jewish bioethics essay

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Jewish Bioethics 101

By My Jewish Learning

Judaism does not categorically approve or disapprove of abortion. Jewish law does not consider a fetus to be a human being ; thus it actually requires abortions when a pregnant woman’s life is in danger. Jewish authorities disagree on whether to extend the permissibility of abortion to situations where the pregnancy or birth is psychologically but not physically dangerous. Those who allow for abortion in suchcases disagree on how far to extend this permissibility. Most of these authorities allow abortion in cases of incest or rape and cases where the fetus is affected with a terminal genetic disease such as Tay-Sachs. Other authorities extend permissibility further and may include cases where the fetus has a non-terminal genetic defect or even situations where the mere fact of pregnancy and anticipated childbirth is a threat to the mother’s mental health .

Organ Donation

A slew of ethical and halakhic questions arose when organ transplants first became viable. Ultimately, however, most of these problems were neutralized by a single legal and ethical concept– pikuach nefesh , the Jewish obligation to save lives . Except in those cases where one of two parallel organs, e.g. kidneys, can be donated by a living individual, it is imperative that an organ donor be halakhically dead before her vital organs are removed; thus, defining the moment of death is essential. Today, most rabbinic authorities accept brain stem death–as opposed to cessation of heartbeat–as halakhic death, thus allowing organ transplantation under Jewish law.

Genetic Issues

According to the Talmud , a goses , a dying person, is considered no different than any other human being. Not only does the Talmud consider one who kills a goses to be a murderer, it prohibits any actions that may speed up her death. Thus, traditionally , euthanasia and physician-assisted suicide are prohibited by Jewish law. Nevertheless, most Jewish authorities object to any actions that impede the death of a sufferer. Additionally, modern authorities like Reform rabbi Peter Knobel support the termination of life in situations of extreme suffering, when a person’s tzelem elohim , or divine image, is compromised. Conservative rabbi Elliot Dorff has also questioned the relevance of the goses category, and in doing so comes to more liberal conclusions about end-of-life issues.

Fertility Technologies

A host of options now exist for couples and individuals who have difficulty conceiving through conventional means. “Artificial” insemination , in vitro fertilization (IVF), and surrogate motherhood all raise ethical and legal questions. Could insemination with donor sperm be considered adultery? Is the child born from such procedures illegitimate? What is the status of unused embryos after IVF is completed? Who is the mother–and what is the Jewish status–of a child born to a surrogate mother? There are few unanimous answers to such questions. However, procreation is a mitzvah , a fundamental Jewish obligation, and so these procedures are often permitted, particularly when the egg and sperm are those of husband and wife .

Pronounced: TALL-mud, Origin: Hebrew, the set of teachings and commentaries on the Torah that form the basis for Jewish law. Comprised of the Mishnah and the Gemara, it contains the opinions of thousands of rabbis from different periods in Jewish history.

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In This Article Expand or collapse the "in this article" section Jewish Ethics

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Jewish Ethics by Jonathan Crane LAST REVIEWED: 30 June 2014 LAST MODIFIED: 30 June 2014 DOI: 10.1093/obo/9780199840731-0087

Jewish ethics investigates both theoretical and practical questions of what Jews can and should do in the world. It involves weaving together theology, philosophy, and law—the classic triumvirate for religious ethics—as well as lore, history, science, and sociology, among other facets of human knowledge and experience. With these tools in hand, some Jewish ethicists have wrestled with such questions as the relationship between law and ethics; the role of external, non-Jewish influences and thinkers; and the relationship between science, medicine, and revelation. Others contend with theories of the good and the right, with theology and ethics. And still other Jewish ethicists hone in on the minutiae of lived life, such as the pragmatics of behavior and policy. Though both ethics and morality can certainly be extracted from biblical and early rabbinic materials, it was not until the 9th century that Saadia Gaon discussed ethics as a subject matter worthy of distinct and extended consideration. For the next thousand years, only a few handfuls of volumes were exclusively devoted to ethics and morality, usually embedded in legal, philosophical, and theological texts. Increasing intellectual exposure to Western thinkers and society, especially to Immanuel Kant’s universal rationalistic philosophy and ethics, challenged and inspired Jews to clarify and explain Jewish ethics and morality. Hermann Cohen’s fin-de-siècle neo-Kantian revisioning of Judaism as ethical monotheism catapulted 20th-century Jewish ethical and moral thought from occasional meditations to central conversations across the streams of modern Jewry. Indeed, the last century’s incomprehensible tragedies and awesome technological advancements provided much fodder for Jewish ethical and moral consideration. Jewish bioethical discourse budded and bloomed after World War II; tracts on social, environmental, warfare, and political moral issues exploded in the 1960s and 1970s; first generations of feminist and covenantal ethics emerged in the 1980s and 1990s; a return to virtue ethics took root in the 1990s and early 2000s; and a renewed concern with business morality responded to embarrassing scandals and economic turmoil in the 2000s. Historically, Jewish ethics has been dominated by male voices and by contributors from North America and Israel, but the field is becoming increasingly diverse, as evidenced by the membership and leadership in the Society of Jewish Ethics, the premier, if not only, independent academic society devoted to this field. To be sure, Jewish ethicists will continue to wrestle with the most perplexing and enduring questions of human civility and creativity.

The first wave of anthologies in this field, comprising Fox 1975 and Kellner 1978 , included both theoretical and practical issues, and each focused on the ethics of military power—an understandable theme given the recent wars in Vietnam and Israel. The second generation is perhaps best exemplified by Dorff and Newman 1995 , which broadened the voices contributing to both methodological and practical debates. The third generation divides into the more pragmatic volumes of Dorff, et al. 2008–2010 , and the more comprehensive dual focused (theoretical and pragmatic) collection Dorff and Crane 2013 . Kolatch 1985 and Sherwin and Cohen 2001 reflect the emerging self-help ethos with a collection of short answers to or instructional essays on questions of ethical and moral concern. Newman 1998 surveys the breadth of the field and offers a taxonomy of its features.

Dorff, Elliot N., and Jonathan K. Crane, eds. The Oxford Handbook of Jewish Ethics and Morality . New York: Oxford University Press, 2013.

The most comprehensive anthology to date, complete with original essays from scholars throughout the Jewish world. The volume covers historical, thematic, denominational, and practical issues. Each essay includes suggested readings, and the index identifies classic texts, themes, and figures.

Dorff, Elliot N., and Louis E. Newman, eds. Contemporary Jewish Ethics and Morality . New York: Oxford University Press, 1995.

A diverse collection of previously published—and classic—essays (many edited for length) addressing metaethical concerns, methodological issues, virtue ethics, and sexuality and gender, as well as social, economic, and ecological issues, medical ethics, and the political exercise of power.

Dorff, Elliot N., Louis E. Newman, and Danya Rutenberg, eds. Jewish Choices, Jewish Voices . 6 vols. Philadelphia: Jewish Publication Society, 2008–2010.

This series of slim volumes, designed for college students, integrates case studies and questions with classic sources and contemporary essays. Each volume includes suggested readings. Volumes address Body ; Sex and Intimacy ; Power ; Social Justice ; War and National Security ; and Money .

Fox, Marvin, ed. Modern Jewish Ethics: Theory and Practice . Columbus: Ohio University Press, 1975.

Now considered a classic, the volume includes presentations and responses from a 1971 conference in Israel that wrestle with the legal and philosophical bases of Jewish ethics, in addition to essays on the political exercise of power. The index points to traditional sources as well as themes and names.

Kellner, Menachem M., ed. Contemporary Jewish Ethics . New York: Sanhedrin, 1978.

Perhaps the first collected edition in this field, its essays confront the questions of whether Kantian autonomy can countenance religious ethics, and whether Judaism and its legalism can countenance ethics beyond law. The volume includes classic pieces on political and medical ethics, capital punishment, business ethics, sexual ethics, and the Holocaust. Includes suggested readings and a brief glossary.

Kolatch, Alfred J. The Second Jewish Book of Why . Middle Village, NY: Jonathan David, 1985.

The second volume in this series is an introductory book using a Socratic method to cover social, personal, bioethical, gender, and dietary issues. The index is helpful.

Newman, Louis E. Past Imperatives: Studies in the History and Theory of Jewish Ethics . Albany: State University of New York Press, 1998.

Perhaps the best overall descriptive survey of the field of Jewish ethics, examining the tensions between ethics and law, ethics and theology, and methodological issues. One of the chapters, “Woodchoppers and Respirators: The Problem of Interpretation in Contemporary Jewish Ethics,” is now a classic in the field, especially for bioethics and euthanasia.

Sherwin, Byron L., and Seymour J. Cohen. Creating an Ethical Jewish Life: A Practical Introduction to Classic Teaching on How to Be a Jew . Woodstock, VT: Jewish Lights Publishing, 2001.

A creative “how-to” book integrating classic sources on the three fundamental relationships of Judaism: relations with God, relations to the self, and relations with others. Helpful notes, bibliography, and index.

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Method in Jewish Bioethics

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The goal of this essay 1 is to give an overview of methodology in Jewish bioethics (which of course is simply Jewish ethics applied to a specific con­stellation of issues). To the extent possible in one paper, I will introduce the reader to the process by which Jewish ethical reasoning brings old insights to bear on new problems.

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Davis, D.S. (1994). Method in Jewish Bioethics. In: Camenisch, P.F. (eds) Religious Methods and Resources in Bioethics. Theology and Medicine, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-015-8362-6_5

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Bioethics for clinicians: 22. Jewish bioethics

Gary goldsand.

*Doctoral candidate, Joint Centre for Bioethics and Centre for the Study of Religion, University of Toronto; †Research Assistant, Baycrest Centre for Geriatric Care, Faculty of Arts and Science, University of Toronto; ‡Vice-President of Medical Services and Head of Geriatrics and Internal Medicine, Baycrest Centre for Geriatric Care, Head, Division of Medicine, Mt. Sinai Hospital, Professor of Medicine, University of Toronto, and member, Joint Centre for Bioethics, University of Toronto, Toronto, Ont.

Zahava R.S. Rosenberg

Michael gordon.

Jewish bioethics in the contemporary era emerges from the traditional practice of applying principles of Jewish law (Halacha) to ethical dilemmas. The Bible (written law) and the Talmud (oral law) are the foundational texts on which such deliberations are based. Interpretation of passages in these texts attempts to identify the duties of physicians, patients and families faced with difficult health care decisions. Although Jewish law is an integral consideration of religiously observant Jews, secularized Jewish patients often welcome the wisdom of their tradition when considering treatment options. Jewish bioethics exemplifies how an ethical system based on duties may differ from the secular rights-based model prevalent in North American society.

Mrs. L is an 85-year-old resident of a Jewish long-term care facility who has vascular dementia, controlled heart failure and diabetes mellitus. The gastrostomy feeding tube she received 2 years ago has begun leaking and needs to be replaced. Her daughter, who has become her surrogate since the recent death of Mrs. L's husband, has indicated that if the tube were to come out, she would not consent to the insertion of a new tube: a decision she feels would be in accord with her mother's true wishes. She would not, however, request that the tube be deliberately removed. The staff are concerned that, by not replacing the tube, they would be failing to maintain the current level of treatment. They feel that this would amount to taking the mother's life without any substantial decline in her clinical condition. The daughter acknowledges the concern and devotion of the staff and her mother's unchanged clinical status but reiterates her belief that her mother would prefer to be allowed to die rather than to continue with feeding through a gastrostomy tube.

What is Jewish bioethics?

Although discussions of medical ethics can be found in Jewish writings since ancient times, modern medical technologies have placed new challenges before interpreters of Jewish tradition. 1 , 2 , 3 , 4 , 5 , 6 The zeal with which these questions have been addressed has given rise to the field of Jewish medical ethics over the past 40 years. In keeping with Jewish ethics generally, Jewish bioethical inquiry appeals to the principles found in Jewish scriptures and commentaries and applies them to clinical decision-making. In doing so, it takes a duty-based approach rather than the predominately rights-based approach characteristic of contemporary secular bioethics. As the late Benjamin Freedman pointed out, bioethical deliberations that are focused on rights may do well in solving the procedural question of who gets to decide a particular question, but they do not necessarily offer guidance as to what the best decision might be. 7 Framing a dilemma in terms of the duties owed to those involved can clarify the issues and suggest a satisfactory course of action.

Interpersonal behaviour in Judaism is traditionally conceived as the execution of duties within the context of relationships. From this perspective, a preoccupation with rights implies the relative isolation of individuals making claims upon one another; this further implies an implicitly or overtly adversarial relationship. In a “regime of duty,” participants seek to enable each other to satisfy the obligations inherent within relationships, 8 including professional relationships. Judaism urges one to perform mitzvoth (good deeds), that is, to act in accordance with one's duties, and this applies in the health care setting no less than anywhere else. The clinic thereby provides a relatively new arena in which mutual obligations between patients, physicians and families can be explored. Such explorations inevitably begin with the established norms of Jewish law and behaviour, collectively known as Halacha (literally, “the way”).

A variety of approaches

Traditional Jewish legal and ethical thinking is based on reading and interpreting 3 main sources, each of which is vast, varied and complex. The oldest and most authoritative is the Bible, which includes the 5 books of Moses (the Torah), the Prophets and additional writings. The second source is the Talmud, which is composed of multilayered commentaries on biblical texts and oral traditions by learned rabbis of the second to fifth centuries CE. To make the voluminous Talmud more accessible, several great codifications of Jewish law emerged that attempted to summarize the Talmud's primary teachings. 9 , 10 One of the most notable, the Mishne Torah, 11 comes from Maimonides, the noted 12th-century physician and scholar. The third main source of Jewish legal authority is the Responsa literature, in which prominent Jewish scholars through the centuries have given opinions on contemporary matters as interpreted through the Bible and Talmud. 12 , 13 Responsa are the continuation of a 2000-year-old interpretative tradition, which creates an intellectual link to the past, helping to keep the law relevant and vital to the present. (Descriptions of codes and responsa can be found in references 14 and 15 14 , 15 , or in any general guide to the sources of Jewish law.)

Bioethical questions are treated by Jewish authors in a variety of ways, which reflect different orientations toward Judaism and degrees of strictness in the interpretation of Talmudic texts and cases. Pioneering work in contemporary Jewish medical ethics in the 1960s and 1970s came primarily from Orthodox Judaism, in which the authority of God, as expressed through the Torah and Talmud, underlies the deliberative process. 16 Much Jewish bioethics literature comes from this perspective, which assumes that, through the proper interpretation of Talmudic texts and commentaries, answers to the most difficult questions can be discovered. In practice, the rabbi whose opinion is sought for an ethical answer serves as an “expert counsellor” to physician and patient, interpreting Halachic law for the situation in question. A local rabbi or chaplain may, in turn, consult more learned Halachic authorities in difficult cases.

Inspired by these Orthodox sources, Jews from the more liberal Reform and Conservative movements have also made contributions to contemporary bioethics. 17 , 18 , 19 , 20 The interpretative method and texts used are basically the same, but their rulings are often more flexible than those provided by Orthodox rabbis. Even within Orthodox Judaism there exist multiple interpretations of most texts, with a resultant variability of rulings. Jews of the Reform movement are often more open to “extra-Halachic Jewish ethical analysis,” 21 in which Halacha becomes only one of several sources of moral authority.

Common principles

Although traditional Jewish scripture expresses many principles worthy of ethical consideration, there are a few foundational tenets that ground much of the Jewish bioethical tradition. One commentator identified 3 main principles: “human life has infinite value; aging, illness and death are a natural part of life; and improvement of the patient's quality of life is a constant commitment.” 22 Other important principles are that human beings are to act as responsible stewards 23 in preserving their bodies, which actually belong to God, 24 and that they are duty bound to violate any other law in order to save human life (short of committing murder, incest or public idolatry). Compared with secular values, these principles suggest a diminished role for patient autonomy. The duty to treat illness or preserve health overrides any presumed right to withhold treatment or to commit suicide.

In general, traditional Judaism prohibits suicide, euthanasia, withholding or withdrawal of treatment, abortion when the mother's life or health is not at risk and many of the traditional “rights” associated with a strong concept of autonomy. For example, an observant Jew would not consider it his or her right to seek physician-assisted suicide as a way to avoid present or future suffering from metastatic carcinoma. Exceptions to these prohibitions are sometimes made in extreme circumstances.

The problem faced by Jews in end-of-life decisions is not usually in determining the appropriate Halacha; a greater challenge is determining the moment when hope for continued life is lost and the process of death has begun. Jewish law is relatively clear that life is not to be taken before its time. It is equally clear that one is not to impede or hinder the death process once it has begun. 25 Lenient rulings in such cases may well be based on the same texts as strict rulings; one authority may see continued treatment as prolonging life, where another may see it as prolonging death. Working through this dilemma is a common feature of Jewish end-of-life decision-making. Both the duty to treat and the duty not to prolong death must be considered in light of the more general duty to care for one's parents in old age or ill health.

Why is Jewish bioethics important?

To traditionally minded Jews, Jewish bioethics is a subset of Halacha, which guides all of their activities. To more secular Jews seeking guidance in difficult decisions about their health, Jewish bioethics offers helpful lessons and considered opinions from the sages. Many nonreligious Jews welcome traditional views to help ease the uncertainty inherent in difficult ethical decisions, even though they may not live according to traditional religious practice. Of the 360 000 Jews in Canada (over 13 million worldwide), 1990 Canadian statistics revealed that 40% of the affiliated Jews identified themselves as Orthodox, 40% from the Conservative movement and 20% from the Reform movement. 26

An understanding of Jewish bioethics can help anyone, Jewish or not, who wishes to explore the many ways people think about difficult ethical issues. Even without accepting the authority of the Bible and the Talmud, physicians may benefit from seeing how principles or norms can be derived from authoritative texts, how minority opinions can be incorporated into such deliberations (the Talmud consistently records these), and how grappling with tough questions in this structured way can increase sensitivity to ethical and decisional nuance. Perhaps the most important lesson to be learned is that there are few easy answers to complex problems. Jews do not have a guidebook that explicitly tells them what to do in every situation. Rather, their guidebook is cryptic and requires them to consider thoroughly the range of possible answers to ethical dilemmas. It is a tradition of continued and ongoing questioning rather than one of absolute theological law passed down from above. 27 Furthermore, familiarity with Jewish bioethics would give the practitioner the perspective to consider ethical dilemmas through the lens of duty rather than of rights, asking the question, “What are the obligations of each of the parties involved in this discussion?” Although the rabbis of the Talmud would have appreciated the procedural question, they were more concerned with finding the best course of action, irrespective of the participants' wishes.

How should I approach Jewish bioethics in practice?

Both Jewish and non-Jewish physicians can benefit from being acquainted with Jewish bioethics in caring for patients and their families when issues related to Judaism are raised. Table 1 summarizes essential points to keep in mind when providing care to Jewish patients.

The patient's life history might have some bearing on the type of treatment approaches he or she requires. Older Jews not born in Canada might be more likely to appreciate a rabbi's input, as they are often more traditional than their children. Also, there are still a significant number of Holocaust survivors in most Canadian cities, some of whom have significant psychological associations stemming from traumatic experiences.

Very traditional or religious Jews may have concerns about modesty in the health care setting, and many might appreciate being cared for by nurses or physicians of the same sex. Hospital attire that preserves modesty may be doubly appreciated by patients who are religious. Some Jewish patients may also appreciate brief periods set aside for prayer or other ritual obligations.

A physician treating a Jewish patient should not make assumptions about the extent to which he or she would like his or her care to be guided by Jewish tradition. It would be perfectly appropriate to ask a patient whether Jewish opinions are considered in the decision-making processes, and to consult with a rabbi — a specific one if so requested — when the patient wishes to explore the tradition's wisdom on a particular matter.

Mrs. L's daughter is undoubtedly trying to respect her mother in not consenting to the insertion of a new gastrostomy feeding tube, but she will find it difficult to get rabbinical support for reducing or withdrawing treatment that would result in her mother's death without a prior serious decline in Mrs. L's overall condition. How best to respect her parent is not easy to determine, but usually Judaism teaches that prolonging life is more respectful than assuming an incompetent patient wishes to end her suffering prematurely. There is a clear duty to “cause to eat” 28 in the Jewish tradition that her daughter should not, according to the Halacha, violate unless Mrs. L is deemed to be a goses (a person in the throes of dying), in which case treatment or feeding that would hinder the dying process would not normally be allowed. Even as death approaches, performing duties as articulated by Jewish law is the essence of traditional Jewish life, a source of joy and fulfillment for both patients and families, and Jewish bioethics suggests that the articulation and performance of such duties be the focus of clinical decision-making. The daughter agrees to have the gastrostomy tube replaced. She and the health care team determine conjointly the basis for future care within a palliative care framework. Mrs. L succumbs comfortably to pneumonia some months later.

Related Web sites

• American Physicians Fellowship for Medicine in Israel: www.apfm.ed.org/discus
• The Gemara (Talmud): www.acs.ucalgary.ca/~elsegal/TalmudMap/Gemara.html
• Institute for Jewish Medical Ethics: www.ijme.org
• Jewish Community Online's Inernet Resources (Family/Health and Bioethics): www.jewish.com/search/Family/Health_and_Bioethics
• Jewish Law: www.jlaw.com
• Judaism and Medicine on the Web: http://shamash.org/shuls/einstein/medlinks.html
• Judaism 101: www.jewfaq.org/toc.htm
• Mish Mash (Linking Judaism Worldwide): http://mishmash.virtualave.net
• Page from the Babylonian Talmud: www.acs.ucalgary.ca/~elsegal/TalmudPage.html
• Physician-assisted suicide: www.jlaw.com/Articles/phys-suicide.html and www.jlaw.com/Articles/suicide.html
• The right to die: a Halachic approach: www.jlaw.com/Articles/right.html
• Risk: Principles of Judgment in Health Care Decisions: www.thebody.com/iapac/freedman.html
• Shulchan Aruch: www.torah.org/advanced/shulchan-aruch
• The Thirteen Principles of Jewish Medical Ethics: http://members.aol.com/Sauromalus/index.html

This series began in the July 15, 1996, issue and can be found on CMAJ's Web site ( www.cma.ca/cmaj/series/bioethic.htm ).

This article has been peer reviewed.

Acknowledgements : We thank Peter A. Singer, David Novak, Robert Williams and Rabbi Norman Berlat for their editorial comments and assistance with content for this paper.

Competing interests : None declared.

Reprint requests to: Dr. Michael Gordon, Medical Administration, Baycrest Centre for Geriatric Care, 3560 Bathurst St., Toronto ON M6A 2E1

Understanding the Major Branches of Judaism

This essay about the major branches of Judaism—Orthodox, Conservative, Reform, and Reconstructionist—explores how each interprets Jewish law, tradition, and identity differently. Orthodox Judaism adheres closely to traditional Jewish law, with subdivisions like Ultra-Orthodox and Modern Orthodox Jews balancing religious observance with varying degrees of engagement with the modern world. Conservative Judaism finds a middle ground, upholding traditions while allowing for their evolution. Reform Judaism emphasizes ethical teachings and personal choice over strict observance, adapting practices to fit contemporary values. Lastly, Reconstructionist Judaism views Judaism as a dynamic civilization that evolves democratically according to the needs of its community. These branches reflect the diversity within Judaism, showing how it adapts to cultural and historical contexts while maintaining core commitments to monotheism, moral guidance from the Torah, and the preservation of Jewish culture. This diversity not only helps Judaism stay relevant across different eras and geographies but also highlights its capacity to offer varied and meaningful ways for Jews to express their faith and identity.

How it works

Judaism, among the ancient monotheistic faiths, presents an intriguing narrative of how religious traditions adapt across diverse historical and cultural contexts. It stands as a testament to diversity, boasting multiple distinct branches, each interpreting Jewish law, tradition, and identity uniquely. The principal branches—Orthodox, Conservative, Reform, and Reconstructionist—exhibit a spectrum of beliefs, practices, and observance levels tailored to the varied spiritual and lifestyle needs of Jewish communities globally.

Orthodox Judaism epitomizes traditional Jewish practices in the public consciousness. It adheres rigorously to the Halacha, or Jewish law, as interpreted from the Talmud.

Orthodox adherents meticulously observe dietary laws, Sabbath restrictions, and daily prayers, endeavoring to uphold commandments passed down through generations. The Orthodox branch encompasses various subgroups, including Ultra-Orthodox or Haredi Jews, and Modern Orthodox Jews. Haredi Judaism advocates separation from secular society, prioritizing religious study, while Modern Orthodox Jews engage with the modern world, integrating secular knowledge into religious observance.

In contrast to Orthodox Judaism, Conservative Judaism emerged in the late 19th century as a mediating force between Orthodox and Reform Judaism. It emerged from a movement that perceived the need for traditional Judaism to adapt to contemporary realities. While Conservative Jews respect traditional laws, they believe in their evolution. This branch interprets the Torah and Talmud within historical contexts, advocating for a flexible approach that respects Jewish traditions while adapting to modernity. The Conservative movement endeavors to balance preservation of Jewish law with openness to change, appealing to those seeking a blend of tradition and progressivism.

Reform Judaism, originating in the 19th century, embodies a liberal ethos within Judaism. It arose among Jews who believed in significant revisions to align the religion with contemporary values. Reform Judaism prioritizes the ethical dimensions of the Jewish faith over ritual observance, granting individuals autonomy in selecting practices. This branch is noted for its inclusivity and adaptability, often incorporating local languages and modern symbols into its rituals to connect with congregants. Reform Judaism espouses a proactive stance toward religious life, continuously seeking innovative interpretations of ancient teachings that resonate with modern ethical and social realities.

The youngest major branch, Reconstructionist Judaism, was founded in the 20th century by Rabbi Mordecai Kaplan. It views Judaism as a continually evolving civilization rather than a static set of laws. Reconstructionism champions a democratic model of Jewish life, encouraging communal decision-making on traditions’ preservation and application. The movement emphasizes social justice and community service as central to Jewish identity and expression. Reconstructionist Judaism is forward-thinking, often leading discussions on Judaism’s need to adapt to new challenges effectively.

Despite their divergences, all branches of Judaism share core commitments—to monotheism, to the moral and spiritual guidance of the Torah, and to Jewish culture and learning’s preservation. These shared principles provide common ground, while the diversity among branches allows Jews to find expressions of faith resonant with their beliefs and lifestyles.

Understanding Judaism’s branches is essential not only for Jews but also for those interested in how religions adapt to historical and cultural shifts. It offers insights into the internal dynamics of a faith that, despite its ancient origins, continues to evolve amidst modern challenges. Judaism’s diversity is its strength, enabling it to thrive globally and maintain relevance amidst societal changes.

Looking ahead, Judaism’s branches will undoubtedly continue interacting, prompting new interpretations and practices that enrich the tradition. Whether through renewed Torah interpretations, innovative rituals, or redefined social roles, Judaism will demonstrate its remarkable capacity to balance tradition and change, offering meaningful avenues for followers to express their faith and identity in an ever-evolving world.

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• Israeli Views of the Israel-Hamas War

1. Views of the Israel-Hamas war

Table of contents.

• Views of the Israeli military response against Hamas
• Attitudes toward Israel’s war cabinet
• Current concerns about the war
• Confidence in Biden
• Views of how Biden is handling the Israel-Hamas war
• Who is Biden favoring in the conflict, or is he striking the right balance?
• Views of the U.S.
• Who Israelis want to play a role in diplomatically resolving the war
• Success against Hamas
• Israel’s future national security
• The future of Gaza
• Views of Palestinian leaders
• Palestinian statehood and coexistence
• Acknowledgments
• Methodology

At the time of the survey in March and early April, Israelis voiced differing views of the war. Reactions to the military response against Hamas were generally mixed, as were attitudes toward the principal decision-makers – the three members of Israel’s war cabinet . However, most Israelis shared concerns that the war could expand across the region and last a long time.

When asked to assess their country’s military response against Hamas in Gaza, about four-in-ten Israelis say it has been about right. Another 34% say it has not gone far enough, while 19% say it has gone too far.

Israeli Arabs are much more critical of the military response, with 74% saying it has gone too far. Only 4% of Israeli Jews agree.

Views of the military response are divided along ideological lines. Roughly half of those who place themselves on the right (52%) say the military response has been insufficient. About a quarter of those in the center (24%) agree and only 9% of Israelis on the left say the same.

On the other hand, a majority of Israelis on the ideological left (55%) say the military response to Hamas has gone too far. Only 15% of those in the center and 5% of those on the right share this view.

Among Israelis who have a favorable view of Prime Minister Benjamin Netanyahu, roughly half (49%) say the response to Hamas has been about right, but another 45% say it has not gone far enough. Only 1% of those who favor Netanyahu think the military response has gone too far.

In the days following the Oct. 7 attack on Israel, the country’s then-governing coalition struck a deal with National Unity, an opposition party, to join an emergency government . The leader of the party, Benny Gantz, together with Netanyahu and Minister of Defense Yoav Gallant, formed the core of the new war cabinet , which was tasked with navigating the course of the conflict. (The survey was conducted before Gantz threatened to leave the war cabinet .)

Of the cabinet’s three voting members, Gallant enjoys the most public support in our survey: 61% of Israelis say they have a very or somewhat favorable view of him. Around half say the same about Gantz. As for Netanyahu, approximately four-in-ten Israelis have a positive view of the prime minister. 

For more on views of Palestinian leaders, refer to Chapter 3 .

The majority of Israelis (58%) see their prime minister in a negative light. The share of Israelis who have a somewhat or very unfavorable view of Netanyahu is the largest it has been since the Center first started asking the question in 2013, up 6 percentage points from last year.

Related: A growing share of Americans have little or no confidence in Netanyahu

Netanyahu’s favorability ratings have fallen among Jews and Arabs alike. However, roughly half of Israeli Jews still see him positively, compared with only 7% of Israeli Arabs.

Favorability among right-leaning Israelis – the mainstay of Netanyahu’s political coalition – has also declined. In this group, 69% have a favorable view of Netanyahu, compared with 85% last year.

Views of the three members of Israel’s war cabinet vary by ethnicity, ideology and levels of religious observance.

• About three-quarters of Israeli Jews have a favorable view of Gallant, but only 9% of Israeli Arabs agree. Of the three war cabinet members, Gantz has the highest share of support among Israeli Arabs (30%).

• Among those on the ideological right, about two-thirds have a favorable view of the prime minister. Only 18% of centrists and 8% of those on the left share this view. Gantz, a centrist party leader, is favored by 71% of Israelis in the center and a smaller majority (56%) of those on the left.
• Most Hiloni (“secular”) Jews in Israel (76%) say they have a favorable view of Gantz – more than double the share of Haredim (“ultra-Orthodox”) and Datiim (“religious”) who say the same (32%). Netanyahu, who relied on religious parties and their voters to build his governing coalition, is seen favorably by 88% of Haredi and Dati Jews, but by only 21% of the Hiloni public.

Most who have a favorable view of the prime minister feel similarly about Gallant, his minister of defense and fellow Likud member (84% have a favorable view of him). Gantz has less appeal among those who express a favorable view of Netanyahu – only about a third in this group also hold a favorable view of his political rival.

Thinking about the course of the war, most Israelis express a great deal of concern about its scope and duration.

Around six-in-ten are extremely or very concerned about the war expanding to other countries in the region, and about seven-in-ten are seriously worried about the war lasting a long time. (The survey was fielded amid escalating conflict along Israel’s border with Lebanon but prior to Iran’s missile attack on Israel in mid-April.)

Jewish and Arab Israelis are equally concerned that the war might expand to other countries (61% in each group voice this concern), though Arabs are slightly more likely than Jews to say they worry about a long war (77% vs. 66%).

Approximately a quarter of Israelis on the ideological left and in the center are extremely concerned about the war expanding across the region – roughly double the share of right-leaning Israelis who express the same level of alarm.

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World May 18

Mexicans Are on the Verge of Electing Their First Female President

Claudia Sheinbaum is the front-runner in Mexico’s presidential race, but she is wrestling with the image that she could be a pawn of the current president.

If elected president of Mexico this weekend, Claudia Sheinbaum will inherit a long list of troubles from her predecessor and mentor, Andrés Manuel López Obrador. Credit... Marian Carrasquero for The New York Times

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By Natalie Kitroeff

Reporting from Mexico City

• May 30, 2024 Updated 9:56 a.m. ET

Claudia Sheinbaum’s list of accolades is long: She has a Ph.D. and a shared Nobel Peace Prize and was the first woman elected to lead Mexico City, her nation’s capital and one of the largest cities in the Western Hemisphere.

Now she has another chance to make history. Ms. Sheinbaum, 61, is the clear front-runner in the Mexican election on Sunday, putting her in position to become the country’s first female president.

But she has an image problem, and she knows it.

Many Mexicans are wondering: Can she be her own leader? Or is she a pawn of the current president?

“There’s this idea, because a lot of columnists say it, that I don’t have a personality,” Ms. Sheinbaum complained to reporters earlier this year. “That President Andrés Manuel López Obrador tells me what to do, that when I get to the presidency, he’s going to be calling me on the phone every day.”

With the Mexican election just days away, Ms. Sheinbaum is facing a fundamental dilemma.

She insists she will govern independently from her mentor, Mr. López Obrador, and has some different priorities. But veering too far from his agenda could be very risky.

She and Mr. López Obrador are “different people,” she said in an interview. He’s an oilman who invested in environmentally questionable projects; she’s a climate scientist. Yet Ms. Sheinbaum has risen to the top in part by aligning herself completely with him, and by backing moves like his big bet on the national oil company and constitutional changes that critics call antidemocratic.

Will she dare to stray from those policies if she wins office, inviting the reproach of Mr. López Obrador and the movement that got her there? Or will she dedicate herself to cementing his legacy, even if it means stifling her own vision?

“Claudia can’t say what she’s going to do, because right now she has to show absolute loyalty to Andrés Manuel,” said Ana Laura Magaloni, a legal expert who advised Ms. Sheinbaum during her first year as mayor.

“What’s going to happen when Claudia is free from that yoke, when Andrés Manuel is no longer there?” Ms. Magaloni said. “No one knows.”

The other top contender is a woman named Xóchitl Gálvez, a tech entrepreneur who is representing several opposition parties. But with Ms. Sheinbaum leading the polls by 20 percentage points, much of the national debate has centered on who she would really be as president.

Ms. Sheinbaum says it is sexist to suggest that the possible first female leader of Mexico is really only the puppet of a man.

“There’s a trace of misogyny, of machismo there,” she told one interviewer. “They say, ‘The only reason she’s ahead in the polls is because she’s the same as the president, or she’s the president’s favorite.’”

Mr. López Obrador will be remembered for doubling the minimum wage and lifting millions out of poverty, but also for empowering the military, prioritizing fossil fuels and pushing measures that critics say could weaken Mexico’s democratic institutions.

His successor stands to inherit a long list of troubles. The state-owned oil company is buckling under debt, migration through the country has reached historic highs, violence is raging and former President Donald J. Trump is already threatening tariffs if he wins the American election.

Ms. Sheinbaum told The New York Times that she was prepared to work with whichever candidate wins the next U.S. election. Publicly, she has echoed Mr. López Obrador’s emphasis on tackling Mexico’s cartel violence and migration by addressing their root causes. In a hint of potential change, she said in a recent debate that she would seek to reform the c ountry’s migration authority , an agency often accused of corruption.

“We need to be more effective in decreasing irregular crossings,” Juan Ramón de la Fuente, a member of her campaign team who is seen as her likeliest pick for foreign minister, said in an interview.

Some in Washington have privately questioned whether Mexico’s cooperation on migration could lag after the country’s elections, but Mr. de la Fuente batted away those concerns. “We will continue with the same, I would say, rigor trying to contain those flows of migrants,” he said.

A former ballet dancer, Ms. Sheinbaum calls herself “obsessive” and “disciplined.” But discipline may not be enough, analysts say.

Mr. López Obrador is a generational political talent who built his party into a juggernaut by relying on the force of his personality. When his coalition became fractious, he used his enormous political capital to corral internal rivals. When problems arose, he persuaded Mexicans he was solving them even if his own government’s statistics disagreed .

Now comes Ms. Sheinbaum, her demeanor more professorial than fiery, trying to take control of a political world defined by Mr. López Obrador’s brand of power.

“She needs him,” said Carlos Heredia, a Mexican political analyst. “She doesn’t have the charisma, she doesn’t have the popularity, she doesn’t have the political stamina of her own, so she needs to borrow that from López Obrador.”

The Times spoke with two dozen people who have worked with or know Ms. Sheinbaum and also visited campaign events, reviewed her writings and her media appearances and interviewed her, once in 2020 and again this year.

What became clear is that Ms. Sheinbaum has long seemed more comfortable quietly getting things done than selling herself or her achievements.

The granddaughter of Jewish immigrants who fled Europe, she rarely discusses being Jewish or almost anything about her personal life, colleagues say. When interviewers ask her about the Nobel Prize she shared with a panel of climate researchers, she notes how many others were involved in the work.

She is known as a tough boss with a quick temper who can inspire in her staff fear and adoration at the same time. Publicly, though, her affect is so controlled it verges on aloof.

Mr. López Obrador, by contrast, is entirely comfortable revealing his inner emotional state to the world. Nearly every weekday for the last five years, he has held a morning news conference in which he spends hours hashing out his anxieties, celebrating his wins and assailing his critics. When he’s not going for the jugular, he comes across as warm and charming.

“Andrés is more charismatic,” Marcelo Ebrard, the former foreign minister who is now on Ms. Sheinbaum’s campaign team, said in an interview. A one-time rival of Ms. Sheinbaum’s within the party, Mr. Ebrard didn’t mean this negatively. Hers is “a different kind of leadership” he said, which may be “more efficient” than personality-driven.

For some Mexicans, a thrills-free woman may be an ideal antidote to an entertaining man who plunged the country into partisan turmoil.

But her opponents just see an opportunity.

At a recent campaign event for college students , Jorge Álvarez Máynez, the third-place candidate, was asked to define Ms. Sheinbaum.

“Very boring,” he said, smirking. The room broke into applause.

‘The Mayor Said To’

Born to two scientists who were leftist activists in the capital, Ms. Sheinbaum was always “a serious girl,” said Arturo Cano, a journalist who wrote a biography of the candidate. As a child, she made family visits to feed political prisoners, Mr. Cano said.

While at the National Autonomous University, she helped lead a movement protesting a plan to raise student fees and change admissions. She married one of the leaders of the movement and had a child with him.

In the early 1990s, they moved to California, where she studied Mexico’s energy consumption at the Lawrence Berkeley National Laboratory.

The candidate’s political career began when Mr. López Obrador was elected mayor of Mexico City in 2000 and invited her to a meeting at a diner. “What I want is to reduce pollution,” she recalled Mr. López Obrador telling her. “Do you know how to do that?”

Ms. Sheinbaum, who by then had written more than a dozen reports on energy use and carbon emissions, said yes. She became his environment minister. In meetings, she seemed willing to do almost anything to make her boss happy, according to several people who worked with her.

“The phrase she used over and over again was ‘The mayor said to,’” said Mr. Heredia, who worked with her in city government under Mr. López Obrador.

What that meant, according to Mr. Heredia: “We are not a cabinet for giving ideas,” he said. “We are a group of people here to execute what he decides.”

Mr. Heredia was confused when he learned that Ms. Sheinbaum, the climate expert, was overseeing the capital’s big new investment: building an elevated highway across Mexico City. The project would just encourage people to drive more, critics said.

At the time, Ms. Sheinbaum said that the new road reduced pollution by easing traffic, though experts say it is hard to corroborate that claim. One 2018 study said the effect on emissions was “not significant” because even though congestion was lower, the number of cars increased.

In 2006, Mr. López Obrador ran for president and lost by less than one percentage point. He disputed the results and led his supporters in a monthslong occupation of the capital’s downtown.

There, he held his own inauguration ceremony, where he proclaimed himself “the legitimate president” of Mexico. Ms. Sheinbaum helped adorn him with a presidential sash. When he then set up a “legitimate cabinet,” he named Ms. Sheinbaum as a minister.

“Many of us didn’t want to join them in this insanity of a ‘legitimate cabinet,’” said Guadalupe Acosta Naranjo, now in the opposition, who was then part of the leftist party Mr. López Obrador belonged to.

“But she was there with him,” Mr. Acosta Naranjo said, “living in this underworld, in this alternate, parallel universe full of people who thought they were making a revolution.”

‘What Do You Want, Someone Soft?’

In the years that followed, Ms. Sheinbaum straddled academia and politics, but she always stayed close to Mr. López Obrador. When he founded his Morena party in 2014, he asked her to run on the party’s ticket to become mayor of Tlalpan, a borough of Mexico City. With his backing, she won.

In 2018, he was swept into the presidency in a landslide and she became Mexico City’s mayor. She quickly gained a reputation as an exacting boss.

“One doesn’t go to her meetings to tell her, ‘I’m working on it,’” said Soledad Aragón, a former member of Ms. Sheinbaum’s cabinet. When she walked into a room, Ms. Aragón said, everyone sat up straight.

The mayor could remember specific numbers mentioned in a meeting weeks after it occurred, Ms. Aragón said, calling her “brilliant” and “demanding,” especially with herself, adding: “It has gotten results.”

Five officials who have worked with Ms. Sheinbaum, who were not authorized to speak publicly, said that she was quick to anger at times and would yell at her subordinates in front of large groups. Through a spokesman, Ms. Sheinbaum declined to comment on the accusation.

Mr. Cano, the biographer, said that when he asked Ms. Sheinbaum about the “many, many stories” he had heard of her toughness as a boss, she told him: “If there’s one thing I can’t stand, it’s lazy people.”

Her defenders say some people merely reacted badly to a woman in charge.

“I know that in her government, sometimes people got offended or felt bad because she yelled at them,” said Marta Lamas, a longtime feminist activist who has been close to Ms. Sheinbaum and her team. “But if a man yells, it wouldn’t be an issue because culturally, it’s different.”

“People say it in a critical way: ‘She’s tough,’” Ms. Aragón said. “What do you want, someone soft in charge of the city?”

By the time Covid hit Mexico, Ms. Sheinbaum had eked out some space to govern her own way, empowering technocrats over party loyalists and investing in the police to fight crime, instead of relying on the military like Mr. López Obrador.

Now, in interviews, she points to the pandemic as evidence that she and Mr. López Obrador are not always aligned .

Mr. López Obrador rarely wore masks in public, suggested two amulets would protect him from Covid and did not emphasize nationwide testing. Ms. Sheinbaum tested aggressively and pushed mask-wearing.

But when scientific principles conflicted with her loyalty, Ms. Sheinbaum chose loyalty.

As Christmas approached in 2020, with hospital beds running low, the federal government misled citizens about the severity of the virus in the capital, saying it hadn’t reached the critical level of contagion that would have required a full lockdown. The capital stayed open for weeks.

Ms. Sheinbaum could have shut the city down earlier, but didn’t. The result was an enormous outbreak.

An independent commission this year called the episode “one of the most serious government failures” of the pandemic in Mexico. Ms. Sheinbaum has said she disagrees with the commission’s findings.

No Confrontation, No Submission

Ms. Sheinbaum’s behavior during the campaign has been a kind of Rorschach test for the Mexicans obsessing over what path she would take if elected president. Those who think she would break from Mr. López Obrador see signs of autonomy everywhere. Those who disagree see only obedience.

Subscribers to the first narrative point to the candidate’s appointment of well-respected experts to her campaign team, her vow to promote renewable energy and her openness to re-evaluating the military’s expansion into public enterprises.

But she has also gotten behind some of the president’s most contentious ideas.

In February, Mr. López Obrador put forth a set of profound changes to the constitution, including eliminating independent regulators and requiring Supreme Court justices to be elected by popular vote. The move provoked alarm among critics, who said the president was trying to obliterate checks and balances.

Still, a day later, Ms. Sheinbaum fell in line, holding a news conference where she announced she would adopt all his proposals as her own.

To the naysayers, this was an illustration of their worst fears: Ms. Sheinbaum following instructions from Mr. López Obrador to take steps that would harm democracy.

But Mr. de la Fuente, who is helping to design Ms. Sheinbaum’s plans, seemed to downplay the importance of the proposed changes to the judiciary.

“I wouldn’t say it is necessarily the top priority,” he said, adding that Morena would need to win a supermajority in Congress to push the measures through, something party officials see as unlikely.

Between Ms. Sheinbaum and Mr. López Obrador, he added, “There will be no confrontation, but there will be no submission.”

For years, the candidate has tried to explain how she can be so in step with the president while also being herself. The answer, she says, is simple: She genuinely believes in him.

In 2022, a radio host asked her a pointed question from a female listener: “Why don’t you choose to be a woman who governs with her own ideas? Why don’t you get out of AMLO’s circus?” she asked, using Mr. López Obrador’s nickname. “Why have the same rhetoric with the same words?”

Ms. Sheinbaum didn’t hesitate.

“If you think the same as another person, it’s not that you’re copying them; you just agree with the ideas,” she said. “You can’t deny what you believe.”

Emiliano Rodríguez Mega contributed reporting from Mexico City.

Natalie Kitroeff is the Mexico City bureau chief for The Times, leading coverage of Mexico, Central America and the Caribbean. More about Natalie Kitroeff

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17 Jewish Bioethics: The Beginning of Life

Elliot N. Dorff (Ph.D, Columbia; Rabbi, Jewish Theological Seminary of America) is Rector and Distinguished Professor of Philosophy at American Jewish University and a Visiting Professor at UCLA School of Law. He has been awarded four honorary doctoral degrees, and he has chaired four scholarly organizations -- the Jewish Philosophy Association, the Jewish Law Association, the Society of Jewish Ethics, and the Academy of Judaic, Christian, and Islamic Studies. He has served on federal government advisory commissions on health care, sexual ethics, and the ethics of research on human subjects, and he currently serves on the California Advisory Commission on Stem Cell Research. Author of over 200 published articles and twelve books on Jewish thought, law, and ethics, he has edited fourteen other books as well. His books on ethics include Matters of Life and Death (on medical ethics), To Do the Right and the Good (on social ethics), Love Your Neighbor and Yourself (on personal ethics), and The Way Into Tikkun Olam (Repairing the World).

• Published: 28 January 2013
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This chapter begins with a discussion of fundamental convictions of Judaism that affect Jewish approaches to moral issues at the beginning of life, and then considers Jewish views about preventing pregnancy through contraception and abortion, and, conversely, assisting those with infertility problems. The analysis is also used to discuss embryonic stem cell research and genetic testing.

Fundamental Convictions

A number of Judaism’s fundamental convictions affect Jewish approaches to the moral issues at the beginning of life: 1. The body belongs to God. Unlike American secular ethics, in which each person’s body belongs to him- or herself, Jewish classical texts assert that God, as Creator of the universe, owns everything in it, including our bodies. 1 Close Therefore God can and does make certain demands of us as to how we use our bodies, demands articulated in Jewish law. It is as if we were renting an apartment: we have fair use of the apartment during our lease—and, in the biological analogue, during our lease on life—but we do not have the right to destroy the apartment (commit suicide) or harm it unnecessarily, because it is not ours. What constitutes “fair use”—that is, the risks that we may take—depends, according to Jewish law, on whether most people assume the risk. 2 So, for example, one may drive a car, even though it clearly raises the possibility of injury or even death, but whether one may engage in experimental medical procedures depends on the degree to which they have a chance of preserving one’s life or curing an illness or disability.

2. Humans may and should use medicine to prevent, mitigate, or cure illnesses. The Torah maintains that God imposes illness as punishment for sin 3 —although the biblical Book of Job strongly challenges this belief—and that God is our healer. 4 That idea might lead some to conclude that medicine is an improper human intervention in God’s decision to inflict illness, indeed, an act of human hubris.

The Rabbis of the Talmud and Midrash were aware of this line of reasoning, but they counteracted it by pointing out that God Himself authorizes us to heal. In fact, the Rabbis maintained, God requires us to heal. They found that authorization and that imperative in several biblical verses. Exodus 21:19–20 requires that an assailant must provide for his victim to be “thoroughly healed,” thus presuming that physicians have permission to cure. Deuteronomy 22:2 (“And you shall restore the lost property to him”), in their interpretation, imposes an obligation to restore another person’s body as well as his/her property. On the basis of Leviticus 19:16 (“Nor shall you stand idly by the blood of your fellow”), the Talmud expands the obligation to provide medical aid to encompass expenditure of financial resources for this purpose. And Rabbi Moses ben Nahman (“Nahmanides,” thirteenth century) understands the obligation to care for others through medicine as one of many applications of the Torah’s principle, “And you shall love your neighbor as yourself” (Lev 19:18). 5 God is still our ultimate Healer, and hence Jewish liturgy has Jews pray to God for healing of body and soul three times each day; but the physician, in Jewish theology, is God’s agent in accomplishing that task, and so use of the medical arts is not only permissible, but required. Jews, in fact, may not live in a city lacking a physician, 6 for that would mean that people could not take reasonable care of their bodies, which belong to God. This appreciation of medicine has led to a virtual love affair between Jews and medicine over the last 2,000 years, and it means that Jews trust medicine—and use it extensively—when they encounter medical problems, including those involving sex or procreation.

3. Sex has two goals, the pleasurable bonding of the couple and procreation. The Torah includes a number of sexual prohibitions regarding with whom one may have sex 7 and at what times during the woman’s menstrual cycle, 8 but it also includes two positive commandments. One, the very first commandment mentioned in the Torah, is “Be fruitful and multiply” (Gen 1:27). Although the command is given to both the first man and woman, and although both are clearly necessary to produce children, for exegetical and possibly for moral reasons the Rabbis of the Mishnah and Talmud asserted that only the man was obligated to fulfill this commandment. 9 Among the moral concerns were the facts that the man was going to have to support his children and so he had to be commanded to procreate against his economic self-interest, and that pregnancy endangers a woman and so it would not be fair to command her to have children. In any case, as we shall see, this rabbinic decision has important consequences for the use of contraceptives, for it makes it much easier to allow women, who have no duty to procreate, to use them than it is to justify their use by men.

A man fulfills his duty to procreate, according to Jewish law, when he produces one boy and one girl, 10 thus imitating the way that God created humans “male and female” (Gen 1:27). Because the Jewish tradition sees children as a great blessing, however, men were supposed to try to have as many children as possible, in fulfillment of two biblical verses—“God did not create it [the earth] a waste, but formed it for habitation” and “Sow your seed in the morning [that is, in your youth], and do not hold back your hand in the evening [that is, in later years].” 11

Sex, however, is not exclusively for procreation; it is also for the mutual bonding of the couple, emotionally as well as physically. The Rabbis derive this notion from Exodus 21:10, according to which a man owes his wife “her food, her clothing, and her conjugal rights.” 12 As they usually do with regard to any commandment, they then define exactly how this commandment may be fulfilled by determining how often a man must offer to engage in sexual relations with his wife. They maintain that it depends on the degree to which his job enables him to be home at night, and that consequently a man may not change his job to one that will bring him home at night less often without his wife’s permission. Conversely, men also have rights to sex in marriage, but, remarkably, the Talmud already prohibits marital rape, 13 which was not prohibited in any American state until 1975 and not in all American states until 1993. 14 If his wife repeatedly refused to engage in conjugal relations, then, the Mishnah’s remedy was that he could diminish what he owed her in divorce by a certain amount each week until he could divorce her without paying her anything and marry someone else, 15 for he too has a right to sexual satisfaction in marriage. This recognition of the role of sex in a couple’s physical satisfaction and emotional bonding, together with their respect for medicine, has made Jews quite willing to use medical and psychological interventions to overcome sexual dysfunctions, and to use artificial reproductive techniques to overcome infertility.

4. The status of the embryo/fetus. Exodus 21:9–10 says that if two men who are fighting hit a pregnant woman who miscarries, then if there is no other injury to her, the assailant must pay compensation for the lost fetus “to be based on a reckoning”—presumably depending on how far along she was in the pregnancy. But if there is other injury to the woman, then the remedy is “life for life, eye for eye, etc.” The Rabbis later interpreted “eye for an eye” to mean monetary compensation in lieu of physical retribution, 16 but the Torah is clearly distinguishing the status of the woman, who is a full human being, from that of the fetus, who is not. This fact leads the Rabbis to rule that if a woman is having difficulty in childbirth, those attending her must dismember the fetus within her (safe Caesarian sections were not available until the late 1940s), for she is a full-fledged human being and the fetus is not.

The fetus becomes a human being when its head—or, in a breach birth, its shoulders or, according to some, the greater part of its body—emerges from the vaginal canal. At that point, if doctors cannot save them both, the usual rules of triage apply—namely, that they should save the one whom they have the better chance of saving.

Before birth, the Rabbis divided pregnancy into two stages. During the first forty days, the embryo is “simply liquid” 17 ; from then on it is “like the thigh of its mother.” 18 Note that unlike modern obstetricians, who count from the woman’s last period, resulting in a forty-week pregnancy, and unlike modern geneticists, who count from conception, resulting in a thirty-eight-week pregnancy, the Rabbis were probably counting from the first period that the woman missed, so that their “forty days” is approximately fifty-four days of gestation. That is so because they could have known what the fetus looks like only from the miscarriages they witnessed. During the first month of pregnancy, a miscarriage is simply a heavy menstrual flow. During the second month it looks like a clump of cells. It is only after that—roughly at fifty-four days of gestation—that the fetus gains a bone structure, so that a miscarriage at that point has bone, flesh, and even hair. At that stage, given that it comes from the groin area of the body, it does indeed look like its mother’s thigh. Thus, unlike American law, which sees the fetus as part of the mother and therefore, with some limitations in some states, subject to her discretion until the moment of birth, and unlike current Roman Catholic authorities, who maintain that the fertilized ovum is already a full human being, Jewish tradition takes an intermediate, developmental position, in which the embryo over time emerges from “simply liquid” to “the thigh of its mother” to a full-fledged human being. As one might expect, this view will have significant implications for Judaism’s view of abortion and embryonic stem cell research.

Birth Control

Jewish sources from as early as the second century describe methods of contraception. A rabbinic ruling from that time prescribes the use of such methods when pregnancy would endanger either the woman or the infant she is nursing. 19 Subsequent rabbinic opinion splits between those who sanction the use of contraception only when such danger exists and those who mandate it then but allow it for other women too.

If couples are going to use contraceptives, Jewish law prefers those that prevent conception in the first place over those that abort an already fertilized egg, because, as will be discussed in the next section, in most cases Jewish law forbids abortion. The most favored form of contraception from a Jewish perspective is thus the diaphragm, for it prevents conception and has little if any impact on the woman’s health. If the contraceptive pill or implant is not counterindicated by the woman’s age or body chemistry, those are usually the next most favored forms of contraception. RU486 and any other means of retroactively aborting an embryo are, from this understanding, considered legitimate only when pregnancy would threaten the mother’s physical or mental health, as defined in the ways discussed in the next section. 20

The only nonpermanent, male form of contraception currently available is the condom. As was noted above, in Jewish law the male is legally responsible for propagation, and that fact argues against the man using contraception, at least until he has fulfilled that duty. 21 Condoms, moreover, sometimes split or slip off, 22 and even if they remain intact and in place, they do not always work. Nevertheless, condoms must be used if unprotected sexual intercourse poses a medical risk to either spouse, for condoms do offer some measure of protection against the spread of some diseases, and the duty to maintain health and life supersedes the positive duty of the male to propagate. 23

It should be noted, though, that rabbis from past centuries who permitted contraception for nontherapeutic reasons never anticipated that Jews would postpone having children as long as many Jewish couples now do. Even with modern medical advances, the late teens and the twenties are biologically still the best time for the human male and female to conceive and bear children. 24 Those who wait until after those ages to try to procreate often have infertility problems. 25 This means that even if young couples choose to use contraceptives for a time, they are well advised, both medically and Jewishly, not to wait too long.

There are, of course, good reasons why so many Jews wait so long. In addition to long-term schooling, in which Jews engage at far higher percentages than the general population, 26 most women in our society find that they must earn money to support themselves and their families, just as their male partners or husbands do, and so they often try to get their careers up and running before bearing children. Moreover, many people who would love to find a mate and get married in their early twenties may not be so fortunate, and once out of college it is often difficult for them to meet someone they want to marry. The painful reality of infertility and the increased likelihood of birth defects as one ages, though, argue strongly for seeking a mate and procreating earlier than most Jews now do.

Infertility is not only a great source of pain for the couples involved, it is also a demographic problem of major proportions for the Jewish people. Christians make up a third of the world’s population, Muslims about 22 percent. Jews, numbering just over 13 million, are only two-tenths of one percent. 27 Furthermore, because of the factors described above, the reproductive rate among North American Jews is only 1.8 (where 2.1 is required for replacement), 28 and among Israeli Jews it is about 2.0. Add to that the effects of intermarriage and assimilation, and there is a real possibility that Jews and therefore Judaism will not survive for many more generations. The contemporary, demographic problem of the Jewish people, then, must also be a factor that figures into the thinking of Jews using contraception.

As is true for other highly educated communities, Jews have been concerned about the world’s overpopulation since the 1960s, and sometimes that is another factor that convinces couples not to propagate altogether or to have only one child. Jews, though, constitute only two-tenths of one percent of the world’s population, and so even if the entire Jewish population were to be eradicated, that loss would do almost nothing to resolve the overpopulation problem. To do that, we need to raise the standard of living of poor populations, teach people how to use birth control and provide it to them cheaply, and change the policies of some groups that forbid artificial forms of birth control. Eliminating Jews and, with them, Jewish culture is not an effective or wise way of resolving the very real problem of world overpopulation.

On the contrary, given the demographic crisis of the Jewish community, rabbis are currently encouraging couples who can propagate to consider having three or four children. As Maimonides says, “If one adds a soul to the People Israel, it is as if s/he has built an entire world.” 29 In the current Jewish demographic crisis, doing so is all the more imperative. Thus although a couple’s first two children fulfill the commandment ( mitzvah ) to procreate, the Conservative Movement’s Committee on Jewish Law and Standards has approved a rabbinic ruling urging couples to have one or more additional children who are also “ mitzvah children,” both in the original sense of that word meaning “commandment” in that Jewish law requires couples who can to have more than the minimum number of two, and also in the sense of “ mitzvah ” as “good deed,” in that they are helping to make Jewish physical continuity, and therefore Jewish religious and cultural continuity, possible. 30

As Jewish communities have increasingly come to realize, the Jewish pattern of long-term education and the Jewish demographic crisis must also be factors in communal planning. Many adult Jews are now meeting each other through commercial dating websites focused on Jews, and Jewish communities are creating programs to help young adult Jews meet each other. To encourage young Jewish couples to have children, the family and community must share in the financial burden of raising them. So, for example, the Talmud imposes a duty on grandparents to educate their grandchildren in the Jewish tradition, 31 just as it obligates parents to do so, and so grandparents with the means are increasingly being educated to contribute to the tuition for their grandchildren’s Jewish education. Some Jewish day schools, camps, and youth group programs are giving discounts for each additional sibling. 32 Moreover, Jews, acting out of their own best interests and out of Jewish values are increasingly supporting profamily legislation such as laws that provide for family leaves for both mothers and fathers and for high-quality, affordable day care.

All this means, then, that young marrieds, especially those who marry in their late twenties or later, should use contraceptives for family planning purposes only for a very short time, if at all. In the end, the Jewish tradition thinks of children—and many people experience them—as a true blessing from God.

Because Jewish law perceives the woman as a full-fledged person and the fetus as not of that status, abortion is required when the woman’s life or health is at stake, with rabbis variously interpreting how serious a threat the fetus must be to the woman’s health in order to require an abortion. When the woman has a condition that puts her more at risk than a normal pregnancy would be—if, for example, she has diabetes—then she may choose to accept that risk and go ahead with the pregnancy (but consult her doctor much more often than usual), or she may choose to abort the fetus in order to avoid the risk.

What about mental health as a rationale for abortion? Rabbi David Feldman summarizes the evidence as follows:

Precedent for equating mental health with physical health comes from a late-seventeenth-century Rabbi…On the basis of Talmudic teaching, Rabbi Israel Meir Mizrachi argued that serious danger to mental health ( tiruf da’at ) is tantamount to risk to one’s physical wellbeing, and issued a permissive ruling…At least one Responsum (dated 1913), applied it specifically to the matter of abortion. 33

Mental health as a justification for abortion, though, has generally been construed rather narrowly, especially in the Orthodox community, so it would not justify abortion, for example, simply because the woman does not want to have another child. That would be a good reason to use contraception, but not retroactively to abort. (In the Reform movement, where individual autonomy is a major value, rabbis discourage abortion when it is contemplated for this reason, but they maintain that it is ultimately and properly the individual woman’s choice. 34 )

In modern times, with the advent of techniques to test embryos for genetic diseases, some rabbis in the Orthodox community, and most in the Conservative community, would permit an abortion when the fetus has a lethal genetic disease such as Tay-Sachs or Familial Dysautonomia. When the disease is debilitating but the child will have more or less normal life expectancy, some rabbis permit, and others forbid, abortion directly on the grounds of the disease. The problem with that approach, however, is that it inevitably involves sensitive and controversial judgments; when is a disease sufficiently serious to warrant an abortion, and when not? And which rabbi, if any, has the authority to make that judgment?

More commonly, then, rabbis use the maternal (and paternal) reactions to the fetus’s disease to determine whether it should be aborted. So, for example, Rabbi David M. Feldman, a Conservative rabbi who wrote the first comprehensive treatment of abortion in Jewish law, has written that if such a woman tells him that suffering from Down Syndrome will be terrible for her child, he would tell her that that may or may not be so, but in any case that is not a reason to abort. If the same woman, however, tells him that she is going crazy over the thought of bearing a Down Syndrome child, he would tell her that that is indeed an acceptable justification to abort. In the first case, she was talking about her child’s feelings and the future, neither of which she knows; in the second case, she was describing her own present feelings, and Rabbi Feldman would therefore invoke her mental health to justify an abortion. 35

This writer would instead ask the couple to talk to three other couples who are raising children with Down Syndrome so that they know what it is really like and not what they imagine it to be. Then, if the couple believes that they really cannot raise such a child, I would consider that a sufficient reason to abort the fetus, based on the mother’s and father’s mental health. (As we shall see in the last section of this chapter, couples with family histories of these diseases increasingly engage in preimplantation genetic diagnosis precisely to avoid the need for aborting a fetus with such a disease.)

In sum, the Jewish tradition requires abortion when the mother’s life or her physical or mental health is at stake. Judaism sanctions abortion when the mother’s physical or mental condition makes pregnancy more risky than it normally is. Abortion, though, is generally prohibited as an act of self-injury (not murder, because the fetus is not a human person who bears the legal protections against murder until birth), and the burden of proof is always on the one who wants to abort.

Embryonic Stem Cell Research

Stem cells are those cells that produce more than one kind of cell. Adult stem cells—called that if they come from any born human being from infancy through adulthood—are produced, for example, from bone marrow, which manufactures four different kinds of blood cells, and from skin, which produces three kinds of skin cells. Embryonic stem cells come from the inner cell mass of embryos that are five or six days old. At that stage, the embryo has produced a circle with cells inside it; if the embryo is in a woman’s womb, the circle will become the placenta, attaching the embryo to the woman’s body to provide the nutrients necessary for the embryo to develop, and the cells inside the circle (the “inner cell mass”) will ultimately become all the cells in the infant’s body. As such, these cells are “pluripotent”—that is, they are able to produce many different kinds of cells, including those that will ultimately become the infant’s heart and circulatory system, its nervous system (brains, spinal cord, and neurons), its respiratory system, its bone structure, and so on.

Because embryonic stem cells are more flexible than adult stem cells, they hold out more promise for producing cures for a variety of serious and even life-threatening illnesses. If we could figure out how cells “decide” to differentiate into the specific cells they become, we might be able to produce cardiac cell lines, for example, that could cure the damage brought on by a heart attack or stroke, or neurological cells to cure a spinal cord injury or Alzheimer’s. Embryonic stem cells also turn off, so that we get one head and not more, and if we could determine the mechanism that turns them off, we would have the ultimate cure for cancer, which is precisely the production of too many cells of a given type. Thus while research using adult stem cells holds out some promise and certainly should be pursued, embryonic stem cell research is even more promising, as demonstrated not only by the pluripotency of the cells, but by a number of animal studies in which they actually did cure some diseases. 36

The embryos used for such research are donated by couples who created them in an effort to overcome infertility through in vitro fertilization (IVF) but who have now had as many children as they want or have given up on having their own biological children. The choice, then, is either to discard the remaining embryos or to donate them to research. (Creating embryos for purposes of research might involve other objections, but that has not been the question at issue because of the availability of embryos created for infertility treatments.)

The problem with embryonic stem cell research is that in order to carry on such research, one must remove the inner cell mass from an embryo, which kills the embryo. The question, then, is the status of the embryo. Although Church Fathers as important as Augustine and Aquinas viewed the fetus developmentally, 37 very much as the talmudic Rabbis did, Roman Catholic doctrine over the last several centuries has classified the embryo in a woman’s uterus as a full human being, as a result of the invention of the microscope, and Catholic authorities construe embryonic stem cell research as murder. In recent years they have extended that concept even to embryos in a Petri dish, where there is no chance whatsoever for the embryos to become a human being unless they are implanted into a woman’s womb.

As we saw above, on the basis of Exodus 21 and their own observation of miscarriages, the Rabbis of the Mishnah and Talmud instead viewed the fetus developmentally, with embryos less than forty days old—and certainly those at five or six days of gestation—classified as “simply liquid.” They were clearly well aware that in a woman’s womb some of that “liquid” may become a human being, but to classify it as such so early in pregnancy is to confuse a potential state with an actual one. In fact, we now have good hormonal studies to indicate that as many as 80 percent of fertilized egg cells in a woman’s womb will miscarry, 38 and so even there one has only a one in five chance that the embryo will become a human being. In a Petri dish, that chance is zero. At the same time, the Jewish tradition includes a strong mandate to seek to cure (or at least mitigate the effects of) diseases, and the embryos in question would otherwise simply be discarded. Therefore, rabbis across the denominations have ruled that until and unless embryonic stem cell research proves to be unsuccessful in producing the cures it promises, engaging in such research is not only permissible, but desirable. 39

Infertility

A surprising number of biblical figures had fertility problems. Abraham and Sarah, Rebekah and Isaac, Rachel and Jacob, and Elkanah and Hannah (who ultimately bore the prophet Samuel) all had difficulties. 40 No other culture’s sacred scripture focuses so extensively on infertility.

What can we learn from this? First, that children are precious. Indeed, the Jewish tradition sees them as a great blessing. In part this is so because of the psychological growth and joy they bring to their parents. In addition, of course, the future of Judaism and the Jewish people depends on procreation. But the very difficulty that so many couples have in conceiving and bearing children is itself a mark of how precious they are when they come.

Second, the biblical stories amply indicate that infertility causes immense tensions in a marriage. Infertile couples begin to question who they are individually as a man or woman and what their future together holds. Worse, couples seeking to become pregnant have the equivalent of a final examination each month, and if they are having difficulties conceiving, they will fail many of those examinations. Nobody likes to fail, least of all in a matter as important and personal as childbearing. Some couples break up over this issue, and those whose marriages survive must revise their hopes and dreams of their lives together.

In our own time, Jews are especially troubled by this problem, in part because of Jewish genetic diseases but primarily because Jews have adopted the American ideology that makes work the fundamental source of one’s identity and pride. As was noted earlier, this situation leads Jews to engage in extended education and to postpone marriage until the late twenties or later, producing low birth rates and problems with infertility.

Another factor that contributes to infertility is that men commonly believe that infertility is only a woman’s problem¸ that only women have a biological clock for procreation. Actually, about a third of infertile couples are so because of a problem in the woman; a third because of a problem in the man; and a third because of a problem in both or for reasons that are unclear. 41 Age is not the only factor in infertility, but it complicates all the rest in both men and women and makes it harder to fix.

Yet another part of the American milieu that deceives Jews is its emphasis on technology as the cure for all that ails us. Jews have greatly honored medicine for the last two thousand years, and many young Jewish adults now trust that at whatever age they want to bear children, medicine will enable them to do so. Although infertility specialists have made great strides in making it possible for many couples to bear children, they cannot do that for everyone, and the younger the couple is, the greater the chance that the new techniques will work.

To respond to the problems infertility poses for both couples and the Jewish people as a whole, Jews are becoming aware that they need to take a number of steps (described more fully in my book Love Your Neighbor and Yourself: A Jewish Approach to Modern Personal Ethics ). 42 Among them are these: ensuring that Jewish teenagers choose colleges where there are many Jews, for social as well as educational and religious purposes; communicating that it is not too early to look for a spouse while in college, and if one finds one, it is not too early to marry and begin to have children in graduate school, for the pressures of graduate school are no greater than those of the first years of one’s job; creating methods for those beyond college to meet other Jews; and providing affordable and good day care arrangements and tuition aid for Jewish day schools, supplementary schools, and camps so that young couples are not deterred by the costs of having three or four children. At the same time, because the emphasis on children in the Jewish tradition only exacerbates the problems of infertile Jewish couples, steps to encourage couples to procreate must be balanced by measures to make infertile couples feel valued, including a clear statement that like all obligations in Jewish law, the duty to procreate ceases to apply to those who cannot fulfill it through no fault of their own. Couples may avail themselves of the many assisted reproduction techniques (ARTs) now available—although Orthodox authorities generally prohibit the use of donor sperm or eggs, and, in any case, there are some special issues with using them that the couple needs to confront—but from the point of view of Jewish law they need not do so. 43

Genetic Testing

Beginning with amnioscentesis, developed in the 1960s, and followed by corrianic villae sampling and sonograms, among other techniques, modern science has provided us with mechanisms to know much more about the genetic structure of the fetus than our ancestors did. Like every new ability, this development raises the question about when it is appropriate to use it, and when not, for just because we can do something does not mean that we should. Jews use these new techniques and thus encounter their moral ambiguities more than most other subsets of the population, in part because of their commitment to medicine but also because of those genetic diseases to which Jews are especially predisposed.

The Torah already indicates its displeasure when Jews marry outside the community, 44 and endogamy increasingly became the norm in the Second Temple period and beyond. 45 Because Muslim and especially Christian regimes under whose authority Jews lived during the Middle Ages and as late as the twentieth century forced Jews to dwell in small, concentrated areas, and because Jews never were a large percentage of the world’s population, they suffer more than other communities from the founder effect—that is, the continuation of genetic abnormalities over generations. Ashkenazic (northern and eastern European) Jews are at greater risk than the general population especially for six or eight such diseases and to a lesser extent for as many as ten more; Sephardic Jews (from the Mediterranean Basin) are at risk for two others. Some of these diseases, such as Tay-Sachs and Familial Dysautonomia, are lethal, killing their victims often in the first years of life but sometimes not until their teens; others, such as Gaucher’s Disease, do not shorten life span but are debilitating and expensive to treat. 46

To combat these diseases, Jews have developed several strategies. When the tests for Tay-Sachs were created in the early 1970s, Jews aggressively encouraged their young couples to be tested for it before procreating. If both members of a couple tested positive, until the 1990s the only thing they could do was to have the woman undergo an amniocentesis in the fifth month of pregnancy and then, if the child was going to have the disease, abort it. Because Orthodox rabbis generally approved of abortion only for maternal reasons and not for fetal conditions, a program called Dor Yesharim was initiated in that community, in which young people who were contemplating marriage would need to get the approval of a particular member of the community who had access to all the Tay-Sachs results of everyone who was tested so as to avoid marriages of two carriers. As a result of these measures in the Orthodox and non-Orthodox communities, Tay-Sachs has been effectively eliminated as a Jewish genetic disease within a generation—although Jews still need to be tested to see if they are carriers.

In October 1989, scientists first successfully used preimplantation genetic diagnosis (PGD) to test embryos for a genetic disease so that they might choose only unaffected embryos to implant in the woman’s uterus. 47 This procedure, widely available since the early 1990s, is expensive—although not nearly as expensive as caring for a child who has the disease—and it does not work for all genetic diseases, but this new technology has enabled couples who are both carriers of a genetic abnormality to have normal children without abortion.

The problem is that once you can test for lethal and debilitating diseases, you can also test for many other traits, such as gender, that are not diseases at all, and you can also test for some disabilities, such as deafness, that some in the disabled community see as devaluing them by trying to rid society of those affected. Furthermore, once you go beyond lethal and severely debilitating diseases (such as Fragile X Syndrome), where, if anywhere, do you draw the line as to what is morally appropriate? Is this, as some have feared, the new, effective methodology to engage in eugenics in order to create “the designer child”—however that is defined? Concerns such as these have led Rabbi Mark Popovsky, for example, to write a rabbinic ruling for the Conservative Movement’s Committee on Jewish Law and Standards that limits the appropriate use of PGD to lethal and severely debilitating diseases. 48

The Blessings of Sex and Children

In the end, it is important to remind readers that Jewish responses to issues at the beginning of life come out of a strong conviction that God has indeed blessed us in giving us sexual pleasure and children and that, as in all other forms of medicine, we act as God’s partners and agents in enabling people to overcome whatever difficulties they have in these areas. It is appropriate, then, to end this chapter with the Psalmist’s description of these blessings:

Blessed are all who revere the Lord, who follow in His ways. You shall enjoy the fruit of your labors, you shall be happy, you shall prosper. Your wife shall be like a fruitful vine within your house, your children like olive shoots round about your table… May you live to see children’s children. May there be peace for the people Israel. 49

Suggestions for Further Reading

Because positions on these matters depend generally on one’s approach to Jewish law, I have identified the movement affiliation of each of the authors on this list, when clear and relevant, so that readers can read their works in that light.

Bleich, J. David . 1998 . Bioethical Dilemmas: A Jewish Perspective. Hoboken, NJ: Ktav. [Orthodox]

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Cardin, Nina Beth . 1999 . Tears of Sorrow, Seeds of Hope: A Jewish Spiritual Companion for Infertility and Pregnancy Loss. Woodstock, VT: Jewish Lights. [Conservative]

Dorff, Elliot N . 1998 . Matters of Life and Death: A Jewish Approach to Modern Medical Ethics. Philadelphia: Jewish Publication Society. [Conservative]

———. 2003 . Love Your Neighbor and Yourself: A Jewish Approach to Modern Personal Ethics . Philadelphia: Jewish Publication Society, esp. chaps. 3 and 4.

Feldman, David M . 1968 . Birth Control in Jewish Law. New York: New York University Press. (Subsequently republished by Schocken in 1974 and by Jason Aronson [now Rowman and Littlefield] in 1996 as Marital Relations, Birth Control, and Abortion in Jewish Law. ) [Conservative]

Feldman, David M . 1968. 1986 . Health and Medicine in the Jewish Tradition. New York: Crossroad. [Conservative]

Feldman, Emanuel , and Joel B. Wolowelsky , eds. 1997 . Jewish Law and the New Reproductive Technologies. Hoboken, NJ: Ktav. [Orthodox]

Gold, Michael . 1988 . And Hannah Wept: Infertility, Adoption, and the Jewish Couple. Philadelphia: Jewish Publication Society. [Conservative]

Jacob, Walter , and Moshe Zemer . 1995 . The Fetus and Fertility in Jewish Law: Essays and Responsa . Pittsburgh: Freehof Institute of Progressive Halakhah. [Reform]

Mackler, Aaron L. , ed. 2000 . Life and Death Responsibilities in Jewish Biomedical Ethics. New York: The Jewish Theological Seminary of America. [Conservative]

Rosenberg, Shelley Kapnek . 1998 . Adoption and the Jewish Family: Contemporary Perspectives . Philadelphia: Jewish Publication Society.

Rosner, Fred , and J. David Bleich , eds. 2000 . Jewish Bioethics. Hoboken, NJ: Ktav. [Orthodox]

Schiff, Daniel . 2002 . Abortion in Judaism. Cambridge, UK, and New York: Cambridge University Press. [Orthodox]

Steinberg, Avraham . 2003 . Encyclopedia of Jewish Medical Ethics.   Fred Rosner , trans. Jerusalem and New York: Feldheim Publishers. 3 vols. [Orthodox]

Washofsky, Mark . 2000 . Jewish Living: A Guide to Contemporary Reform Practice. New York: UAHC Press, esp. chap. 6, “Medical Ethics.” [Reform]

For example, Deuteronomy 10:14; Psalms 24:1.

B. Shabbat 129b.

Leviticus 26:16; Deuteronomy 28:22, 59–61.

Exodus 15:26; Deuteronomy 32:39; cf. Isaiah 19:22; 57:18–19; Jeremiah 30:17; 33:6; etc.

5. B. Bava Kamma 85a, 81b; B. Sanhedrin 73a, 84b (with Rashi’s commentary there). See also Sifrei Deuteronomy on Deuteronomy 22:2 and Leviticus Rabbah 34:3. Nahmanides , Kitvei Haramban , Bernard Chavel , ed. (Jerusalem: Mosad Harav Kook, 1963 [Hebrew]), Vol. 2, p. 43 ; this passage comes from Nahmanides’ Torat Ha’adam (The Instruction of Man), Sh’ar Sakkanah (Section on Danger) on B. Bava Kamma , chap. 8, and is cited by Joseph Karo in his commentary to the Tur, Bet Yosef, Yoreh De’ah 336. Nahmanides bases this interpretation on similar reasoning in the talmudic passages cited above. See also Sifrei Deuteronomy on Deuteronomy 22:2 and Leviticus Rabbah 34:3.

B. Sanhedrin 17b with regard to “students of the Sages”; J. Kiddushin 66d, with regard to all Jews.

For example, Leviticus 18, 20.

See Leviticus 15:19–32, esp. 19–24.

B. Yevamot 65b; B. Kiddushin 35a; M.T. Laws of Marriage 15:2; S.A. Even Ha-Ezer 1:1, 13.

10. M. Yevamot 6:6 (61b); M.T. Laws of Marriage 15:4; S.A. Even Ha-Ezer 1:5. There was some debate about this, however; see Elliot N. Dorff , Matters of Life and Death: A Jewish Approach to Modern Medical Ethics (Philadelphia: Jewish Publication Society, 1998), p. 336, n. 9 , repeated in Elliot N. Dorff , Love Your Neighbor and Yourself: A Jewish Approach to Modern Personal Ethics (Philadelphia: Jewish Publication Society, 2003), pp. 275–76, n. 61 .

B. Yevamot 62b and M.T. Laws of Marriage [Ishut] 15:16) encourage as many children as possible on the basis of Isaiah 45:18 and Ecclesiastes 11:6.

12. Some biblical scholars think that the Torah’s word here, onata , means conjugal rights; others think that it means housing; and still others think that it means ointments. See Nahum Sarna . The JPS Torah Commentary: Exodus (Philadelphia: Jewish Publication Society, 1991), p. 121 . The Rabbis, however, understood it to mean conjugal rights (M. Ketubbot 5:6), and that is what is controlling for Judaism.

B. Eruvin 100b; Leviticus Rabbah 9:6; Numbers Rabbah 13:2; M.T. Laws of Ethics 5:4; M.T. Laws of Marriage 14:15; M.T. Laws of Forbidden Intercourse 21:11; S.A. Orah Hayyim 240:10; S.A. Even Ha-Ezer 25:2, gloss.

In Common Law, in force in North America and the British Commonwealth on many matters, the very concept of marital rape was an impossibility. Thus Sir Matthew Hale, Chief Justice in seventeenth-century England, wrote in his classic treatise, Historia Placitorum Coronae , that “The husband cannot be guilty of a rape committed by himself upon his lawful wife, for by their mutual matrimonial consent and contract the wife hath given up herself in this kind unto her husband, which she cannot retract.” In December 1993 the United Nations High Commissioner for Human Rights published the Declaration on the Elimination of Violence Against Women ( www.unchr.ch/huridocda/huridoca.nsf/ (Symbol)/A.RES.48.104.En?Opendocument). This establishes marital rape as a human rights violation. As of 1997, however, UNICEF reported that just seventeen nations had criminalized marital rape. In 2003, UNIFEM reported that more than fifty nations had done so. In the United States, in 1975 South Dakota was the first state to remove the husband’s protection from prosecution; by 1993 all fifty states had done so, but in thirty of them the husband still was exempt from prosecution if he did not have to force his wife to have sex—if, for example, she was unconscious or asleep, or if she was mentally or physically impaired. See Raquel Kennedy Bergen, “Marital Rape: New Research and Directions,” http://www.vawnet.org/applied-research-papers/print-document.php?doc_id=248 (accessed June 8, 2012).

M. Ketubbot 5:7.

M. Bava Kamma 8:1, and see the Talmud thereon.

B. Yevamot 69b.

B. Hullin 58a and elsewhere.

19. T. Niddah 2; B. Yevamot 12b, 100b; Ketubbot 39a; Niddah 45a; Nedarim 35b. On this entire topic, see David M. Feldman , Birth Control in Jewish Law (New York: New York University Press, 1968), chaps. 9–13, esp. pp. 185–87 . (The subsequent, paperback edition, published by Schocken in 1973, is called Marital Relations, Birth Control, and Abortion in Jewish Law , and so is the revised 1996 edition published by Jason Aronson and now Rowman and Littlefield.)

For a recent, comprehensive review of available forms of contraception and Jewish law, see Miriam Berkowitz and Mark Popovsky, “Contraception,” at http://www.rabbinicalassembly.org/sites/default/files/public/halakhah/teshuvot/20052010/Contraception%20Berkowitz%20and%20Popovsky.pdf (accessed June 8, 2012).

The language of the Mishnah (M. Yevamot 6:6) suggests that the man may use contraceptives after fulfilling the commandment with two children. It reads: “A man may not cease from being fruitful and multiplying unless he has children. The School of Shammai says: two males; the School of Hillel says: a male and a female.” As is noted in note 11 above, however, this was not the position of later Jewish law (B. Yevamot 62b; M.T. Laws of Marriage [Ishut] 15:16), which encouraged as many children as possible on the basis of Isaiah 45:18 and Ecclesiastes 11:6.

British researchers, citing World Health Organization statistics and their own study of 300 men at a south London clinic, have suggested that the failure of condoms may be due largely to the use of the same size for all men, a size too small for one-third of the men of the world. See “One Size of Condom Doesn’t Fit All,” Men’s Health , March 1994, p. 27.

23. For more on the Jewish imperative of safe sex, see Michael Gold , Does God Belong in the Bedroom? (Philadelphia: Jewish Publication Society, 1992), pp. 112ff .

24. The optimal age is twenty-two: The Columbia University College of Physicians and Surgeons Complete Guide to Pregnancy , as quoted in Beth Weinhouse, “Is There a Right Time to Have a Baby? The Yes, No, and Maybe of Pregnancy at 20, 30, 40,” Glamour , May 1994, pp. 251, 276, 285–287, which presents a helpful description of the physical factors in pregnancy through a woman’s twenties, thirties, and forties. Infertility increases with age: 13.9 percent of couples in which the wife is between thirty and thirty-four are infertile; 24.6 percent where the wife is between thirty-five and thirty-nine; and 27.2 percent where the wife is between forty and forty-four. See U.S. Congress, Office of Technology Assessment, Infertility: Medical and Social Choices , OTA-BA-358 (Washington, DC: U.S. Government Printing Office, May 1988), pp. 1, 3, 4, and 6 .

Carl T. Hall, “Study Speeds Up Biological Clocks: Fertility Rates Dip After Women Hit Age 27,” San Francisco Chronicle (April 30, 2002), citing a study of 782 European couples using only the rhythm method of contraception, published on that date in the journal Human Reproduction ; available at http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2002/04/30/MN182697.DTL (accessed April 3, 2011). See also Elizabeth Heubeck, “Age Raises Infertility Risk in Men Too: Risks Associated with Men’s Biological Clocks May Be Similar to Women’s,” citing 2003 and 2004 studies published in the Journal of Gynecology, Human Reproduction Update , and the Journal of Urology , available at http://www.webmd.com/infertility-and-reproduction/guide/age-raises-infertility-risk-in-men-too (accessed April 3, 2011).

26. “More than half of all Jewish adults (55%) have received a college degree, and a quarter (25%) have earned a graduate degree. The comparable figures for the total U.S. population are 29% and 6%.” (No authors stated), The National Jewish Population Survey 2000–2001 (New York: United Jewish Communities, 2003), p. 6 , available at www.UJC.org/njps/pdf (accessed April 3, 2011).

27. The best estimate of the current number of Jews in the world is 13,089,800. See Sergio Della Pergola , “World Jewish Population,” American Jewish Yearbook 2006 (New York: American Jewish Committee, 2006), vol. 106, pp. 559–601, esp. p. 571 . With the world’s population at 6.477 billion in 2006, and now over 7 billion, Jews are 2.02 per 1,000 of the world’s population—that is, approximately 0.2 percent of the world’s population.

28. [No author listed.] The National Jewish Population Survey2000–2001: Strength, Challenge and Diversity in the American Jewish Population (New York: United Jewish Communities, 2003), p. 4 ; available at http://www.ujc.org/page.html?ArticleID=33650 (accessed April 3, 2011).

M.T. Laws of Marriage 15:16. Maimonides’ theme of a whole world being created with the birth of a child is echoed in M. Sanhedrin 4:5, “If anyone sustains a soul within the People Israel, it is as if he has sustained an entire world,” and the converse appears in B. Yevamot 63b: “If someone refrains from propagation, it is as if he commits murder (literally, 'spills blood’) and diminishes the image of God.”

Kassel Abelson and Elliot N. Dorff, “Mitzvah Children,” available at http://www.rabbinicalassembly.org/sites/default/files/public/halakhah/teshuvot/20052010/mitzvah_children.pdf (accessed July 14, 2011).

B. Kiddushin 30a.

On the duty to educate children and its costs today, see Dorff, Love Your Neighbor (at n. 10 above), pp. 143–54.

33. David M. Feldman , Birth Control in Jewish Law (New York: New York University Press, 1968), p. 286 . The talmudic sources he cites are B. Yoma 82a, 83a, and 83b. The 1913 responsum is Responsa L’vushei Mordekhai, Hoshen Mishpat , #39. See also Daniel Schiff   Abortion in Judaism (New York: Cambridge University Press, 2002) .

34. Mark Washofsky , Jewish Living: A Guide to Contemporary Reform Practice (New York: UAHC Press, 2001), pp . 242–45 .

35. David M. Feldman , “This Matter of Abortion,” in his Health and Medicine in the Jewish Tradition: L’Hayyim—To Life! (New York: Crossroad, 1986), pp. 79–90, esp. pp. 87–88 ; reprinted in Contemporary Jewish Ethics and Morality: A Reader , Elliot N. Dorff and Louis E. Newman , eds. (New York: Oxford University Press, 1995), pp. 382–91, esp. pp. 388–89 .

For more on the science of embryonic stem cell research, see “Stem Cells: A Primer,” National Institutes of Health, May 2000, pp. 1–2, http://stemcells.nih.gov/info/basics/ (accessed July 15, 2011).

37. See the testimony of Margaret Farley to President Clinton’s National Bioethics Advisory Commission, in Ethical Issues in Human Stem Cell Research , Volume III: Religious Perspectives (Rockville, MD: National Bioethics Advisory Commission, June 2000), pp. D1–D5 , http://bioethics.georgetown.edu/pcbe/reports/past_commissions/nbac_stemcell3.pdf (accessed April 3, 2011).

38. Allen J. Wilcox et al. , “Incidence of Early Loss of Pregnancy,” New England Journal of Medicine 319: 189–94 (1988) .

39. The official Conservative/Masorti position: Elliot N. Dorff, “Stem Cell Research,” at http://www.rabbinicalassembly.org/sites/default/files/public/halakhah/teshuvot/19912000/dorff_stemcell.pdf . The official Reform position: Mark Washofsky , “Human Stem Cell Research,” in Reform Responsa for the Twenty-First Century , Mark Washofsky , ed. (New York: Central Conference of American Rabbis, 2010), pp. 121–42 , available for a fee at www.ccarnet.org , under the heading “Rabbinic Materials” and the subheading “Responsa.” The Orthodox community is too splintered to have one official position, but Rabbi Moshe Tendler, a biologist at Yeshiva University and an influential Orthodox voice in bioethics, has strongly endorsed it; see his testimony before President Clinton’s National Bioethics Advisory Commission, in Ethical Issues in Human Stem Cell Research, Volume III: Religious Perspectives (Rockville, MD: National Bioethics Advisory Commission, 2000), pp. H-1–5 , available at http://bioethics.georgetown.edu/nbac/stemcell3.pdf (accessed April 14, 2011).

Genesis 15:2–4; 18:1–15; 25:21; 30:1–8, 22–24; 35:16–20; 1 Samuel 1:1–20.

“Infertility,” www.womenshealth.gov (National Women’s Health Information Center of the U.S. Department of Health and Human Services, Office on Women’s Health), esp. p. 5.

Elliot N. Dorff, Love Your Neighbor and Yourself (at note 10 above), pp. 95–111.

For more on Jewish norms relevant to the use of artificial techniques of reproduction, and the range of positions on the use of donor gametes, see Elliot N. Dorff, Matters of Life and Death: A Jewish Approach to Modern Medical Ethics (at note 10 above).

See, for example, Genesis 24 and 27:46–28:5 for the measures taken by Abraham and Sarah and by Rebekah and Isaac to make sure that their sons married within their clan, and see Genesis 26:35 for the displeasure that Rebekah and Isaac have when Esau marries Hittite women—so much so that Esau takes an additional wife from Ishmael’s daughters to placate his parents (Gen 28:6–9). That said, the Bible records many men who married outside the tribe, including Moses himself (Exod 2:21) and later leaders of the Jewish people, in some cases for apparently political reasons (e.g., Judges 3:6; Ruth 1:4; 2 Samuel 3:3, 11:3; 1 Kings 3:1, 7:14, 9:1; 1 Chronicles 2:17). Still, both Moses (Exod 34:16; Deut 7:3–4) and Joshua (Josh 23:12) declare God’s commandment not to marry Canaanite women.

Ezra and Nehemiah, in the fifth century bce , require Jewish men who want to move from Babylonia to Israel to rebuild the Jewish community there to divorce their non-Jewish wives; see Ezra 9 and 10, and Nehemiah 13:13–30.

46. For a thorough description of Jewish genetic diseases, see Batsheva Bonne-Tamir and Avinoam Adam , eds., Genetic Diversity Among Jews: Diseases and Markers at the DNA Level (New York: Oxford University Press, 1992) .

47. A. H. Handyside , J. G. Lesko , J. J. Tarín , R. M. Winston , and M. R. Hughes (September 1992), “Birth of a normal girl after in vitro fertilization and preimplantation diagnostic testing for cystic fibrosis.” New England Journal of Medicine 327 (13): 905–9 . doi:10.1056/NEJM199209243271301. PMID 1381054.

Mark Popovsky, “Choosing Our Children’s Genes: The Use of Preimplantation Genetic Diagnosis,” http://www.rabbinicalassembly.org/sites/default/files/public/halakhah/teshuvot/20052010/Popovsky_FINAL_preimplantation.pdf (accessed April 3, 2011).

49. Psalms 128:1–3, 6. For lack of space, this volume does not include a chapter on the ethics of parent-child relationships. For a discussion of a Jewish view of filial and parental duties, see Elliot N. Dorff, Love Your Neighbor and Yourself (at note 10 above), chap. 4; and Elliot N. Dorff , The Way Into Tikkun Olam (Repairing the World) (Woodstock, VT: Jewish Lights, 2005) , chaps. 9 and 10.

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