Wednesday, January 04, 2006

The Third Wheel

It's bad enough for most infertile couples, this loss of privacy in what is, for many people, the most private activity they will ever engage in: conceiving a child. Tests, drugs, monitoring, procedures...someone else telling you that you're pregnant (or not), insurance companies deciding whether they'll help you pay for what most people get for free.

Infertily and Orthodox Judaism? Now you're really having fun.

By request of Lut C., here is a pretty good starter explanation for my readers who are unfamiliar with the issues. The short story: as with just about everything in life, Orthodox Judaism has rules about infertility tests and treatments, and corresponding loopholes and leniencies to help people navigate the rules as needed. In order to navigate, though, you need yet another fertility expert: a rabbi. Not just any rabbi, but one who is very familiar with fertility issues. And not just any rabbi familiar with fertility issues, but one that you and your spouse can actually communicate with.

Because it's not like there's some blanket rule for every situation - just about everything is open to interpretation, and where Rabbi X will permit a semen analysis by standard sample collection, Rabbi Y will require a collection condom and Rabbi Z will say no to any semen analysis whatsoever. This rabbi allows donor egg; that one does not. The trick is finding the rabbi whose rulings will be more or less in line with your own views, and whose methodologies and phiosophies make you most comfortable - but doing so before you actually know what decisions he will make.

Granted, in the end the decisions are your own. But we, like many other Orthodox couples, choose to make the religion, its rules, and the guidance of its clergy, a major part of our lives. A governing part of our lives, in fact. And if that means adding another person to the gaggle of experts, advisors, overseers, and hangers-on who will be involved in ou reproductive endeavors, then so be it.


At 9:06 AM, January 05, 2006, Anonymous EJW said...

I don't want this to sound confrontational, but I have a question about this process of finding a rabbinical tagalong for your fertility treatment.

You say that rabbis have different ideas on the "rules" regarding testing and treatment and that you have to find one who works with your (plural) mindset.

How is this different from cafeteria Catholics? If you're picking someone who agrees with you, why bother at all? It sounds like you are just shopping around for someone to justify or validate your choices.

Again, I'm not trying to be critical, I'm just not understanding the need for this role.

At 11:07 AM, January 05, 2006, Blogger Robber Barren said...

ejw - I could be misunderstanding Catholicism here, but the main difference is that the Catholic hierarchy all points to the Pope and the Vatican, which sets or adjusts the rules for an entire generation. On the other hand, Judaism, even the apparent monolith of Orthodox Judaism, is pluralistic in the interpretation and practical application of the laws. One of the most widespread (and well-known?) divisions is between Ashkenazi Jews (those of eastern European descent) and Sephardi Jews (those of Spanish descent, though this term is often used as a catch-all by Ashkenazim for Middle Eastern and Persian Jews). The views of the major decisors for each of these groups, passed down through the years, can vary widely on matters such as whether women are allowed to make certain blessings, what foods are and are not permitted on Passover, or the required period of niddah separation. The strength of following one's own heritage is such that, in many circumstances, an Ashkenazi rabbi (for example) would tell a Sephardi congregant to follow a particular law that runs contrary to that rabbi's own observance, or to consult with another rabbi.

Now, the type of selection I'm talking about here is not as pronounced (though, to be sure, if we followed Sephardi rulings a primary concern would have been to find a Sephardi rabbi), primarily because many of the issues of concern are relatively recent developments in Jewish law, and also in part because new methods of communication mean one is no longer bound to ask all questions of one's local rabbi.

I could go on about differences, in theory, but I'm having some difficulty articulating it. It's one of those things where, when you live the life you understand it completely, but explaining to an "outsider" is suddenly very challenging. Perhaps one of the other O.J. IF bloggers could step in and help me here?

As for this question: If you're picking someone who agrees with you, why bother at all? - It's really not that simple. The (Jewish) law in this area is very complex, and rulings for specific issues for specific couples are almost always based on the particular circumstances of the situation. Factors such as what tests have been performed, what treatments have been used so far and for how long, whether either partner has any other children...these all can have an effect on whether a particular test or ART procedure is acceptable or not under Jewish law. The average Jew is not expected to understand all the complexities - even the average rabbi is not expected to. Going to your local congregational rabbi (as knowledgeable as he may be about the laws of Sabbath observance) with your infertility questions would be akin to asking a criminal defense lawyer to handle your divorce...he may be able to hack through it, but you may end up with lots of cookie-cutter paperwork and he'll probably have to consult a lot of other lawyers along the way.

At 12:39 PM, January 05, 2006, Anonymous wessel said...

EJW, think of it this way: Catholicism is more like a benign dictatorship, where laws are set by the dictator and no challenges to it are allowed. The pope is "infallible." If someone wishes to go against the ruling set by the dictator, he will have a dilemma. If he goes against the law, then he will be in violation of it, and must make a decision about whether it is worth it to him.

Judaism, historically, functions more like the Supreme Court, with various Justices rendering decisions on complicated laws. It has always been that way, and our Talmud is based upon explanations of disagreements between ancient Torah scholars over various issues in the law.

As for being a "cafeteria Catholic," there are some Orthodox Jews who would agree with you, but only in certain situations. I will try to explain.

Most Orthodox Jews have identified a central halachic (Jewish law) authority that they follow in ALL matters. This person is usually someone more prestigious than their local synogogue rabbi. Chassidic Jews have a "rebbe" who serves this purpose as well. However, there are halachic authorities who will yield to other halachic authorities if the latter has more experience in a particular area, say, medical ethics. Rabbis can, in effect, specialize in certain areas of the law, much like attorneys and judges do in our secular system of government.

In general, an Orthodox Jew would not feel it appropriate to "shop" for a rabbi who will render a decision that they want. However, I'm speaking here about more common, usual matters. When it comes to infertility, there are relatively few halachic experts. So most Orthodox Jews wouldn't be able to turn to their main halachic authority for infertility matters, because he wouldn't be specialized enough in that field.

It is sort of like having a family attorney, one you go to for a wide variety of legal needs. It would hurt his feelings if you went to another attorney for just any old thing. However . . . if he is not qualified to represent you in a certain legal matter, then everyone, including him, would expect you to seek an expert. Now that you are free to seek an expert, you can "shop." And no, that doesn't make you a cafeteria Jew!

Where it can get tricky is that sometimes, your regular halachic authority may point you toward a halachic infertility authority who will not give you a decision that you prefer. This happens a lot in the ultra-Orthodox or Chassidic world, where you are expected to seek a "specialist" within a narrow group of like-minded authorities. If you go outside of that group, you may be perceived as being a cafeteria Jew. But in reality, according to our Torah, it is permissible to seek a decision from any halachic authority you choose. What you are NOT supposed to do, however, is go to one rabbi for a decision, then turn around and go to another rabbi with the same question if you didn't like the first decision, and then another, and then another. That is not allowed. You are obligated to accept and respect the decision of the first rabbi you approach. (Someone correct me if I am wrong about this, because I think there may be some exceptions to this rule.) In this situation, you want to make sure that you don't go to a rabbi who will likely give you a decision you feel you cannot live with. So you have to ask around and find out by word of mouth what a rabbi's position is on a certain thing, like, say donor egg.

Hope that helps.

At 1:47 PM, January 05, 2006, Blogger persephone said...

EJW, I think you picked up on the first half of Robber Barren's sentence, and missed the significance of the second: "The trick is finding the rabbi whose rulings will be more or less in line with your own views, and whose methodologies and phiosophies make you most comfortable - but doing so before you actually know what decisions he will make."

When an Orthodox Jew "chooses a rabbi who is likely to be in line with our own views", we're talking about the broad strokes. Although all Orthodox Jews are committed to traditional Jewish law, there are very real differences as to how those laws are applied in different segments of the community: RB talked about Ashkenazi vs. Sephardi. There's also modern Orthodox vs. Chareidi vs. Chasidic. There's also personal factors, although those are more difficult to articulate: one rabbi might be more likely to take a hardline approach than another, even within the same community.

So ideally you need a rabbi who is appropriate to your own philosophy in the broad sense. As a fairly modern Jew it would make little sense for me to consult a Chasidic rabbi: although his rulings have halachic validity, they would not fit with the rest of my halachic lifestyle. But within the modern Orthodox world, it is perfectly acceptable for me to pick any of the major rabbis. And it's perfectly acceptable to do so by any criteria: his publicized views on infertility treatment, his personal phone manner, or even his reputation for being strict vs. lenient.

The thing is, once I pick him, I'm going to stick with him -- and again, I can only know the broad strokes of what he's going to say beforehand. The whole reason we need a rabbi in this area is that the laws are too complex for a layperson to navigate without years of study and experience. We might pick a rabbi because we know that under at least SOME circumstances he believes a semen analysis is permitted - but we don't know in advance what those are. We will be consulting him to find out when and how we are permitted to carry one out, and we will generally consider ourselves bound by all the details of those rulings. Each of us has had the experience of being told we can't do something we wanted to do.

That's not to say people never switch rabbis when they run into a broad position they can't live with - but if they do, they stick with that rabbi from then on, and they follow whatever further rulings he gives them. It's never just a "tagalong" to what you've already decided you're going to do.

There's a principle in Judaism that there are at least seventy ways to interpret the Torah, and each of them is the word of Gd. As Orthodox Jews we do have some freedom to pick one of the broad approaches out there based on what feels right to us. But once we do that, we need expert help to make sure we are carrying out that approach with integrity to the sources. That's where a rabbi comes in.

I hope that helps.

At 3:03 PM, January 05, 2006, Blogger persephone said...

Oops. Just realized it sounds like I'm challenging Wessel on one minor point -- I didn't mean that it would be unacceptable to consult a rabbi outside my own corner of Orthodox Judaism, just that it's unusual to do so.

But yes, as you get to the more and more specialized questions (whether it's a complex medical question or a complex emotional situation), there are so few rabbis with the required expertise, that it certainly happens. And there's nothing wrong with that. The ruling of any properly trained rabbi is religiously valid.

At 3:43 PM, January 05, 2006, Blogger projgen said...

I can't add to the explanations already here, because they're brilliant. I can only add my personal experience: my rabbi has no experience with or knowledge of the halacha relating to infertility. My husband and I asked others in the infertility world for recommendations for a knowledgeable rabbi. We made sure to only ask people whom we felt had halachic views much in line with ours. We received the name of a knowledgeable rabbi and after some discussion with our rabbi, our rabbi agreed that we should use this recommended rabbi as our halachic authority for infertility.

None of this is done in a vacuum. I really liked the analogy of the lawyer; works for a doctor too - a good GP would want you to see a neurologist if you suffered nerve damage.

That was a great question; I appreciated being able to read everyone's responses to a difficult issue.

At 3:47 PM, January 05, 2006, Blogger Lut C. said...

First, I want to thank you ladies for taking the time to explain this.
I live in a city with an old Chasidic community (if you really want to know exactly where, please ask me by mail). Except sharing the train or metro with them, I have no personal contacts with these communities.

The idea of having an authority like a rabbi make such far reaching decisions in my life is foreign to me. Not that I think that I make al my decisions independently, not at all. The sources that influence me are just very diffuse, I suppose. The IF blogosphere is one such source, for instance.

With regard to Catholicism, I agree it is a dictatorship, but I don't think it's that benign. This is my very personal opinion, but I find the Churches policy on birth control, and specifically on condoms, very very wrong. The Vatican has a campaign to spread the message among Catholics that condoms don't work and that it's a mortal sin to use them. Meanwhile, an Aids epidemic is wiping out entire communities around the world.
Tell people to be faithful to their spouse, fine. Tell couples to procreate, fine. But even if extra-marital relations are a sin, even a mortal sin, surely using a condom when doing so is the lesser of two evils. After all, the whole ideology of the Catholic church is built on the idea that people are sinners, no matter what. So tell them they need to go to confession after using condoms, but don't discourage their use!
Honestly, I don't know how the Pope can sleep at night. How he can rhyme this with the commandment to 'love thy neighbour' I don't know.

Ok, I'll stop ranting know. My country used to be a predominantly Catholic country, and its influences can still be felt now and again. Practicing Catholics are becoming rare, however.

At 6:51 PM, January 05, 2006, Anonymous ruth said...

A very insightful discussion as to why we consult rabbeim 'at all'. Thank you robber barren, wessel, persephone for the clear insight and ejw for posing the question! I've been looking for a way to word this and you have done perfectly.

Thank you.

At 10:46 AM, January 06, 2006, Anonymous EJW said...

Thanks for the explanations. The lawyer analogy was great and made it much clearer.

I must say that Judaism sounds like a great way of thinking. I love that there's 70 ways to interpret the Torah and they're all God's words. What a breath of fresh air after 18 years of hard-line Catholicism being crammed down my throat.


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