Multifetal Pregnancy Reduction in Halacha
Teacher’s and Student’s Guides
by Avi Lasdun, Ph.D.
NLEResources.com welcomes the submission of educational materials to assist educators in their teaching. We are greatly appreciative to Dr. Lasdun for investing the time to prepare and share this class on “Multifetal Pregnancy Reduction in Halacha” with the NLEResources.com community.
The focus of this presentation is to explore the Halachic permissibility of performing multifetal pregnancy reduction (MPR), by applying the teachings of the Talmud (Mishna and Gemara), Rishonim (medieval-period commentators), Acharonim (more recent commentators) and Poskim (Halachic decisors).
MPR is an interventional procedure performed by obstetricians in cases of multifetal pregnancies (for our purposes, we will characterize multifetal pregnancy as a triplet or higher order gestation) to reduce the number of fetuses in utero, thus increasing the survival probability of the remaining fetuses through a full-term pregnancy. Multifetal pregnancies are associated with several undesirable outcomes including complete pregnancy loss (miscarriage and stillbirth) and preterm birth which is often complicated by neonatal death and long-term disabilities. Reducing the number of fetuses in utero to a twin pregnancy leads to improved outcomes, as measured by lower rates of miscarriages, pre-term births and perinatal mortality (see Appendix C).
It is understood that the goal of MPR is to optimize the survival chances of the remaining fetuses in cases where there is a high risk of total fetal death without intervention. Yet, since MPR by definition, terminates one or more fetal lives, contemporary Poskim and religious physicians have toiled to understand how Halacha views this predicament. This dilemma falls into the rubric of the universal question: can we end a life to save another life? Generally, taking a life cannot be justified even if it is the very (and only) means for promoting the survival of another life. This principle is described in the Mishna Ohalot as Ain Dochin Nefesh Mipnei Nefesh (אין דוחין נפשׁ מפני נפשׁ – we may not push aside one life on account of another life). Nonetheless, in very limited applications discussed in the shiur, we are instructed to save a life even if this will lead to the demise of another life. The shiur describes applications and limits of Ain Dochin Nefesh Mipnei Nefesh and the relevance to the Halachic permissibility of MPR.
Please kindly dedicate the מִצְוָה of לִימוּד תוֹרָה involved in using these educational materials in memory of my brother and teacher, Rabbi Yosef Lasdun, ZT”L לעילוי נשמת אחי ורבי ר׳ ישראל יוסף אליהו בן ר׳ טוביה הלוי זצ״ל
Note: This shiur it is not intended as a source of practical halachic (legal) rulings. For matters of halachah (practical details of Jewish law), please consult a qualified posek (rabbi).
- Multifetal Pregnancy Reduction – Main Shiur file
- Appendix A – Dispute of Rebbi Yochanan & Reish Lokish in Talmud Yerushalmi
- Appendix B – The ‘מאי חזית logic’ according to Rashi (explained by Rav Moshe Feinstein)
- Appendix C – Multifetal pregnancy risks and outcomes of reduction
- Appendix D – ‘אין דוחין נפש מפני נפש’ according to Rashi (explained by Rav Moshe Feinstein)
- Supplement 1 – Additional Sources & References
- Supplement 2 – Rav Moshe Feinstein – 1) Obstructed labor & fugitive cases; 2) דין of יהרג ואל יעבור
- Supplement 3 – Rav Chaim HaLevi on the Rambam – The obstructed labor case
- Supplement 4 – Rav Shach on the Rambam – The obstructed labor case
- Multifetal Pregnancy Reduction in Halacha – Shiur and Appendices A-D
- Supplemental Sections 1-4
Dr. Avi Lasdun attended Telshe Yeshiva in Wickliffe Ohio, graduated with a bachelors in Biology from Touro College in 1985 and a Ph.D. in Biomedical Sciences from City University of New York in 1990. Avi worked for over twenty years in the pharmaceutical industry as a scientist. He is currently adapting scientific analytical and writing skills gained during his career to help develop Torah teaching tools that he hopes will activate a fuller array of intellectual and emotional capacities to enable a more holistic learning experience for students.