bravo.
i'd also add that the posek's assumption is that if you diagnose something in utero, the choice will be to abort. maybe. but your personal path proves how advance knowledge can help save a life too.
kind of a 'stick your head in the sand' 'shev v'al taaseh' approach', as opposed to a more common sense, proactive one.
Chanie-
I wanted to thank you for sending that article in the first place.
This whole business of relying on anecdotal evidence is a great contributor to the problem. In this day and age, we have statistical techniques and thousands of researchers who spend all day using them to derive relative risks and outcomes from large numbers of cases. I don't see how anyone can dispute that this process yields an understanding of relative risks that is far more accurate than one based on whatever anecdotes may have come to an individual's attention.
In medical matters like the one you brought up, pos'kim must (IMVHO) use the best statistical information available before they make a decision. Sure, they may have different values than the people who did the research, so they needn't come to the same conclusions as the researchers as to what a person should do (if the researchers came to such a conclusion at all). However, the pos'kim cannot apply their halachic understanding to the relative risks without first learning, as they best can, what those risks are. Pos'kim who don't have the ability to read the scientific literature themselves should consult with people who can. The consultants provide the facts, and the pos'kim apply the Halachah. Pos'kim who are unable or unwilling to learn the science should not give p'sak on medical matters.
To any pos'kim reading this comment, I apologize for my strident tone. I don't actually intend to prescribe what pos'kim may or may not do, since I'm not qualified to do that, but these are my opinions and suggestions as a frum Jew who has some understanding of how both Halachah and scientific research work.
Isaac-
First of all, you're right. It needs to be based on real, hard data. Nevertheless, data can always be misleading, because each individuals case really IS an individual case. Even if a system is flawed, there can be ways to make it work.
I think a better proof is in the overwhelming consensus among people that this is a good thing. Bad procedures don't really last.
As to your apology for the strident tone, I think that I read the poskim much more than they read me. I doubt you have what to worry about.
For the record, the mother of the twins did have several ultrasounds: http://www.jpost.com/servlet/Satellite?
pagename=JPost/JPArticle/ShowFull&
cid=1127874075019
Gil et al-
In the particular instance in Israel, an good ultrasound diagnosis unfortunately couldn't have accomplished more than psychologically preparing the parents for what lay ahead.
Zman Biur posted about the problems with ultrasound use in israel a few onths ago: http://biurchametz.blogspot.com/...-be-
deadly.html
(thanks, soccerdad, for the link)
The present case reminded me of my own experience with ultrasound (in Israel), and how it saved my child's life. As I pointed out in the post, human failure is no reason to run away from technology.
ADDeRabbi,
First, let me join you in gratitude that your child's life was saved due to prenatal ultrasound. It's easy to get caught up in statistics and forget that there are real lives at stake.
Clearly there are rare circumstances such as yours where prenatal ultrasound can indeed save an infant's life. Speaking in terms of medical evidence, though, the statistics do not support the claim that prenatal ultrasound improves overall outcomes. The poseik you mention may have been relying on anecdote and intuition, but had he relied on medical evidence he may well have reached the same conclusion.
Any medical decision is ultimately based on a consideration and balancing of risks, and people can be harmed by the wrong decision in their particular case, even if it may be the right decision "statistically".
I don't know if any studies have been conducted in Israel, but I wouldn't be surprised if far more healthy babies - or those with insignificant imperfections - are aborted due to ultrasound scans than the number of sick babies whose lives are saved.
The consultants provide the facts, and the pos'kim apply the Halachah.
Unfortunately, when it comes to medicine, many routine decisions are made not on the basis of hard evidence, but due to hospital policy, cost-saving considerations, convenience of the staff, fear of lawsuits, or other non-medical motivations. It would take a poseik truly expert in medicine to separate the facts from the hype.
what would be gained by declaring ultrasounds assur? anyone who would listen to the psak wouldn't casually abort in the first place.
and how does the worry caused by a false positive compare to the grief of losing a child, who could have been saved?
Great point, Rivka. The decision to abort is, at the end of the day, made by the parents. I didn't mention that in our case, several doctors encouraged us to consider abortion.
Again, the issue at stake is not one of technological failure, but human failure.
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