whoso sheddeth the blood of
man in man, his blood shall be shed (Genesis 9:6).
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Research on aborted fetuses
Question: Is it permissible to perform medical research on a spontaneously or therapeutically aborted fetus? If the fetus is alive? If the fetus is dead?
Answer: No, if the fetus is alive; yes if the fetus is dead.
Comment: If the fetus is alive, although not viable because
of prematurity or malformation, it is considered to be a living person
in all respects. Any research activities that might shorten the life
of this fetus are absolutely prohibited.
If the abortus is dead as defined by halachic criteria, viz. absence
of respiration and absence of cardiovascular pulsations, then there
does not exist any Biblical requirement for burial. However, it is desirable
to secure the fetus for burial, in order to preserve the dignity of
man "created in God's image" and the sanctity of the dead.
Since there is no absolute halachic requirement for burial, for cogent
and critical medical research a dead fetus may be used without halachic
objection.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Sterilization
Question: Is sterilization of a man or a woman permissible in Jewish law? Is ligation of the vas deferens during prostatectomy permissible? Is oophorectomy or orchiectomy for malignant disease allowed?
Answer: Only in cases of absolute medical need is a sterilizing procedure (ligation of Fallopian tubes or vas deferens) or ablative sterilization by surgical or medical (radiation or drugs) means permissible.
Comment: Surgical or physical impairment of the reproductive
organs of any living creature violates Jewish law, except in cases of
urgent medical necessity. In the case of males upon whom the Biblical
commandment of be fruitful and multiply rests, only a risk to life can
justify such procedures: hence, unless medically demanded, the ligation
of the vas deferens during prostatectomy should be avoided. The prohibition
against impairing the male reproductive organs and functions is unrelated
to man's fertility. It applies even to a man known to be sterile or
impotent, whether by reason of age or physiological aberration.
The sterilization of females is permitted when medically imperative.
Rabbinic opinion, as well as the consent of the husband, should always
be secured prior to considering ligation of the Fallopian tubes or other
surgical procedure leading to sterility. Contraceptive techniques such
as diaphragm with spermicidals should be evaluated before the decision
to intervene surgically is made.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Vasectomy and/or orchiectomy
Question: Is it permitted to perform a vasectomy or orchiectomy or in any other way castrate or sterilize a male?
Answer: Only in cases of absolute medical need is vasectomy or orchiectomy permitted.
Comment: It is prohibited in Jewish law to render a male human
or animal sterile. This halacha makes it difficult for a Jew to practice
as a veterinarian since the castration and spaying of animals is a major
part of urban veterinary practice.
Only in cases of urgent medical need (e.g., cancer) where a risk to
life exists, is such a procedure permissible. Hence, unless medically
essential, the ligation of the vas deferens during prostatectomy should
be avoided. The prohibition against impairing the male reproductive
organs and functions is unrelated to man's fertility. It applies even
to a man known to be sterile or impotent, whether by reason of age,
or of anatomic or physiologic aberration that have occurred after birth.
Vasectomy as a "population control" technique is not condoned
in halacha. It is forbidden to assist at such surgery in any way on
man or animal.
The halachic evaluation of new experimental techniques, such as gold
valves and silicon plugs, and the impact of "reversible vasectomies"
by virtue of new surgical procedures, is not yet complete. The initial
opinion is that they cannot be condoned, but more study is needed. The
imbibition of a sterilizing potion by a male (hormonal or cytotoxic)
is prohibited, and the physician may not prescribe such a medication
for men.
Source: Karo's Shuichan Aruch, Even Ha'ezer #5:11-13
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Tubal ligation, hysterectomy and oophorectomy
Question: Under what circumstances, if any, is it permitted to sterilize a woman or female animal?
Answer: Sterilization of females is permitted in Jewish law when medically imperative.
Comment: In a previous Halacha Bulletin, we pointed out that
in Jewish law it is prohibited to surgically, radio-therapeutically,
physically or medically impair the reproductive organs of any living
creature, male or female; human, animal, fowl or beast.
Although the Biblical commandment to be fruitful and multiply rests
primarily on the male, sterilization of females is only permitted for
specific medical indications.
Veterinary medicine is thus not a desirable profession for an orthodox
Jew because much of the day to day practice consists of spaying and
castration of animals, acts prohibited in Jewish law.
Source: Karo's Shuichan Aruch, Even Ha'ezer #5:11-13 and the commentary of the Vilna Gaon there in subsection 25
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Medical management of infants with ambiguous genitalia
Question: How does one halachically approach a child with ambiguous genitalia? Do psychological considerations play a role in the decision to "make" the child into a boy or a girl?
Answer and Comment: The sex determination of an infant or child
with ambiguous genitalia must be based on cytological and genetic (i.e.,
medical) evidence, not on psychological considerations. The presence
of testes is to be considered an absolute sign of maleness.
A genetically male infant must not be surgically modified to permit
rearing him as a female. His inability to function as the male partner
in marital relations is not adequate justification for such a sex change.
In true hermaphroditism, or when no clearly differentiated gonad is
evident, the decision as to the sex identity of the child must be arrived
at by careful consultation with competent medical and Rabbinic authorities.
Source: Rashi in Chagigah 4a, s.v. heshebeitzirri mibachutz
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
Subject: Sex change in adults
Question: Is an adult Jew (male or female) allowed to undergo a medical and/or surgical sex change? Would a woman who becomes a man be obligated to fulfill the precepts incumbent upon a man?
Answer: Jewish law prohibits sex change operations.
Comment: Surgical procedures or medical intervention (i.e.,
hormonal therapy) to effect a sex change in an adult is strictly forbidden
for a variety of reasons, including the prohibitions of castration (sirus)
and homosexuality (mishhav zachar).
Surgery, not recognized as necessary for correction of anatomic or physiological
abnormalities, is viewed as an act of mutilation. The psychological
stresses that underlie the patient's request for such self-mutilation
must be dealt with by psychiatric therapy, not surgery.
If in violation of Torah law such a sex change operation was performed,
the individual maintains his pre-surgical sex with all its halachic
implications.
This Halacha Bulletin was written by Fred Rosner, MD, FACP and Rabbi Moshe D. Tendler, PhD and reviewed by HaRav Moshe Feinstein, zt"l.
