Volume 25 Number 63
Produced: Tue Dec 31 20:21:55 1996
Subjects Discussed In This Issue:
Blood Donations and Other Issues
[Chana Luntz]
Bone Marrow Transplant and Halacha
[Freda B Birnbaum]
Bone Marrow Transplant v25 #59
[Neil Parks]
Bone Marrow Transplants (2)
[Michael J Broyde, Steve White]
Bone Marrow Transplants and Chillul Hashem
[Yosef Bechhofer]
Detached retina from shofar blowing
[Michael J. Elman]
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From: Chana Luntz <heather@...>
Date: Tue, 31 Dec 1996 19:39:35 +0000
Subject: Blood Donations and Other Issues
In message <199612291904.OAA26660@...>, Moss M Ellenbogen
writes:
>About five or six years ago a jewish girl from the Northeast needed a
>bone marrow transplant due to leukemia--all the local shuls (here in
>Miami) had a drive to provide blood samples for potential donation--this
>resulted in the donor becoming part of the American Red Cross blood
>marrow database.
>...
>All this raised the question----Can one donate bone marrow to a
>non-jew?? The procedure entails, from what I have been told, an
>invasive procedure in the hip area to draw about a pint of marrow from
>each side of the donor and a mandatory overnight hospital stay. Is this
>injuring yourself, which is prohibited? Some say you can do it if you
>are paid--which is not part of the plan. Has any body seen any teshuvos
>or the like or experienced this and discussed it with a Rav??
I must be missing something.
You or I are required to be mechallel shabbas to save the life of a non-
Jew. In fact, all the doctors of my acquaintance do it all the time.
The prohibition against wounding oneself is a far less stringent
prohibition than that of shabbas (for shabbas you are chayav Kares and
mitas beis din - ie death).
And especially in this kind of case. If you are a good match for this
girl, there is a good chance that she will be a good match for you or
your children, should you/they ever need such treatment in return. So
there is a possible kind of mutuality that there is not necessarily in
the case of saving the life of some non-Jew on shabbas and yet, because
of aiveh we are commanded to be mechalel shabbas. (And besides
which, of course, if she and you are genetically similar, it is not
impossible that she really is Jewish even if she does not know it -
mother's mother's mother may well be Jewish, for all you or she knows, -
you can't rule that possibility out either).
All in all, i am having difficulty seeing what argument there is to
counter the one that this is not only permissable, but mandatory, if
indeed, it would be mandatory in the case of a Jew. (Of course, if it
would endanger your own health, it may not be mandatory/permissable in
the case of a Jew either). Am I missing something vital here?
Regards
Chana
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From: Freda B Birnbaum <fbb6@...>
Date: Tue, 31 Dec 1996 08:50:36 -0500 (EST)
Subject: Bone Marrow Transplant and Halacha
In v25n62, Esther Posen wrote forcefully and to the point about bone
marrow transplants. Thanks for bringing out the halachic bottom line:
> Bottom line is your not mchuyuv to but you should. You will most likely
> save a jewish life and if you save a non-jewish life - cest la vi. (this
> is not my bottom line. this is the bottom line we heard from many
> rabbonim)
> As far as the halachic issues are concerned, there seems to be great
> confusion. Most jews match other jews. The chances that you match
> another jew vary depending on the bone marrow types. We are pretty sure
> that jews have died waiting for non-responding frum matches. Many
> gedolim were misquoted to us. I.e. someone said "rav so-and-so said"
> you should not respond and when we called "rav so and so" he said "I
> can't tell anyone they are m'chuyav" to respond".
This came up for me as I had once gotten tested in one of those massive
drives, gotten into the general registry, and quite a few years later
got a second call to come and get tested again. The issue became moot
as I didn't meet the second set of criteria. While I was waiting in the
long line to get tested the first time, I read the handed-out literature
rather carefully. The procedure isn't totally risk-free. The question
appears to be, to what degree are you OBLIGATED to put yourself at X
amount of risk for the possibility of Y amount of benefit to another
person? Hence Rav "so and so's" reply that he can't tell anyone that
they are OBLIGATED to respond. (And what is your situation in life, the
effects on your family if something happened to you, etc. etc.) But that
is FAR different from saying you shouldn't respond!!
> they recognize "frum" addresses and claim that the majority of frum
> people do not respond when they are contacted for further testing.
> Besides causing a chilul hashem, it also causes a tremendous expense for
> the frum community because these people are automatically removed from
> these registeries when they don't respond and bone marrow tests are
> expensive. Frum people tend to run and finance private drives and
> people need to be restested because they don't stay in the registry.
We need to consider the cost to the community in both the practical and
the chillul haShem aspects, of frum Jews en masse not being involved in
the general community efforts. We know a frum family whose young son
did receive a bone-narrow donation. Quite possibly the donor wasn't
Jewish. At the very least, hakaras tov to the community would indicate
that Jews ought to be involved as donors in this project. And religious
people in general ought to be seen at the forefront of these drives, not
lagging behind their secular (or Reform) fellow-citizens.
> gedolim were misquoted to us. I.e. someone said "rav so-and-so said"
> you should not respond and when we called "rav so and so" he said "I
> can't tell anyone they are m'chuyav" to respond".
Classic example of hearing what you wanted to hear!
> There also are a number of rabbonim misquoting other rabonim (I hope it
> is not sacreligous to say this). I know there are a number of people,
> including the pediatrician who worked with our family, who are working
> to try to get a "das torah" position on this publicized. Bottom line is
> your not mchuyuv to but you should. You will most likely save a jewish
> life and if you save a non-jewish life - cest la vi. (this is not my
> bottom line. this is the bottom line we heard from many rabbonim)
Thanks for bringing this out in public to mail-jewish; let's hope it
spreads farther as well.
Freda Birnbaum, <fbb6@...>
"Call on God, but row away from the rocks"
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From: Neil Parks <nparks@...>
Date: Tue, 31 Dec 96 12:59:59 EDT
Subject: Bone Marrow Transplant v25 #59
>From: <Moss_M._Ellenbogen@...> (Moss Ellenbogen)
>All this raised the question----Can one donate bone marrow to a
>non-jew?? The procedure entails, from what I have been told, an
>invasive procedure in the hip area to draw about a pint of marrow from
>each side of the donor and a mandatory overnight hospital stay. Is this
>injuring yourself, which is prohibited? Some say you can do it if you
>are paid--which is not part of the plan. Has any body seen any teshuvos
>or the like or experienced this and discussed it with a Rav??
I haven't asked the question of any Rabbi, and I don't presume to know
the halacha. I do know that whenever there is a bone-marrow test in
this area, the LOR's support it and encourage congregants to be tested.
If I'm ever called upon to be a donor, I will not presume to question
whether the prospective recipient is a Jew or a non-Jew. I will
unhesitatingly do whatever is necessary to save a life, and if it turns
out that I suffered a minor injury to save a non-Jew, I will be very
happy to let the heavenly court decide after 120 years whether to count
it as a mitzva or an aveira.
...This msg brought to you by NEIL PARKS Beachwood, Ohio
mailto:<nparks@...> http://www.en.com/users/neparks/
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From: Michael J Broyde <relmb@...>
Date: Tue, 31 Dec 1996 09:19:16 -0500 (EST)
Subject: Re: Bone Marrow Transplants
One writer recently wrote on the issue of bone marrow transplants:
> I know there are a number of people,
> including the pediatrician who worked with our family, who are working
> to try to get a "das torah" position on this publicized. Bottom line is
> your not mchuyuv to but you should. You will most likely save a jewish
> life and if you save a non-jewish life - cest la vi.
I believe this is quite mistaken. Rabbi J. David Bleich has an
excellent article in Tradition on this, and I have had conversations
with other poskim also. Rabbi Bleich's article concludes that given the
fact that modern bone marrow transplants are both relatively safe and
involve only minor pain, there is a halachic obligation to serve as a
match for a Jew who is in need of a bone marrow transplant, if you are a
normal person of average risk. To decline to give such a transplant
violates the Torah prohibition on "lo ta'amod al dam re'acha" -- not
standing by while your neighbor's blood was shed. A beit din could
force such a transplant, if needed. Other poskim have confirmed to me
that they agree with this psak.
In terms of donating to a Gentile, I believe that this is a case of
darkai shalom, and when we participate in a communal activity for the
benefit of all, we are under an obligation to help others who have
offered to help us (unless such help is affirmatively prohibited by
halacha). On top of that, there is the issue of chillul hashem and
aiva. (this issue is not discussed by Rabbi Bleich).
Michael J. Broyde
Rabbi
Young Israel of Toco Hills, Altanta
2070 Lavista Rd., Atlanta, GA 30329
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From: <StevenJ81@...> (Steve White)
Date: Tue, 31 Dec 1996 10:53:35 -0500
Subject: Re: Bone Marrow Transplants
In #62, <eposen@...> (Esther Posen) writes:
> You will most likely save a jewish life and if you save a non-jewish
> life - cest la vi. (this is not my bottom line. this is the bottom
> line we heard from many rabbonim)
Really only "c'est la vie"? It seems to me that it's a whole lot better
than merely "c'est la vie," or, "Oh, well." After all, the halacha
l'ma'aseh is still that we can even *mehallel shabbos* to save even a
non-Jewish life where no non-Jew is readily available. And given the
rarity of these donor matches, it would have to be argued that no
non-Jew is readily available.
In any case, to Esther, let me just say "Baruch Hashem" that you found a
match, and that you have perservered, and may you continue to have
"chizuk" to bring this important issue to people's attention.
Steven White (on the registry and proud of it, hoping I'm not needed,
but ready to get on a plane at the drop of a hat if I am)
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From: Yosef Bechhofer <sbechhof@...>
Date: Tue, 31 Dec 1996 08:54:25 -0600 (CST)
Subject: Bone Marrow Transplants and Chillul Hashem
> From: <eposen@...> (Esther Posen)
> In going through this process we stumbled upon this halachic issue. The
> bone marrow registries are not allowed to release confidential
> information (like the religion of the bone marrow recipient) and they
> usually stick to their policy. They are also "anti-frum" by now because
> they recognize "frum" addresses and claim that the majority of frum
> people do not respond when they are contacted for further testing.
> Besides causing a chilul hashem, it also causes a tremendous expense for
> the frum community because these people are automatically removed from
> these registeries when they don't respond and bone marrow tests are
> expensive. Frum people tend to run and finance private drives and
> people need to be restested because they don't stay in the registry.
>
> As far as the halachic issues are concerned, there seems to be great
> confusion. Most jews match other jews. The chances that you match
> another jew vary depending on the bone marrow types. We are pretty sure
> that jews have died waiting for non-responding frum matches. Many
> gedolim were misquoted to us. I.e. someone said "rav so-and-so said"
> you should not respond and when we called "rav so and so" he said "I
> can't tell anyone they are m'chuyav" to respond".
I cannot understand why, at the vey least, "mishum eiva", lest the Goyim
come to detest and wreak similar revenge upon us, we are not "mechuyav",
mandated, to indeed respond to calls to donate marrow. Aside from mishum
eiva, there are other considerations, such as the, albeit minority,
opinions of such luminaries as the Meiri and Rabbi Yaakov Emden that
Christians are worth saving inherently! At least in this case, it would
seem that "safek nefashos lehakel" - and to respond.
Yes, the Radbaz does say that we can never demand that anyone undergo
even a minor medical procedure to save another's life - but that is only
if the excuse is bona fide fear, not another consideration.
But, in fact, the bottom line is the Chillul Hashem inherent in the
issue. I suspect that the primary consideration of many individuals is
clearly not: "What does Hashem want me to do in this regard?" The answer
would be clear...
Yosef Gavriel Bechhofer
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From: <MJELMAN@...> (Michael J. Elman)
Date: Tue, 31 Dec 1996 19:02:16 -0500
Subject: Detached retina from shofar blowing
From: <myarczow@...> (Matthew Yarczower)
> A friend developed a detached retina. He raises the question whether
> it was induced by his shofar blowing which he has done for many
> years. The detached retina is on the same side as his blowing. His
> father, also a shofar blower, also developed a detached retina. Does
> anyone reading this know of any other similar cases?
I am a retinal surgeon who cares for many patients from the frum
community.
I have never seen or heard of retinal detachment developing in
association with shofar blowing. Retinal detachment results from the
vitreous jelly within the eye tearing the retina as the vitreous peels
away from the retina. Fluid within the eye can then go through the tear
and lift up or detach the retina. Once repaired successfully, a retina
generally does not redetach, unless scar tissue develops as part of the
heeling process.
Shofar blowing involves a valsalva maneuver, which can raise the
pressure to the blood vessels in the head including the eye. However,
this should not cause a retinal detachment. More likely, there are
other risk factors contributing to your friend's detachment. The fact
that his father had a retinal detachment indicates that there is a
family history of retinal detachment, a well recognized risk factor. I
would not be surprised if your friend had high myopia, (nearsightedness)
is also a risk factor for retinal detachment. Nonetheless, I will
perform a Medline search to see if there is any connection. I would not
advise this patient to avoid shofar blowing although others may
disagree.
Michael J. Elman, M.D.
Baltimore, MD
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End of Volume 25 Issue 63
