Wednesday, August 17, 2011

The Burden of Choice

בס''ד

Parshat Re'eh
17 Menahem Av, 5771
August 17th, 2011

The New York Times Magazine this week published an article on a startling dilemma of medical ethics. The introduction of In Vitro Fertilization (IVF) has made it common that women seeking infertility treatments will become pregnant with multiple embryos. In a number of cases, women carry more fetuses than they can safely bear to term. In order to protect the mother’s life, doctors terminate all but two or three.
As is the case with so much of medical progress, new technology has brought unprecedented choice. In the words of the article, “…what began as an intervention for extreme medical circumstances has quietly become an option for women carrying twins. With that, pregnancy reduction shifted from a medical decision to an ethical dilemma.” Women now may choose to reduce twins or triplets to a single fetus.
The Torah’s view of abortion maps very poorly onto contemporary discourse. It would understand neither Catholic/Protestant ideas that life begins at conception, nor the idea of a “right to choose.” Depending on circumstance, Torah permits, forbids, and even compels abortion.* But I do not believe that the criticality of this ethical question – whether one may electively reduce a pregnancy – is found in a discussion on abortion. Rather, this is a question about the will of God.
The will of God is a powerful idea in Torah. It most often means accepting that which is placed before us and relinquishing control. Death, for example: every time a person dies we say a prayer, the tziduk hadin (acknowledging the righteousness of the judgment), which understands that mortality is the will of God.
But in IVF-related pregnancies, the problem is that multiple embryos are not the will of God.** They are the direct result of human intervention, an acknowledged statistical possibility of a medical technique. The situation has evolved from accepting what God ordains into the question of making Godly decisions between the possibilities available to us.
These decisions are not simple: since the pregnancy was artificially initiated, should women have more choice about how it progresses? Which reasons for doing so are moral and which not? The stakes are high.
Our headlong hurtle into undreamed technologies is changing our fundamental relationship to God and the world. We are vastly more powerful, but still just as corruptible. We carry an unheard of burden of choice, but are moving so quickly that we do not bear the burden easily.
I think it foolish to believe that we could just take a breather from technological progress. But we do need to spend much more time understanding what is happening to us and what we are becoming. Not doing so means morally abandoning those confronted by the difficult decisions that progress occasions. We owe them, and ourselves, and God more.

*Two well-grounded synopses of halakhic views of abortion: http://www.myjewishlearning.com/beliefs/Issues/Bioethics/Abortion.shtml

**Except in the sense that everything (literally everything) is the will of God. This is some deep theology, so catch me in the halls and we’ll talk about it.

1 comment:

  1. Rabbi Perlo,
    The burden of choice is a moral dilemma, but it is each woman's personal moral dilemma. As a mother, I can't imagine that any woman would make this decision without a good deal of consideration.

    ReplyDelete