L'chvod HaRav,I will begin training in Obstetrics and Gynecology next year. One of the most common surgical procedures performed in the hospital is laparoscopic tubal ligation for women who have completed their childbearing. In teaching hospitals such as the ones I am considering, this procedure is almost always performed by interns and residents in training. I know that surgical sterilization is a halachic problem, and I wanted to
know if I am allowed to perform this procedure.
-Does it matter whether the patient is Jewish or not-Jewish? (It is unlikely that any of my patients will be Jewish at this particular hospital.)
-Do the patients' ages, number of children, medical problems make a difference in the response? (Most patients seeking the procedure in this hospital will have three or more children and diabetes is very common).
-Does the fact that the procedure is sometimes reversible make a difference? Tubal ligation involved either using clips on the fallopian tubes (more likely reversible) or cauterizing the tubes (less likely reversible). Does the method make a difference?
Also, I will be training in programs with very few residents and a large patient population, so not being able to perform this procedure may put a strain on other residents workload and possibly limit the number of patients who could have the procedure done.
Again, if this procedure is absolutely forbidden I cannot do it, (ie I would not perform an elective abortion under those circumstances) but I wanted to know if the prohibition against tubal ligation was this severe.
Thank you for your help in this question.
1. Please read and study:
a. Rabbi Halperin’s basic article on surgical sterilization (“sirus”) [you can see the article at this link: https://www.medethics.org.il/articles/MISC/other1.asp ]
b. Nishmat Avraham כרך ג אבן העזר סימן ה סעיף קטן יג
[you can see the article at this link: https://www.medethics.org.il/articles/NA/NishmatAvraham.EH.5.asp ]
ד"ר דניאל מלאך, "עיקור חצוצרות" ספר אסיא ח' עמ' 121-149 (הוצאת מכון שלזינגר 1995)