מספר מזהה: 6174

- מכון שלזינגר - https://www.medethics.org.il -

backing out of commitments (with mortal consequences) and genetic testing

שאלה:

Lechavod Rabbi Dr. Mordechai Halpern,

   I am a first-year nursing student at Machon Tal and an ola
chadasha. I thoroughly enjoyed the lectures on the evenings about bone
marrow donations and the halachik ruling of abortion during the
Holocaust. These were extremely interesting  and informative topics.
As well, the lecturers presented themselves and their ideas on a very
high academic level and I learned many things from each speaker. I
have been thinking a lot about each evening.

I had a few questions regarding the topic of the evening on bone marrow donors.

   Firstly, I would like to inquire about the story of the sheirut
le’umi girl upon which the evening was based. I had a little bit of
trouble comprehending the reasons why the girl backed out of her
donation at the last minute. It does not seem reasonable that a fully
stable, healthy, young woman- especially one devoting a full year to
her country-would tolerate a death to occur on her behalf.

  Secondly,  Dr. Bracha Zisser, mentioned that in her company, Ezer
Metzion, they do not use swabs as a means to check for potential bone
marrow donors. Instead, they use blood samples. I was surprised when I
heard this. In America and Canada, cheek swabs are the primary means
of conducting these types of genetic tests. Dr. Zisser continued to
say that they have not conducted a bone marrow drive recently because
of lack of funds.I believe these buccal swabs are the cheapest, most
efficient way to screen. If Ezer Metzion does not have the funding,
why do they not, for the time being, open a bank using cheek swabs
and, when funding permits, open a blood bank?

  Lastly, I did some research and came across an article that
discussed a new method of stem cell donation- using umbilical chord
blood. This has been proven to be very useful as it only needs a
donor-matching rate of 60%. An academic evening based upon the
donation of stem cells and bone-marrow donors, should have, perhaps,
mentioned this new, cutting-edge, technology. This source of cells is
extremely relevant in that it does not require finding a living donor,
which was the discussion that evening.

  I very much look forward to attending many more of the educational
and enlightening evenings Machon Schlezinger has to offer. I cannot
thank you enough for opening up the evenings to the public and to
students.
Thank you very much,
S H

 

 

 

 

 

 

 

 

תשובה:

Shalom S
We forwarded your questions to Dr. Zisser and here is her answer:
Regarding Shoshana's questions:
   1. The story about the young woman is regretfully very sad, but true.
Despite her understanding the ramifications of her refusal to continue the procedure, I suspect that other family members were involved in the decision.
   2. Regarding saliva testing: I know that in the USA and Canada they use these tests. They are not cheaper than blood tests and do not reduce the cost of the procedure. The cost of using saliva swabs is identical to the cost of using blood samples. These are two methods of taking samples. We use blood samples for the simple reason that our primary source is the central recruitment station of the Israeli Defense Forces, where all new recruits are requested to join data base of "Ezer mi-Tsiyyon". The blood taken from the soldiers enables us to increase our data base with tens of thousands of young, healthy donors yearly, while the army retains a small sample of each soldier's blood for identification purposes if the soldier falls in combat (heaven forbid) and there is difficulty in identifying the cadaver.
   3. There is indeed a possibility to use umbilical chord blood. But it is important to note that a patient who requires bone marrow transplantation will first seek out a family member.  Only if no suitable family member is found do we turn to the data bases. If still no donor is found, we turn to umbilical blood banks. This is the order of preference is use today. Things might change in the future.
It is important to note that units of umbilical blood are appropriate at this stage principally for children up to 40 kilograms because of their small volume and the small number of cells needed.
In addition, during the evening I appeared they discussed an incident which occurred a number of years ago. Then use of umbilical blood had just begun and the woman was older, and physically large so that umbilical blood was not possible in her case.
Hoping that my responses are satisfactory,
Bracha Zisser