Three parents and a baby

The three-parent in vitro fertilization technique could prevent heriditary diseases such as Tay-Sachs and cystic fibrosis.
The three-parent in vitro fertilization technique could prevent hereditary diseases such as Tay-Sachs and cystic fibrosis.

Last week the United Kingdom became the first country to legalize the creation of embryos made from the genetic material of three people to prevent genetic diseases carried on cell structures called mitochondria.

The process involves inserting the nuclear DNA from the mother and father into a donor embryo that has the mitochondria – which provides the cell’s energy — from another woman.

While such an advance has not yet been legally approved in the United States, it likely will be at some point.

And that raises an interesting question for traditional Jews. Is such a practice kosher?

It’s a question that’s been asked repeatedly in recent years as the practice of pre-implantation genetic diagnosis becomes more popular to help couples avoid hereditary diseases such as Tay-Sachs and cystic fibrosis. Fertility specialists typically remove one cell from an embryo to analyze its chromosomes, selecting only healthy ones to implant.

“We always ask whether this is considered a procedure in which we are still playing God’s junior partner, where we help people achieve the wondrous goal of having a healthy family, or whether we’re playing God,” said Rabbi Kenneth Brander, vice president for university and community life at Yeshiva University in New York City and who is a medical ethicist specializing in infertility issues.
This new procedure, he believes, would fall into the first category since it would be considered a medical procedure that prevents disease.

Only about 800 American women each year could qualify for this type of in vitro fertilization if it were approved for use, according to British researchers in a letter published last month in the New England Journal of Medicine. They estimated the procedure could be useful for about 150 couples each year in Great Britain.

The three-parent IVF technique would raise another important halachic question among Orthodox rabbis: If two mothers are involved in an IVF procedure, which one is the biological mother who confers religion? The question has come up before with the use of donor eggs and remains unresolved with some rabbis concluding that the egg donor is the real mother from whom, according to Jewish law, the child inherits religion. But others have ruled that the woman who carries the child in her womb – donor egg or not – is the biological mother.

“In situations where I’ve been involved with couples who have used anonymous egg donors, I’ve always suggested a conversion for the child,” Brander said, “because you don’t want a situation when the child is ready to marry where an authority may say the child isn’t Jewish.”

But the new technique with a mitochondria donor may actually prove to be less problematic among Orthodox rabbinic authorities, he added, because most of the genetic material comes from the Jewish mother who is carrying and raising the child.

Babies would only carry about 0.1 percent of their DNA from the second woman. However, that mitochondrial DNA would get passed down to future generations, presenting a permanent solution to inherited life-threatening mitochondrial diseases.

Such distinctions don’t concern Rabbi Elliot Dorff, a medical ethicist and professor of philosophy at American Jewish University in Los Angeles. About 20 years ago, the Conservative movement’s Committee on Jewish Law and Standards, which Dorff currently chairs, published an opinion that religious inheritance should pass from the mother who carries and bears the child, rather than the one who donates her egg.

Where the slope starts to get a bit slippery for religious medical ethicists is for elective procedures that couples may wish to use while undergoing IVF. Current technologies enable them, for example, to choose the gender of their embryo, which has raised fierce debate among Jewish religious authorities.

Some rabbis say it’s technically allowed for couples who already have children of only one gender under the “be fruitful and multiply” dictate of the Torah, which instructs men to have at least one boy and one girl.

But they’re in the minority, Brander said, because most halachic experts interpret the command as “try your best” to do this, rather than as a requirement.  Dorff co-authored a statement on this for the Conservative movement a decade ago instructing couples that they should try to have one more child than they originally planned for the sake of increasing the Jewish population but not to worry about the gender balance.

The Israeli Ministry of Health has also weighed in on gender selection, authorizing its use for family balancing only in couples who already had at least four children of the same gender; even then, the ministry insists that an ethics committee and psychiatrist determine that withholding such approval would damage the mental health of either parent. The decision was based on Israeli rabbinic authorities who condemned sex selection as against traditional Jewish values.

Brander, however, said some Orthodox rabbis grant permission for gender selection for “social psychological reasons.” For example, the Cohan or Levy tribal status passes from father to son, but not when donated sperm are used for insemination, according to most Orthodox rabbinical authorities. Couples in this situation may prefer to give birth to only girls to avoid sparing their future sons the embarrassment of having to explain why they cannot participate in the same tribal rituals as their fathers. Brander said he has granted permission for gender selection to be used for this reason.

Continuing advances in genetics could soon open up a can of ethical worms, enabling parents to select for hair color, intelligence, height and other desired features for their embryos. “At that point, we are likely to become more concerned about crossing the line,” Brander said, “from playing God’s junior partner to playing God.”

Deborah Kotz, a former reporter for the Boston Globe, is a regular contributor to WJW’s health and science beat.

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