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114b) how Eliyahu Hanavi, who was a kohen, was allowed to become
impure in order to revive the widow’s son who had died.5]
ɳ Summary and Conclusion
In cases of severe genetic disease, if the couple is liable to lose their
sanity [because of their dire situation] one cannot forbid them from
opting for in vitro fertilization.
ɳ Question
Many thanks to your honor for agreeing to answer the question that
I put to you – with your permission I would like to seek clarification
of one point. At the end of your letter your honor wrote that it is
impossible to close the door of hope in the face of miserable people
who endure terrible anguish from seeing that they have given birth to
children who suffer from genetic disease, such as Tay-Sachs and that
it is hard to forbid them to use artificial insemination of the husband’s
semen, provided extreme care is taken that it is not exchanged with
another man’s semen.
You included a copy of an article published in the medical journal
Ha’rofeh, which describes an alternative to artificial insemination as
a means of diagnosing genetic disease in an embryo before it has
become implanted in the uterine wall namely, rinsing out the womb.
When the womb is rinsed, there is no need to permit artificial
insemination for a couple who can live together in the normal way.
However, although the embryo can be returned to the womb if it is
found to be unaffected, we must deal with the serious problem of
abortion within the first forty days. Is it permitted to offer rinsing of
the womb in the case I described and if it is permitted, which method
5. See what we have written earlier, siman 214 (s.v.‘The Haamek Sheilah explains’)
in explanation of Tosfos’s question.
86 1 Medical-Halachic Responsa of Rav Zilberstein
