Washington Oct 15, 2004 - Medical milestone or privacy invasion? A tiny computer chip approved yesterday for implantation in a patient's arm can speed vital information about a patient's medical history to doctors and hospitals. But critics warn that it could open new ways to imperil the confidentiality of medical records.
"Implantable chip OK'd for medical use" By Diedra Henderson (AP)
Between 1811 and 1817, an anti-technology movement spread rapidly through England. Dubbed the Luddites, after Ned Ludd, an English worker who had supposedly destroyed weaving machinery in the late 1700s, the movement advocated destroying the labor-saving machines created by the industrial revolution. In particular, they attacked wool and cotton mills. Their goal was to fend off the new technologies that were threatening the established way that tradesmen practiced their crafts. They believed that these modern machines would decrease employment opportunities.
The movement became so disruptive that "machine breaking" (a form of industrial sabotage) was made a capital crime in England, and 17 men were executed in 1813. Many others were exiled to Australia. Pitched battles were fought between the army and the Luddites. At one point there were more British troops fighting the Luddites in England than against Napoleon Bonaparte on the Iberian Peninsula.1
While the movement had an underlying economic motivation, the term Luddite has come to mean one who opposes technology and technologic advances.
From cloned sheep to implantable chips in human beings, technology advances at a dizzying pace, bringing with it new ethical problems each day. Are we moving too fast through uncharted territory? Is there a grain of truth to the Luddite position? How do we judge the morality of new procedures and new technologies?
Man's Role in Creation
Let us first assess the Torah's view of the role of humanity in the world. What is our place in the greater creation? The beginning of the Torah describes the creation of man and woman, telling us that "God blessed them and God said to them: 'Be fruitful and multiply, fill the earth and subdue it; rule over the fish of the sea, the bird of the sky, and every living thing that moves on the earth.'"2 Man was created with a mission to rule over the world and to subdue it. Traditionally, this has been interpreted to mean that we are to understand our world in order to master our environment. We are commanded to build bridges and to move mountains in order to improve our quality of life. There are even specific passages in the Torah that command us to heal, giving us a mandate to pursue technology that will heal the sick.3
The world is a God gift to man for him to mold and shape, but most importantly, to improve.
The world is a God gift to man for him to mold and shape, but most importantly, to improve. Man is also instructed to emulate God. When the Torah states: "And God created man in His image, and in the image of God He created him" it teaches us that man was fashioned to be a creator, just as God is a creator.4
We take this mandate very seriously. It is a mistaken form of religiosity to believe that man should not try to improve his lot. Mainstream Judaism would not support the assertion of a reader of one of my previous articles who wrote that: "It is my belief that God alone should decide who conceives and who does not. If my genetic material is meant to be passed along to another individual, it will happen in the natural manner." God certainly does decide who will conceive, but what is the basis for asserting that allowing man to perfect in vitro fertilization is not one of the ways that He utilizes to provide couples with a family?
While one is free to take the view that one will only have children if one can do so in the usual way,5 one certainly should not presume to apply such a concept to others who wish to have families. For the major decisors of Jewish law6 who permit in vitro fertilization, there is no issue of circumventing God's will. If there is no inherent Biblical or rabbinic prohibition in performing an act that will help people, then we fully support it.
With Power Comes Responsibility
This mandate to manipulate the environment also comes with a sense of responsibility. Man is given a twofold mandate. While he is instructed "to subdue" the earth and to "rule over" the rest of creation, he is also placed in the Garden of Eden "to work it and protect it."7 While he was granted permission to exploit and utilize all of the world's natural resources,8 he is still clearly barred from acts of indiscriminate destruction and waste.9 Man is enjoined to protect the world and not harm it.
The midrash writes:
"At the time that God created Adam, the first man, he lifted him up and showed him all of the trees of the Garden of Eden. And He said to him: 'See My creations, how beautiful and praiseworthy they are. And I have created all of it for your sake. Contemplate this and be watchful that you do not damage or destroy My world. For if you damage it, there will be no one else to repair it after you.'" (Kohelet Rabbah, 7:28)
Would the world be better off without the intervention of people?
There are those, like the Luddites, and the back-to-the-land movement,10 who have taken a more negative view of man's manipulation of his environment. They claim that the world would be better off in a more "natural" state.
This is exactly the argument made by the Roman general Turnus Rufus, in his debates with Rabbi Akiva.11 He asked Rabbi Akiva why Jews circumcise their sons. Do Jews believe that they can improve on God's creation of man?
We are partners in creation in all aspects of the world, including technology.
Rabbi Akiva placed grain and bread before the general and asked him which one he would prefer to eat. The general made the obvious choice and took the bread, which clearly represented man's improvement on nature. Just as baking bread is an act of improving wheat, so is circumcision an act of improving man. The moral of the story is that our mandate is to improve the world. Judaism does not consider the world to be complete without the input of man. We are partners in creation in all aspects of the world, including technology.
The role of man in perfecting the world extends beyond just physical change. We are commanded to improve the spiritual state of the world as well. Again we turn to Turnus Rufus and Rabbi Akiva.12 The general asked Rabbi Akiva, if God loves the poor people so much, why does He not support them Himself? Rabbi Akiva answered that God wishes to allow human beings to be partners in the spiritual creation of the world and thereby earn merit for themselves by giving charity.
How far does our mandate go?
Despite the argument of Rabbi Akiva, one might think that the Torah itself limits the development of technology. For instance, Eve was told that all women will have pain at childbirth. Maybe this punishment precludes the use of epidural injections of pain medication to relieve birth pangs? While some 19th century Christian theologians condemned the use of chloroform for relieving the pain of childbirth, the curse of pain in childbirth is approached by Judaism more as a challenge for us to overcome than a requirement to withstand pain that can be alleviated. We support the development of pain relief methods and Jewish law permits epidural injections of pain medication to relieve birth pangs.
Likewise, while man is cursed with the introduction of death soon after creation, he is nevertheless commanded to triumph over death, and strive for life.13 While philosophically God is the source of all illness, He nevertheless commands us to heal. (See: The Mandate to Heal.)
Technology's Mixed Blessing
Despite the great promise of technology, we must keep in mind the repercussions of technology on our fellow man. We must recognize that the long-term benefits of technology have always outweighed the long-term harm, yet we should recognize that innovation may bring short-term economic strife to groups of people displaced by the new technology. While automated toll machines may be efficient, until the human toll-taker finds another job, he will remain unemployed. We must be prepared to deal with the short-range fallout of scientific advance before the benefits accrue.
We must also use technology for noble purposes. Let us take a deeper look at the Jewish approach to technology as it appears in the beginning of the Torah. The creation story introduces a world of vast untapped resources, awaiting the creation of man to unlock their potential.14 With the advent of man comes the immediate explosion of technology as man begins to farm and raise livestock.15 By the eighth generation, man has developed nomadic shepherding,16 invented musical instruments,17 and developed metal tools.18
But Rashi, the 11th century Torah commentator, explains that Jabal, "the father of those who dwell in a tent," built houses of idol worship, Jubal invented the harp and flute "to play music for idolatry, and Tubal Cain invented tools of copper and iron to be used as weapons by murderers.19 We see that soon after the introduction of technology, the world became corrupt and would be destroyed by a flood.20
This progression of events is not meant to be a warning to us regarding the evils of technology. It is meant as warning regarding corruption in the application of scientific progress. The flood is not a consequence of the new technology; it is a response the corruption of mankind. The Torah describes that the world had become corrupt and full of robbery and violence. It was the degeneration of man's interaction with his fellow man that led to the destruction of the world.
Our greatest challenge is applying the fruits of our God-given inquisitive nature in an ethical way.
It is the immoral application of technology that is "off limits" to us. The development of technology has always been welcomed by Judaism because technology is ethically neutral. Questions of ethics are questions of applied technology. When Cain brings a sacrifice from inferior produce and his sacrifice is rejected, he is warned that man has free will to do with his gifts as he sees fit. God's only requirement is that man use his gifts wisely and appropriately.21 Our job is to decide when it is moral to use the new procedure and when restraint should be applied. Our greatest challenge is applying the fruits of our God-given inquisitive nature in an ethical way. Every new breakthrough offers both hope and danger. Nuclear power can fuel our need for energy, but has the potential for destruction in the form of bombs. Radiation can diagnose disease, but can also destroy cities.
Is medicine different?
Medicine is no different. Daily advances in biotechnology offer hope for so many. People live longer than ever before and vaccinations and antibiotics have turned infectious disease into an inconvenience, rather than a scourge. Smallpox has been eradicated. Measles, mumps, whooping cough, and polio are virtually memories. We have mastered the world and subdued disease and Judaism applauds every medical breakthrough.
But not all medical technology is quite so unambiguously good. Let us take the example of in vitro fertilization22 with pre-implantation diagnosis to prevent genetic diseases23 . After several cell divisions, a few cells may safely be removed for genetic screening. For a married couple, each carrying the gene for Tay Sachs disease, pre-implantation diagnosis and implantation of only embryos without Tay Sachs disease may be the only halachically acceptable way to have children born without a tragic fatal disease.
Implanting only "healthy" embryos may be ethical when avoiding a tragedy such as Tay Sachs. But what of using the same technology to choose the sex of our children? Shall we implant only boys? Only girls? Shall we examine every embryo for a myriad of genetic flaws, including low intelligence (or average intelligence), poor eyesight, bowed knees, or brown eyes? Now that the human genome project has identified all of our genes, will we create genetic cripples and design our children according to our own specifications?
Additionally, we must take into account the human suffering that technology may bring. While we usually associate more accurate information with increased and better choices, this is not always the case. Knowledge is only power when we can act upon the information that we are provided. What if the information only engenders fear without offering hope? For instance, we may now test people for the genes that cause multiple deadly diseases. But if the disease for which one tests positive is not curable and if the test only represents a propensity for the disease, what positive information has the test provided. It might be better not to have been tested!
The Power of Restraint
The Jewish view of technology is no different than its view of any other aspect of life. While we can perform technological feats that boggle the mind, we look to the Torah for answers to when we should perform these miracles. In a world that has endless potential, we must decide how to ethically channel our discoveries, when to perform our medical miracles, and when to restrain ourselves from applying the awesome power in our hands because it is simply not the right thing to do. We must subdue the world, but not each other.
As the book of Ecclesiastes states: "Everything has a season, and there is a time for everything under the heaven.24 Jews have traditionally turned to the Torah for guidance in determining when the right time is to act and when is the right time to forego action.
(1) Adapted from the article at Luddite
(2) Genesis 1:28
(3) Exodus 21:18-19 and Deuteronomy 22:1-2.
(4) Rabbi Chaim of Volozhin, Sefer Nefesh HaChaim, Sha'ar Alef
(5) There is no obligation of undergoing in vitro fertilization, but those who do so usually desire to have children if at all possible, regardless of whether they are required to do so.
(6) Not all poskim permit in vitro fertilization, but not because of a fear of circumventing God's will. Rather there are technical halachic issues involved with IVF which they find to be problematic. Most of the objections involve the prohibition of "wasting seed" and a lack of perceived strict oversight of the procedure. Additionally, there is disagreement whether the genetic father has fulfilled his obligation of procreation. For several reasons, Rabbi Waldenberg forbids IVF (Tzitz Eliezer 15:45). On the other hand, Rabbi Nebenzahl (Assia 34, Tishrei 5743), Rabbi Ovadia Yosef (Yebia Omer Volume 8, Even Ha'Ezer 21), and Rabbi Eliashiv allow IVF under certain circumstances (such as when other options have been exhausted and under strict supervision of the process). See English Nishmat Averaham, Vol 3, p.15 (Even He'Ezer 1:6).
(7) Genesis 2:15
(8) Genesis 1:28
(9) Deuteronomy 20:19-20, Sefer HaChinuch Mitzvah 529
(10) "Back-to-the-landers chose to be at nature's mercy and to live with the inconveniences that this may entail. By using solar or wind power and other environmentally benign forms of energy, for example, they were trading convenience for a life that fit their moral values."
(11) Midrash Tanhuma, Tazriah 19
(12) Baba Basra 10a
(13) Exodus 21:18-19, Leviticus 18:5
(14) Genesis 2:5: "now any tree of the field was not yet on the earth and any herb of the field had not yet sprouted, for God had not sent rain upon the earth and there was no man to work the soil." Rashi explains: "And what is the reason that He had not sent rain? Because 'there was no man to work the soil,' and there was none that could recognize the goodness of rains. When Adam came and realized that they are a necessity for the world, he prayed for them and they came down, and the trees and types of vegetation sprouted."
(15) Abel was a shepherd and Cain was a farmer.
(16) Genesis 4:2: "And Adah bore Jabal; he was the father of those who dwell in a tent and with livestock". Rashi explains: "He was the first of those who graze animal in deserts, and he would dwell in tents, a month here and a month there, because of pasture for his flock"
(17) Genesis 4:21: "The name of his brother was Jubal; he was the first of all who handle the harp and flute."
(18) Genesis. 4:22: "And Zillah, too--she bore Tubal-cain, sharpener of any shaper of copper and iron" Rashi explains: "He seasoned and improved the craft of Cain by making weapons for murderers."
(19) Midrash Bereshis Rabbah 23:3
(20) Genesis 6:5
(21) Genesis 4:7 "Is it not true that if you do good, you will be forgiven? But if you do not do good, at the entrance the sin crouches; its longing is toward you, yet you will rule over it."
(22) In vitro fertilization a method of conceiving a child outside of the womb.
(23) See "Stem Cell Research in Jewish Law," .
(24) Ecclesiastes 3:1