Halachic infertility: The evolution of Jewish family purity rituals and the ethical and psychosocial implications of their medicalization

Abstract

Infertility is a globally experienced challenge which indiscriminately affects individuals regardless of race, ethnicity, or socioeconomic status. According to a report published by the World Health Organization (WHO), infertility is estimated to affect between 12.5% and 17.5% adults worldwide (WHO, 2023). Within the Jewish community, the rate of infertility is at the higher end of this spectrum, with as many as 1 in 6 Jewish couples below the age of 37 reporting decreased levels of fecundity (Jewish Fertility Foundation, 2023). The higher prevalence of infertility among the Jewish population could be attributed to the disproportionately high rate at which they suffer from certain gynecological, endocrine, and autoimmune disorders, all of which can result in an impairment to fertility (Ostrer, 2001; Golden et al., 2012). Additionally, observance of Jewish family purity law, a system of requirements and rituals which govern the sexual relationship between a husband and wife in accordance with the menstrual cycle, has important implications for fertility among the Orthodox Jewish population, in particular. Specifically, a substantial number of couples experience a phenomenon known as halachic infertility, which refers to a situation in which a woman is unable to conceive due to ovulation which takes place during the period of abstinence that is mandated by contemporary family purity laws (Haimov-Kochman et al., 2012). Traditionally viewed as a religious problem, the resolution of halachic infertility was historically dependent on the introduction of halachic leniencies. However, in recent years, the emergence of various medical technologies has allowed for the resolution of halachic infertility through hormonal treatment (Ivry, 2013).

¶The sociological concept of medicalization refers to a process by which non-medical issues are interpreted or solved in a medical context (Conrad, 1992) and as such the implementation of medical interventions for the treatment of halachic infertility serves as a unique manifestation of medicalization. The phenomenon of medicalization, especially as it applies in cases of halachic infertility, raises important questions regarding the relationship between religion and medicine. Therefore, this thesis aims to address the various ethical and psychosocial concerns that arise through the medicalization of halachic, or religious-born, infertility. The concept of medicalization will first be introduced and defined, after which the processes by which halachic infertility have emerged and become a medical issue will be examined in detail. Lastly, the potential ethical implications of medicalizing a religiously derived issue will be evaluated from both religious and secular perspectives, as well as the possible psychosocial consequences that may arise. This thesis aims to shed light on the complex intersection of religion, medicine, and bioethics and to provide a deeper understanding of the ways in which the process of medicalization can impact both individuals and communities.