הפסקת הריון במקרה של X שביר

שתפו:

23 באוקטובר 2018

הרב המשיב: פרופ' אברהם שטינברג

שאלה:

As per our conversation about fragile X carriers, I am submitting my question to you in writing so that you can respond with the guidance of Dr. Abrams [sic].

Genetic disorders can be prevented by doing in-vitro fertilization with reimplantation, where they check the genetic status of the embryo at the eight-cell stage by removing two of the cells and examining them. This process obviously involves many halakhic questions. I would like to know exactly how it is done according to halakha. Here in the United States, preimplantation for fragile X carriers is still experimental. Is it offered anywhere in Israel?

I am aware that Rabbi Eliezer Yehuda Valdenberg permits terminating a pregnancy if the child will be mentally retarded. In the case of fragile X, there are times when they know that the child will be severely affected and times when they know the child will not be affected at all, but there are also times when they do not know how severely the child will be affected. The child may be learning disabled or he may be severely retarded. This is all based on the sex of the child. Is terminating such a pregnancy also permitted (if the mother cannot handle it)?

As you probably know, the cost for IVF with pre-implantation genetic testing is very high and there is never a guarantee that it will result in a successful pregnancy. The chances for a fragile X carrier are even less because, as I recently found out, fragile X carriers were found to have high levels of the follicle-stimulating hormone, which complicates matters. Also, as I mentioned in my previous letter, in the US they are still doing research on this. Therefore, the most desirable route is to go the natural way and terminate the pregnancy if the child is affected. The problem then would be what to do in the event that the doctors do not know how much the child would be affected.

תשובה:

1. Most probably, destruction of a pre-embryo with a genetic disorder, such as fragile X, is permitted in the preimplantation stage, according to all opinions.

2. As you already know, according to R. Valdenberg it should be permitted to abort a male fetus that was diagnosed with fragile X syndrome if the percentage of infected babies that will suffer from retardation and learning disabilities is higher than twenty percent.

3. If the mother is suffering severely after her embryo has been diagnosed as fragile X, it is surely permitted to abort according to R. Valdenberg.

4. See the enclosed photocopy on abortion from Prof. A. S. Abraham’s The Comprehensive Guide to Medical Halacha, second edition, pp. 205-6.

Please note that these rulings are theoretical and before actual practice, after collecting all the medical data, one should always ask a qualified rabbi who is familiar with those involved.

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