(This post is part of Sinai and Synapses’ project Scientists in Synagogues, a grass-roots program to offer Jews opportunities to explore the most interesting and pressing questions surrounding Judaism and science. John Loike holds a PhD from Albert Einstein College of Medicine of Yeshiva University, and did his postdoctoral research at Rockefeller University and Columbia College of Physicians and Surgeons. He is well-known as a Jewish medical ethicist, but also for his biomedical research on how the human immune system combats infections, neurodegenerative diseases, and cancer. He has also spoken in several places in Asia and written on emerging ethical/scientific topics and cross-cultural perspectives. This post is excerpted and adapted from a talk Dr. Loike gave at Temple Har Shalom in Warren, NJ on altering the human genome from a Jewish perspective on March 17, 2024.)
Let me tell you about myself. To give some disclosure, I’m not a rabbi. I, of course, value the Talmud very heavily. But I was trained as a scientist. And it’s interesting. I never thought I’d be in this position 20 years ago, because I was focused on only doing biomedical research. I was at Rockefeller, at Columbia. I was heavily immersed in the lab.
I had Rabbi Moshe Tendler as a biology professor. I have to confess to you, I was a terrible student in this class. He was too blunt. I couldn’t figure out anything, but that didn’t stop us. But the first day he would put his arm in front of a microscope, and he had a slide of a human cell, and we’d look and he’d say, “What do you see?” “I see the nucleus.” “That’s the membrane.” “I see something that looks like mitochondria.” “I see…” you know, all this stuff.
He says, “You’re all blind. What you should see is the hand of God.” This is, if you look at science and you don’t see the hand of God, you’re not looking objectively. That’s who Rabbi Tendler was.
With that introduction, we’re going to move on to CRISPR. I think what’s really important to this talk is that in the last few months, the FDA has approved the use of CRISPR for sickle-cell anemia. This is remarkable – let me bring everybody up to par. In sickle-cell anemia, typically one nucleotide is mutated and the hemoglobin still functions very nicely. But what happens is that the hemoglobin becomes sticky and forms a fibrillation structure and becomes the red cell disc, becoming a sickle cell. And that causes aggravation, because it gets stuck in all the branches, and you get anemia because you can’t keep up with the destruction of the red cells. And these patients suffer from anemia. You can imagine. So somebody asked a very, almost Talmudic question many years ago: “Wait a second – this is a genetic disease, involving the production of hemoglobin. Why is it that the embryo survives with no sickle-cell anemia?”
And they did research. They realized that the embryo does not make what we call adult hemoglobin – rather, it makes fetal hemoglobin. Why? Because the hemoglobin has to have a higher affinity for oxygen for it to be carried from the mother across the placenta. And within the first six months, the newborn child turns on a gene that turns off the production of fetal hemoglobin to make adult hemoglobin.
So they said, “Let’s use CRISPR to prevent that gene from being turned on.” And that’s what they did. And you could read – it’s amazing. You read about these people who, within weeks, who were suffering from anemia, and now the sclera of their eyes, instead of being yellow because of all the destruction, are white. They don’t have to have transfusions. It’s an amazing breakthrough. It’s still new. I can’t tell you what the side effects are yet, but it’s an amazing thing.
And it says something profound about CRISPR that the FDA is willing to approve it so quickly. Usually, it takes decades. We’re still just beginning now to get some results with gene therapy. We are at just the beginning of stem cell therapy, which is unbelievable. I think it’s one of the most exciting things. But I think that in my mind, CRISPR technology is one of the most brilliant scientific innovations over the last 25 years.
How CRISPR works
Let’s go over how CRISPR works. Most of your DNA is in the nucleus. It’s compacted and wound up in the histones. And once when you need a protein from a certain gene, there are transcription factors and other proteins come in that allow what’s called the RNA polymerase. It’s a protein that will transcribe and convert the DNA into what’s called a message RNA. The message RNA has different sequences called introns and exons. That’s very important, because we only have 25,000 genes and over 200,000 proteins. So how does one gene make different proteins? By selecting which exons and which introns you want to remove, you have a way of having one gene encode for many different proteins. Once it makes the complete message, it leaves the cytoplasm through the nuclear cores.
It’s kind of like a bowl of M & M’s that are all different colors. And that bowl is the gene. And you can take two reds and a green and a brown, and that all creates one protein. Then you can take a brown and a red. And there are all these combinations. In very large genes, like dystrophin, which muscular dystrophy is involved with, a gene can make literally hundreds of slightly different proteins.
Proteins are these little molecular machines in your body that are actually doing the biology. These proteins survey and jump onto these transcription factors. For example, you have tumor suppressor factors that survey all your DNA to make sure there’s no mutation. If it finds mutations, it stops and will stop the cell cycle to allow it to repair. It’s amazing.
There’s actually a very simple reason why there are so many kinds of proteins you can make from a single gene – the ability to tailor specific variants of proteins to different organs. The brain, for example, needs different forms of the protein than the kidney or the liver or other organs.So just think about that RNA as a code to make your machine.
In these diseases, there’s something a little wrong with that code. So your machine has a broken part; maybe part of that machine doesn’t work, maybe the whole machine doesn’t work. So by taking this ability to edit that code, you can fix that part of the machine, you can fix the whole machine, and then you can carry out that biological process that wasn’t working, or create these personal traits we’re talking about.
But I do want to emphasize a couple of things. The first is that most cells, especially human cells, have at least four primary mechanisms to repair breaks and mutations in the DNA. It’s amazing how they do it. When you teach, you always have to ask: “How do they recognize a defect, a mis-pairing of bases, on the DNA?” And it’s brilliant. I guess the best analogy is that if you have a bump in the road, you know something’s wrong. If you have a depression in the road, something’s wrong. And you have genes that survey the DNA and look for these bumps.
As you may know, DNA also carries electrons. And if there’s a break in the conductivity of the DNA, these enzymes come into play, and they’re amazing in their capacity for repair.
CRISPR technology was discovered in bacteria. If a bacteria is infected with a virus or bacteriophage and it survives, it cuts up some of the sequences of the phage of the virus and incorporates it into its genome. And if subsequently they are re-infected, it has this RNA guide that recognizes that bacterial sequence. It calls in CRISPR to solicit proteins – Cas9 – and form a complex with the invading virus. Like molecular scissors, it breaks up and destroys the virus. And the idea of applying this technology to editing the holy grail, rDNA, is remarkable.
So you have various components. You have, of course, the DNA, the Cas9, which is the molecular scissors, and the guide RNA, which will target. And there are really two targeting things. There’s a guide RNA that’s called a Protospacer Adjacent Motif (PAM). I guess a simple little way to say it is the PAM tells you what street the Cas9 has to go on, and the guide RNA tells you the number of the house.
So a disease causes a molecular break. Now the cell has to repair the break. Now, if it’s a double-stranded break, which often it is, that’s a really challenging thing, because there’s no template. So if you don’t have a template, it’s going to randomly insert whatever base pairs it wants. That’s not good.
So what we do now is provide a complementary DNA, a cDNA, to serve as a template to tell the cell how to repair it, and to correct the actual break, the way we want. It’s like editing. You can correct the whole genome. This is what CRISPR is all about.
Medical Applications of CRISPR
So, what are some of the medical applications of CRISPR? There are about 1,000 genetic diseases. We can theoretically heal all of them. Many of them are caused by single mutations. What’s amazing about CRISPR is that it’s not a one-time, one-process thing. We’ve done CRISPR for 60 or more genes within a genome at the same time, and we have good targeting. We’re in great shape. We’ll be able to affect diseases like ALS, diabetes, or even HIV.
We can use CRISPR for longevity – to improve our lifespan. I don’t know how healthy it’s going to be, but 120 years is not the limit.
There are a lot of therapies that we can be doing. For example, let’s talk about treating HIV. In the simplest simplest application of CRISPR, you take a person who’s infected with HIV, and you give them a vector with Cas9 and a guide RNA that’s going to only target the RNA of the HIV. It’s a nanoparticle, so it’s going to try to invade all the cells. And if it sees that genome from HIV, the molecular system could be activated. It’s going to cut the virus, and if it successfully does, you are now virus-free. That is one example.
Another example is phage therapy, which is, I think, a brilliant idea. They’re doing this in the Netherlands. As I told you, bacteriophages are highly specific. They only invade a specific type of bacteria and they can cause destruction of that bacteria. So what they did is they said, “Wait a second, let’s give that bacteriophage a new weapon. Let’s give it CRISPR.” So you take patients who have bacterial infections that are resistant to the antibiotics, and you give them this therapy with bacteriophages armed with CRISPR, and within two weeks, you’ve really ameliorated most of the infections, since the phage recognizes the genetic sequence of a specific bacteria.The only affects that one bacteria and doesn’t affect any other cell. It’s a truly remarkable technology.
High-T – chimeric antigen receptor therapy – is brilliant. It may have some problems, but it looks like, at least for certain lymphomas and leukemias, it’s 80% effective. And the idea here, again, is to use CRISPR to really target your T-cells, to make sure that your t-cells are going to target the right genetic mutation in the cancer cell to destroy the cancer. It’s remarkable what we’ve learned, and we’re going to see more of that.
CRISPR and Medical Ethics
Autonomy
So let’s review, very briefly, some of the ethics issues in using this biotechnology. There’s timing. What timing means is that you have a right to make a decision, but you have to be knowledgeable. This is not an easy thing.
I’ll give you an extreme example. A 21-year-old patient comes in with glioblastoma, which is expected to kill them within a year. The doctor says, “Here’s what you have. We can’t cure you. These are the various options. What do you want?” The doctor tries to explain all the options to the patient within an hour. Do you think that this patient is going to understand how to make a decision? Not a clue. What does the physician do – since it’s the patient’s choice? What if the patient asked, “What would you do in my position?” In my position, that’s not a fair question, because the genetics and the immunological base of the physician are very different from that of the patient. These are very difficult questions. So that’s autonomy.
Fair distribution
Justice is the idea of fair distribution. How do you fairly distribute therapies to the underserved – those who can’t afford it? The new CRISPR treatment to cure sickle-cell anemia costs $2.2 million per person. There are 100,000 patients with sickle-cel anemia, so it would bankrupt any health insurer or any company to do that. So, what are they going to do?
The idea is that you want to make these live-saving treatments available, and you want to make them available not only to your own country, but globally. As all of you know, if you read about it, we pay more for our drugs so that other countries can have the same drug being sold at a low price – is that ethical? It’s nice, but it creates a lot of imbalance.
What can we do about this? There are a couple of treatments that show promise. CAR-T – that’s antigen receptor technology, using T-cells – is about $600,000. It’s a very effective cure for patients with leukemia. But how do you pay for that? So, you could rationalize, saying, “Well, if you figure out what the cost is to care for these patients under a conventional therapy, it’s much higher – probably $1.1 million per patient.” So in the end, the healthcare insurance companies are going to make money.
Now, what about the patient? If the patient can’t afford it, does he have the right? So in Jewish law, a patient has the right to refuse a treatment if it is painful, stressful, and/or is unlikely to prolong life for more than a year. A patient has already said they only want to go through with this if the treatment has a viable chance. And that’s a good question: what does “viable” mean? Is it a 10% chance of success? 20? 30? That’s a good question. And again, that has to be assessed on a case-by-case basis, then if it’s going to affect your longevity for more than a year, then a patient has less right to refuse.
There’s a principle in Judaism where one may forfeit short-term survival (chayei shaah) if there is any hope for long life (chayei olam), and a year is considered a very substantial demarcation of longevity – living for a year or three years, as opposed to months.
Now, the FDA is faced with a huge problem in evaluating treatments. They might have to evaluate a drug that works in 20% of the cases, has a lot of side effects, and only prolongs life for three months. If it’s a cancer treatment, and that can save hundreds of thousands of lives, even 10%, 10,000, that’s significant. What do you do? These are very difficult questions to address. Again, just remember that according to Jewish law, there’s limited autonomy. But there is autonomy.
Beneficence vs. nonmaleficence
Beneficence means to do good. The idea is, “whatever you do, try to do good.” It’s a very nice ethical guideline. But whatever you do, there’s always a mixed bag. It’s not always good.
And there’s non-maleficence, trying not to do harm. And again, you try not to do harm. But if you are coming in with a glioblastoma, how many people say, “Oh, I know there’s side effects, but if I don’t do this, I’m going to die, I’d rather take a chance.” These are really concrete ethical challenges we have.
Respecting human dignity and autonomy
And of course, the last one is very much a Jewish one: respecting human dignity. Every life you save is important, and you have to respect this idea of “What does it mean to be human? What does it mean to suffer? And does a person have a choice?”
There’s a very interesting case. There was a 17-year-old girl who had been treated for leukemia for many, many years, and she said she’d had enough – “It’s too painful. I don’t want to go to the next treatment.” But she was 17, and she still fell under parental control – and her parents said, “you have to.” And the judge ruled, of course, legally, parents had a right. They forced her to undergo treatment, though the difference between 17 and 18, in terms of intellectual maturity, is debatable.
But these are some cases where the question has come up of respecting human dignity. Parents have a right to intervene and to say, “We’re going to treat our embryo one way or the other. We’re going to treat our fetus they way we would treat our child.” But again, they have a lot of control over this, and parents don’t ask their three-year-old, “Do you want to go to yeshiva? Do you want to go to day school?” And I mean, it has powerful consequences, so these are difficult guidelines, but they at least form a foundation by which we can address some of the issues.
Four Jewish issues with CRISPR
CRISPR treatments bring up at least four issues concerning Jewish law:
- Does CRISPR violate any Jewish laws? Are we playing God or are we “playing, comma, God?”
- Are we enhancing the human condition?
- Are we using CRISPR to cure disease, or to give us blonde hair, blue eyes – which we can do?
- And the fourth is: under what conditions can we create new breeds of plants and animals?
So let’s look at the rabbinical response to the first issue. First of all, as you can imagine, there is no precedent for this technology in Jewish law in the Talmud. Nobody’s ever thought of changing the human genome. They didn’t know about the human genome.
There’s a very interesting rabbi from the early 1900s called Israel Lifshitz. He wrote a comment on the Mishnah: “Anything where there is no reason to forbid, according Torah law, is permissible in Jewish law, and needs no justification, for the Torah has not enumerated all permissible things; rather, the Torah focuses on forbidden laws.”
What he is saying is that we can embrace technology as long as the protocol of the technologists does not engage in any forbidden action. And CRISPR does not. There’s nothing, really, we could argue about this, but in a basic sense, there is this moral obligation to save human lives, and that justifies the use of a technology.
Now, in bioethics, there’s another principle: “Just because we should, that we could, doesn’t mean we should.” I’ll give you an example of what I personally, if you ask me, what technology am I fearful about, and that’s synthetic nucleotides. We can make synthetic letters of the genome. Now, why are we doing this? If you use them for biocomputers, that sounds great, because instead of having an INO, you have eight algorithms. In a flask, a DNA apparatus, you can store enough information that’s encoded by all of the Internet in a day. It’s amazing. It’s slow, obviously, but it’s there, so that makes sense. But the idea of incorporating these foreign, synthetic nucleotides into an e. coli, which has been done, scares me, because, as I told you earlier, those processes of looking at the errors of the mutations, they won’t recognize these errors, and there’s no way to ensure that the genome is going to be maintained the way you want it. And that scares me from a bioterrorism perspective.
So this is basically the idea that if the technology has a good purpose, there’s no reason to forbid it, because it needs no justification. There’s a reason to use CRISPR. Ethically speaking, how is using CRISPR to cure disease different from taking a pharmaceutical remedy, like a pill? We can cure not only the person – we can go to the embryo or the gametes and make sure that they’ve never come down with, say, cystic fibrosis.
We can use it for designing animals, improving cattle and poultry. We can make synthetic meats. I don’t know if you’ve heard about this – I’ve written about this years ago. But they had a great idea. They took the stem-cell technology – they took a needle, injected it, and removed, from a calf’s neck muscle, some muscle cells. They put it in a cell sorter, and they isolated what are called microsatellite cells. These are the precursors to all muscles. And they grow these microsatellite cells in culture, where they make fibers – meat fibers. The first time they did this was about ten years ago in England, and they gave it to one of the top two culinary experts to taste this hamburger. And, of course, what do they say? “It’s almost as good as McDonald’s, and it does cost almost $400,000 for a hamburger.”
We’re now down to about $10 per hamburger. What’s interesting is that under Kosher law, you can make it so they’re not considered meat. They can be Parve; they can be neutral. You can make a cheeseburger. We have foods that we can’t imagine that I’ve ever had. We can change the myoglobin of the meat from, let’s say, cow to pig, to make pork chops. They’ll taste exactly like pork chops. It’s energy consumptive, the whole process. But it’s getting better. The idea is to replace cows, which are lovely animals.
Are we playing God or are we playing, God?
The other thing one has to recognize in Judaism is that we have a very important principle. We are partners with God. God did not finish the creation of the world. There is a gap. And God,, from the Biblical perspective, says, “Human beings, I want you to improve on this world and become partners with us. Make sure that the world is not only safe, but is ecologically safe and sound.” The idea is that since we have dominion over the fish and seas, and every living thing, it’s our responsibility to use all our intelligence and knowledge to make the world a better place, to preserve the environment and fight disease. So we are partners with God.
And to me, it’s a little ironic that the secular bioethicists use wording like, “Oh, you’re playing God by using CRISPR.” I always say, “What? Why are you bringing God into the equation? You’re secular.” But they do anyway. But from a Jewish perspective, it’s very important.
Now, is CRISPR foreign to the body? At this conference I was at, they were all saying, this is foreign technology. But all of your cells already use CRISPR. How? When you make a message, RNA it’s this heterogeneous – it has introns and exons, and the cell has to remove all the introns by a splice. It’s a brilliant process. And the spliceosome basically has a guide RNA that brings in this enzyme and cuts out the introns – just like CRISPR does. So all of our cells have CRISPR technology.
Not only that, but we have about 25,000 genes. But these barely comprise even 2% of the human genome. What’s the rest of the human genome? It’s not junk. God doesn’t create junk. It has a lot of codes for messages – MicroRNAs, and different types of RNA’s that regulate gene function. The way MicroRNAS they work, or siRNAs, silent RNAs, is amazing. They create a small RNA fragment, take it from the nucleus into the cytoplasm, and engage it with Dicer and other proteins, and create a guide RNA and another protein to cut it. They find the message or messages they wants to inactivate, bind to that promoter region, and cut the message.
Changing reproductive dynamics
We discuss how we want to improve the world. What about changing the dynamics of human reproduction? One example is that we can now make a three-pair embryo. As you may know, there are two major sources of DNA in the cell – the nuclear source and the mitochondria. You have about 1,000 mitochondria in each cell, and each mitochondria has at least two to 10 copies of DNA. That’s a lot of DNA. They’re small, only about 37,000 letters, and they go through about 13 proteins. But they’re critical. The mitochondria is the battery house of the cell. It’s very important not only for providing energy, but also, if you have defects in your mitochondria, cause a whole variety of diseases.
The mitochondria also doesn’t have the same repair mechanism of the DNA as the nucleus does. But nonetheless, mutations can arise. And by randomness, you can have women who have mitochondria that are defective, and by random choice, they have more mutated mitochondria in their gametes. And of course, mitochondrial DNA comes from women. So now these women who have defective mitochondria – the gametes, which will result in children who have severe diseases like muscular dystrophy. So these women feel like they shouldn’t ever have kids.
They came up in England with this wonderful method called mitochondria-present therapy. One method they use is they’ll take a donor woman with healthy mitochondria, remove the nucleus, and transplant the nucleus of a woman who has defective mitochondria – just her nucleus – into this donor egg. And then they fertilize it with her husband. And she has three parents – the mitochondria donor, the nuclear donor, and this third.
There’s a very famous Talmudic statement that says there are three partners in the creation of a human being – man, woman and God. What happens if there are more? Here you have a fourth. Commentators have put forth that this is not talking about a halachic, legal statement. Rather, it’s a preferred method. But if there are other methods to reproduction, they can be helpful.
What’s the proof? Adam and Eve. Adam was created with no sperm, no eggs, and never was gestated. Eve was created from a stem cell from Adam. Right. And with God, that’s only two. And what does God say in the Bible? He named them “human beings.”
So this is a very important lesson – according to Judaism, as long as you use a human cell, a human being made to create a human being, the result, by definition, should be human, even though you have three or four parents. What’s really interesting about that is that we know we can take stem cells and I can convert them into gametes. So I can take a man’s blood cell and a woman’s blood cell, convert them into gametes, and make a pre-embryo implantation. Is that a human being, then? But according to Jewish law, it is. It’s not just human cells – it’s a human being. So that’s a very important insight.
Gestational Surrogacy
I’ve co-written papers on gestational surrogacy. Here’s the Jewish issue. You have a couple, and the woman was born without a uterus – happens in one in every 100,000 women – or she has a defective uterus. She cannot carry a child. So they take his sperm and her egg, they do in-vitro fertilization, and get a blastocyst, to implant it into a gestational surrogate. Supposing the gestational surrogate is not Jewish, what do they do? What is the status of the child? These are very interesting cases. As a matter of fact, it’s one of the first cases in which there is no precedent in Jewish law – absolutely no precedent about that.
So in discussing this, there is a process. If there’s no precedent in Jewish law, you have to be very strict. In this case, most of the great rabbis will say, “You must convert this child,” because we don’t know – is Jewishness determined by genetics? Is it determined by the birth mother? It’s a whole interesting element.
And then one of the things he said to me, including Rabbi Tendler was, “But you have to understand that to do this, you have to be very clear to the couple engaging in this about all the dangers and the possibilities.” I said, “What do you mean?” He says, “Well, it may be that the husband is going to fall in love with the surrogate because she’s carrying his child.” I said, “Rabbi, come on, how often is this going to happen?” He said, “Do a literature search and figure it out.”
So I did. I found nothing on this, but it turns out there was a professor at Columbia, Nancy Reame, who had done a major study on gestational surrogacy, on the psychological social aspects. So I sat down with her and I said, “Tell me about all the stuff that you found.” One of the most interesting things she found is how often the biological father would have an affair or divorce the mother and marry her surrogate. So here I kind of understood this.
Therapy vs. enhancement
Okay, so let’s talk about the third ethical issue – when a method used as a therapy comes to be used as an enhancement. Let me tell you something which I find interesting. Since the first test tube baby in 1978, we’ve had 12 million babies born using this method. There has been no published report of a “designer baby.” Does this mean that there’s a moral compass in the world?
We’re not going to use this technology to create designer babies. We’ll use it to create a child that has to give a bone marrow transfer for an older child who needs one. But we also have 100 genes that know affect IQ, and we can modify them with CRISPR – presumably to enhance IQ. What is the response to this? So, again, does it violate the prohibition on harming myself?
We have a really interesting model with plastic surgery. Plastic surgery is enhancement, right? What about dyeing one’s hair, or removing wrinkles? The Jewish response is: “You know what? If there’s a real psychological need, go for it.” There’s no problem. If you’re harming oneself, you shouldn’t do it. I should not get a facelift or improve my face so I can mingle with younger women. That’s not a right idea. But if I need to, because I feel I’m embarrassed because I’m aging too quickly or I look too old.
I’ll tell you an interesting story. There’s a very famous rabbi from Israel who used to come visit America. Wonderful man. I used to meet with him. I was giving a talk, a lecture on facelifts and plastic surgery, and I said, “What is the Jewish response?” He says, “Look at me. what do you see?” I said, he was about 50 years old. I said, “One of your eyebrows is completely white.” He says, “Yes, I was 20 years old. And I woke up one Saturday morning, and my eyebrow had turned white. I was embarrassed because the Gemara and the Jewish law says a man cannot dye his hair from gray to white. So what am I going to do?”
So he went to the head rabbi and asks, “What am I supposed to do?” The head rabbi replies, “Dye it! After Shabbos, put some dye in it! You can’t walk around like this. That’s embarrassing!” And again, you have rabbis who will tell you on a case-by-case basis that if you’re doing this because you need to look younger, for your job or for whatever, that’s legitimate. So again, if CRISPR is being used for a legitimate psychological reason, there’s not going to be a problem, but it has to be assessed on a case-by-case basis.
The idea of a legitimate psychological reason implies consent. An embryo cannot consent. But the ethical issues are getting very, very complicated. There are parents who have one child born who’s horribly sick, who want to specifically choose an embryo where that child is going to be healthy or possibly even able to donate tissue and the like.
But when you get away from life-threatening diseases, there are an increasing number of cases where we need to think about what we consider to be “sick” or “disabled” and what we consider “healthy.” For example, there’s autism, where we now talk about a spectrum, and a lot of people who are on this spectrum also consider themselves non-neurotypical, and that this is an okay way to be, and that anybody who tries to alter them is doing them harm psychologically.
Living a Long – and Meaningful – Life
What about enhancing longevity? We know in the Bible there is this idea that people should only live for 120 years. There’s “a time to be born, a time to die.” What do we do again? This is really not discussed by the rabbis yet.
So I’m giving you my impressions. As I said, I’m not a rabbi, but basically, it works as follows. There is, in Jewish philosophy, the idea that prolonging life as an opportunity to better serve God or mankind and make it a better place, and that is valuable. So if there are limited side effects and you want to do this, then there is room, at least in my opinion, to say, “Let’s go for it.” Right? It’s very interesting philosophy in Judaism, and it’s not universal – can you retire? There are those who say, “No, you’ll know it. You’re here for a purpose. You have a purpose in life. You have to discover that purpose.” We say that in our prayers; we thank God for making us aware of what our purpose is.
So I had a very interesting case. I have a colleague who’s a world expert in low-vision ophthalmology – a really brilliant woman. She deals with a lot of these cases, and she’s also a great scholar in the Bible and the Talmud, and she gives a lot of classes on that. And she goes to her rabbi and says, “I want to retire from ophthalmology, and I want to start giving classes and start being a teacher.” And, the rabbi said, “You can always teach classes, but you can’t retire from being an opthamologist – because your purpose in life is clear, as this expert in ophthalmology. We can’t lose you.” So there’s a very interesting idea of what, philosophically, a human life is about. You have to know what you’re here for, right? And to keep engaging in that.
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