Is vaccination required/permitted? Rav Eliashiv's view

 update see Wikipedia - vaccine controversies
 Regarding the discussion about medical procedures such as genetic testing or vaccinations, I was sent this recording of Rabbi Tatz discussing the issue of vaccinations in a situation where is is accepted in the general population to vaccinate children. He asked Rav Eliashiv who paskened that if everyone does it then it is permitted without evaluating the risks.

The discussion of vaccinations starts at about 27 minutes

Read More

New Genetic Tests for Women Who Are Expecting

Wall Street Journal   Women expecting a baby or planning a pregnancy are being pitched a fast-growing array of tests to check if they are carriers for hundreds of mostly rare genetic diseases.<

Such genetic testing, called carrier screening, has long been targeted mainly at people of certain ethnic groups such as Ashkenazi Jews, who are at higher risk for some conditions such as Tay-Sachs disease. Now, companies that offer carrier screening are promoting the idea that testing everyone for many diseases is a more effective way to reduce the number of babies born with serious disorders, including cystic fibrosis, a life-limiting lung condition, and Canavan disease, a fatal neurological disorder.

“We have the technology and it’s affordable enough that we don’t need to put people into ethnic categories,” says Shivani Nazareth, director of women’s health for Counsyl Inc., in South San Francisco, Calif., one of the largest carrier-screening companies. “If we can offer the same panel to everyone, it’s so much more efficient.”

Scientists keep identifying new gene mutations, or variations, associated with specific diseases. Advances in DNA technology allow companies to quickly screen large numbers of people, using saliva or blood samples, to determine if parents could pass the genetic variations to their children.

Counsyl offers tests that aim to detect heightened genetic risk for at least 98 different diseases, for between $599 and $999. Another company, Gene by Gene Ltd., of Houston, plans in the next few months to introduce First Look, a test billed as the most comprehensive on the market that can screen for more than 300 diseases. The company expects the price could be close to $1,500.[...]

Ashkenazi Jews, those hailing from Eastern Europe, have long been tested for about 20 genetic disorders including Tay-Sachs disease, Canavan disease and familial dysautonomia, a neurological condition. New York’s Mount Sinai Medical Center recently expanded its screening for this group to include 38 possible diseases, after the hospital’s genetic testing laboratory found these patients are at increased risk of being a carrier for a wider range of genetic conditions than previously thought.

Mount Sinai also offers for as much as $1,000 broader carrier screening to all women, Jewish or not, for a total of 111 disorders. “If you want to know your carrier status for a larger number of diseases, do the all-inclusive testing,” says Lisa Edelmann, director of Mount Sinai’s genetic testing lab. “So many people don’t really know their full ancestry. I know on one side that I am a quarter Italian and at least a quarter Polish, but the other half is not as clear.” [...]

Read More

Rav Moshe Feinstein: Medical screening and Bitachon

 update see Wikipedia - vaccine controversies

In a recent post regarding Dor Yeshorim - the question was raised about Reb Moshe Feinstein's true views on medical screening and its relationship to bitachon and about whether there is a generally agreed upon Torah view of the subject. The Bais HaVaad Institute recently published a series of articles that is relevant to this question. Part I  Part II   Part III

 Part I In Parshas Shoftim after prohibiting sorcery, the Torah instructs, “Tomim tihiyeh im Hashem Elokecha”, “You shall be wholehearted with Hashem your G-d”. The sages in the Sifri interpret the verse not to conjecture about the future. The Shulchan Aruch (YD 179:1) rules, “One should not consult star gazers or cast lots [about the future]”. The Rem’a and Sha’ch explain that while these practices do not fall under the prohibition of sorcery, they are nonetheless not advisable because of the precept of “Tomim tihiyeh”, to be faithful to Hashem. [...]

According to Rabbi Gestetner’s view, “Tomim tihiye” is very limited, and may not apply to health screenings and genetic testing at all. As he explained, only practices similar to fortune telling are prohibited. Arguably, the results of a health screening or genetic test point to facts that are in the present, not the future. This is comparable to leaving a glass at the edge of a table. I cannot say that the glass is destined to fall off and break, but its position certainly puts it at greater risk than the other glasses. Likewise, test results showing hypertension or indicating a genetic mutation do not prophesize a future event, rather it indicates a present level of risk. For this reason, health screenings and genetic testing may not be included in “Tomim tihiyeh” because they are quite different than star gazing or psychic readings. 

 Part II Rashi, in his commentary on Parshas Shoftim explains the mitzvah of “tomim tihiyeh”, “Walk before Hashem with wholeness, hope for Him, and do not speculate about the future. Rather, all that comes upon you accept with wholeness (uncomplicatedness) and then Hashem with be with you”. Based on Rashi’s comments Rabbi Moshe Feinstein understood that “tomim tihiyeh” is a general instruction to place our faith in Hashem when confronting the unknown.

An example of this, is Rabbi Feinstein’s comments in Igros Moshe (1, 90) about a couple dating excessively to make sure it is ‘the right one’. He wrote, “One should not be overly smart {with regards to shidduchim}. Therefore, one could marry the woman that finds favor in his eyes in her appearance and family, and has a good reputation about her mitzvah observance, and assume that she is the one destined to him from heaven. He does not need to excessively tryout if they are compatible because it will not help, as the verse says “tomim tihiyeh im Hashem”, you shall be faithful with Hashem”. Clearly, Rabbi Feinstein is taking tomim tihiyeh beyond fortunetellers and astrologers. 

In 1977, after the Entebbe hijacking and rescue, some Yeshiva students wrote to Rabbi Feinstein asking him how this miracle could happen through Jewish soldiers that do not keep the Torah. Rabbi Feinstein dismissed their question by stating simply that we do not understand the ways of Hashem and we should not involve ourselves in these types of analysis as the verse says “tomim tihiyeh im Hashem”. Here too, Rabbi Feinstein invoked “tomim tihiyeh” as a general instruction to place our faith simply in the hands of Hashem.

Although Rabbi Feinstein extolled faith and simplicity, in his classic work on the Talmud, Dibros Moshe (Bava Metzia, siman 31, he’orah 18), he fully acknowledged a person’s right to be wise and far-sighted about personal matters. The Talmud in Bava Metzia (23b) states that in certain situations a Torah scholar may say a white lie to avoid embarrassment. Rabbi Feinstein observes that in these scenarios the probability of the embarrassment actually happening is very far-fetched according to normal halachic standards. He therefore arrived at a fascinating conclusion, the halachic concepts of majority and chazaka were only intended to make halachic determinations and are not necessarily an instruction in making personal decisions. Therefore, because avoiding embarrassment is not a halachic decision but a personal one, it is acceptable to be concerned even about a minute possibility and therefore it is permitted to tell untruths to avoid this possibility. 

Rabbi Feinstein seems to be balancing these opposing concepts in his discussion about genetic testing for tay-sachs before marriage (Igros Moshe EH 4:10). First he writes, since the probability of both spouses being carriers is minute it may be included in the precept of “tomim tihiyeh” according to Rashi, which instructs us not to delve into the future. However, he then writes, since the test is easily available and if an inflicted child is born it is devastating, the public should be educated about their options. 

Part III  How do halachic sources view preventative measures like health screenings or genetic testing? Are they included in our obligation to heal, or are they a form of speculation that the Torah instructs us not to concern ourselves with?

In the previous post we highlighted factors like probability of occurrence, severity, and the reliability of the treatment or testing as important variables in balancing faith and responsibility. In this post we will continue to develop these concepts, and their application to health screenings and genetic testing. 

The famed Rabbi Shlomo Luria (1500’s) wrote, despite the sages’ general disfavor with unreliable practices, an ill person is not expected to rely on faith alone. Therefore, he may seek a sorcerer or astrologer to heal. Rabbi Luria, However, does strongly discourage a well person from such behavior based on the Mitzvah of “tomim tihiyeh”. 

This assertion can be embellished with the comments of the Maharal of Prague (Nesivos Olam, Nesiv Hatemimus). The Maharal explains that faith in Hashem is referred to as temimus, or wholeness, because it is a straight and sensible path. For this reason, seeking astrologers or sorcerers is discouraged because it deviates from a straight and logical approach to life. With this in mind we can gain a better appreciation for Rabbi Luria’s position. The Mitzvah of “tomim tihiyeh” is instructing us to be sensible. Logic dictates that a well person should not be concerned with far-fetched or whimsical possibilities, rather he should place his faith in the Master of the World. Therefore, because sorcery and astrology are far-fetched and whimsical, they should be avoided. That said, if a person is ill and desperate, it is reasonable to seek all possible options, even if they are not reliable (see Maharal Be’er Sheva p.30 in standard edition).

In this light we can understand a conversation of Rabbi Moshe Feinstein about cancer screening from the late 1970s (Mesores Moshe p.293). Apparently, a doctor was urging an ostensibly well person to undergo excessive (lit. strange) and possibly dangerous tests. The patient asked Rabbi Feinstein his opinion on the matter. Based on “tomim tihiyeh”, Rabbi Feinstein asserted that if there are no symptoms present, there is no reason to seek medical attention because it is not part of our normal responsibility to follow “derech hateva”, or the natural ways of the world.

It seems that Rabbi Feinstein had halachic concerns with the testing because it was far more excessive than the normative standards of the time. Additionally, the tests carried health risks, and were possibly inconclusive. In a similar vein, Rabbi Dovid Feinstein permits pregnant women to go for routine ultrasounds, because it is the common standard of care. Therefore, there is no concern of “tomim tihiyeh”. Apparently, the issue of “tomim tihiyeh” is only when the testing is considered excessive compared to the standard medical practice of the times.[...]

Read More

Prince Andrew sex claim: Alan Dershowitz threatens action : Destroying reputations with unsubtantiated allegations

BBC  A US lawyer says he is planning legal action against a woman who claims she was forced to have sex with him and Prince Andrew when she was a minor.

Alan Dershowitz told the BBC he wanted her claims to be made under oath.

He and the Duke of York were named in documents filed in a Florida court over how prosecutors handled a case against financier Jeffrey Epstein.

Buckingham Palace has denied the woman's claims that she was forced by Epstein to have sex with Prince Andrew.

On Saturday, the palace issued a further statement, in which it "emphatically denied that the Duke of York had any form of sexual contact or relationship" with the woman.

The Mail on Sunday has identified the claimant as Virginia Roberts, but the BBC has not been able to verify her identity. 

The woman behind the allegations says she was forced to sleep with the prince when she was under age, and on three occasions - in London, New York and on a private Caribbean island owned by Epstein - between 1999 and 2002.

Mr Dershowitz, a former Harvard Law professor, said he intended to legally challenge the woman's allegations. 

"My goal is to bring charges against the client and require her to speak in court. If she believes she has been hurt by me and Prince Andrew, she should be suing us for damages.[...]

Read More

Dor Yeshorim's work to save children from genetic diseases

Update: see Rav Moshe Feinstein - Medical tests and bitachon

Tablet Magazine     An office sits on a humble corner on Wythe Avenue in Williamsburg, a Brooklyn stronghold for hipsters and Hasidim alike. Above a locked and graffitied metal security gate is a weathered sign, its gold letters scratched and peeling. “Dor Yeshorim: Committee for Prevention of Jewish Genetic Diseases,” it reads. It’s unclear if anyone works there and whether or not the office is now just an idle space below closed-curtained apartment windows. The organization operates quietly, some would even say secretively: Phone numbers linked to Dor Yeshorim are automated, its website outdated and often unclickable, and its services little-known to those outside the Orthodox world.

The Brooklyn-based organization, which now offers Jewish genetic testing across the United States, Canada, Israel, and Europe, works to eliminate any chance that two carriers of the same genetic disease will even date, avoiding the heartache of having to abandon a progressing relationship, or worse, having a child with a fatal or debilitating genetic disorder. After conducting genetic screening, Dor Yeshorim assigns identification numbers that correspond to its clients’ genetic data. Before or soon after meeting, potential partners exchange ID numbers and dial an automated hotline to check genetic compatibility—a phone call that almost always determines if a relationship will move forward or end.

Described as both a matchmaking service and a preventative health organization, Dor Yeshorim provides an anonymous medium for clients to check compatibility. “You have reached Dor Yeshorim, the internationally recognized program for the prevention of Jewish genetic diseases,” answers the hotline’s automated male voice. “To submit a request for compatibility, press 1. To check compatibility, you will need to submit both the male and female’s nine-digit Dor Yeshorim identification number and both their dates and months of birth, not the year of birth,” the robotic voice instructs.

Since Dor Yeshorim’s founding in 1983, numerous Jewish genetic testing services have emerged worldwide. Secular Jews might choose to get screened through their physician’s office or at a hospital-based program. New York City’s Mount Sinai, NYU, Columbia, and Beth Israel hospitals all have medical genetics departments that offer testing. There are also community and nonprofit screening programs, as well as commercial labs. As genetic science advances, screening and access to genetic data have become easier and more affordable for the general population. But Dor Yeshorim differs, in one important way: Those tested never find out their results.

The only information provided is whether a pair is compatible—meaning that the two individuals are not carriers of a mutation for the same disease. If a boy and girl are incompatible, Dor Yeshorim indicates that continuing the relationship is “not advisable” and offers genetic counseling. Meanwhile, everyone’s test results remain locked in a confidential database. [...]

Read More

Bat Melech shelter for religious battered women in Israel to double its capacity

Times of Israel   An organization that runs two shelters for religious battered women will double its capacity and wipe out its current waiting list. 

Bat Melech currently serves over 1,000 women and children each year who require a kosher and Shabbat-observant atmosphere. [...]

“Many of Bat Melech’s residents are English-speakers from the United States, Canada, England and South Africa, so I see ourselves as the ‘international Jewish women’s shelter’ as we provide service to everyone, “ said Bat Melech’s overseas director Amy Oppenheimer.

Read More

Schlesinger Twins: Rebbetzn Rosenberg told the London community about Dr. Schlesinger's cruel and vindictive behavior regarding his children

On Sunday evening 14th of December Rebbetzin Miriam Rosenberg from Bnei Brak addressed a group of women from the Chareidi community in London to highlight child custody issues. She used the tragic case of the Schlesinger twins in Vienna to illustrate her points.

Many of the women who attended, have friends and family in Vienna, and proceeded to make contact their Austrian connections soon afterwards. The general feedback has been that the Chareidi community in Austria are also convinced that it was corruption in the judiciary which led to the injustice of the children being removed from their mother’s care (there can be no other rational explanation for the judge's behavior).

Furthermore, the community in Vienna, from independent sources, informed them that the weekly visitation has been put on hold due to the person doing the handover being unavailable. As such, the mother’s visitation has effectively been reduced to every alternate Sunday until further notice. The father, Dr. Schlesinger, can still allow the weekly visits to continue, if he wishes, under the handover supervision of Chief Rabbi Eisenberg (which has been kindly offered repeatedly), but every such request has been declined by Dr. Schlesinger.

Read More