MORDECHAI HALPERIN 58.
(photo credit: Judy Seigel)
The 1980 amendment to the Anatomy and Pathology Law that gives a veto to
bereaved parents on whether an autopsy may be performed on their infant
suspected of have died of Sudden Infant Death Syndrome (SIDS or crib death
death) must be changed, according to Dr. Pnina Aviram, a senior lawyer and
bioethicist at the Ono Academic College.
Aviram was speaking at an
all-day seminar Tuesday attended by 400 doctors, nurses and families who have
gone through the tragedy of SIDS.
She said that only a couple of
autopsies are performed each year to determine the causes of death of seemingly
healthy infants below the age of one year.
There is widespread opinion
that it would be impossible politically for the Knesset to pass an amendment
that would allow an expanded hospital ethics committee to decide if such a
post-mortem exam were needed, but she strongly advocated this. The religious
parties, as well as others, would resist changing the Autopsy and Pathology Law,
But Aviram noted that there is a good reason why autopsies are
permitted and carried out in many countries – not only when a possible crime has
been committed but also when there is no suspicion of a crime, such as when a
baby dies of apparently natural causes.
Knowing what caused the baby to
stop breathing in its sleep could save the lives of future children in the
family or other children, as there may be some medical problem which was not
detected, she said.
“What I say sounds provocative and even a bit
extreme. I am a liberal. But I have heard many of the medical lectures today on
the causes of SIDS, and though all of them presented lots of data, nobody knows
if the wrong conclusions have been reached. Why does SIDS occur?” She said she
new knew only the statistical answer – going to sleep in a supine position, not
exposing the infant to tobacco smoke and other chemicals, not heating the room
and the child excessively and other factors.
But it is all guessing, she
said, as autopsies in such cases are extremely rare.
Aviram added that
when a child has to undergo any medical procedure, in many cases, parents cannot
make an objective decision; a legal ethics committee must look at each case to
determine what it is needed to learn the truth.
Dr. Rabbi Mordechai
Halperin, the Health Ministry’s medical ethics expert and also a gynecologist,
spoke by telephone to say that there must be reasons for something to be
forbidden by Halacha; if not, it is permitted.
He said that autopsies on
infants suspected of having died of crib death have been allowed by leading
rabbinical arbiters if there is a very good reason, such as saving a life, but
at the same time one must not desecrate bodies unnecessarily by dissecting
Halperin gave the example from 20 years ago, when a baby died soon
after getting a hepatitis B vaccination. The ministry was concerned that there
might have been something wrong with that specific batch of vaccine, in which
case they would have to destroy the batch of vaccine to save other
The late arbiter Rabbi Shlomo Zalman Auerbach said he would agree
if Halperin was present when the autopsy, which could not be replaced by a scan
or x-ray, was performed on the infant. In the end, the operation in Abu Kabir
showed the baby had a rare fatal ear infection, and the vaccine was
Saving a theoretical life is not enough to approve an autopsy, he
Halperin noted that Jewish law prefers a non-invasive way to make
such discoveries. If a scan, CT or even an MRI can provide a good answer, it is
much preferred. But if not, an autopsy can be approved by a leading
The conference was organized by Dr. Anat Schatz, a pediatric
respiratory expert at Jerusalem’s Shaare Zedek Medical Center, which hosted the
conference and also houses the office of ATID, the voluntary organization
founded a decade ago by Schatz to help SIDS families, increase public awareness
of it and promote research.A full Health & Science Page feature on
the SIDS conference will appear on Sunday, March 27.