Improving Reproductive Health Screening in Orthodox Jewish Communities
Shari Esquenazi, BA, MS, Intern, MD Anderson Cancer Center
One of the most theologically conservative forms of Orthodox Judaism consists of the Hareidi Jewish people. The Hareidi consider their belief system and religious practices to extend in an unbroken chain back to the times of Moses and the giving of the Torah on Mount Sinai. As a result of the strict interpretation and application of the Jewish laws, women in this Ultra-Orthodox sect often bypass routine gynecological examinations. Coupling this behavioral habit with the fact that the reproductive gene pool is extremely limited for those in the group, there is a high statistical risk of developing one of the BRCA-1 and BRCA-2 related diseases, including breast, uterine, and ovarian cancers.
Due to the stigma associated with infidelity within a marriage, and moreover, being deemed as impure following premarital or extramarital sexual activity, there is also a risk of developing cervical cancer from an undiagnosed HPV infection for some individuals.
Social factors, including the aforementioned fear of persecution and stigmatization, as well as the hierarchy of decision-making within the family dynamic prevent women from freely visiting with a gynecologist.
This paper explores solutions on how to both respect the religious foundations of these individuals while preventing harm to their health. The health effects discussed within this paper are not exclusive to women; men in this lineage are also at an increased genetic risk of developing prostate cancer, and socially implied risk of penile or throat cancer when HPV is involved. With a primary focus on women’s health, other conditions associated with the strict reproductive requirements include endometriosis and polycystic ovarian syndrome, which often require pharmaceutical intervention in the form of birth control pills in order to prevent infertility. This paper utilizes an anthropological lens in order to develop ethical public health recommendations so that these religiously observant women do not have to sacrifice their health and reproductive capacity in order to observe and respect their faith.
One of the most theologically conservative forms of Orthodox Judaism consists of the Hareidi Jewish people. The Hareidi consider their belief system and religious practices to extend in an unbroken chain back to the times of Moses and the giving of the Torah on Mount Sinai. As a result of the strict interpretation and application of the Jewish laws, women in this Ultra-Orthodox sect often bypass routine gynecological examinations. Coupling this behavioral habit with the fact that the reproductive gene pool is extremely limited for those in the group, there is a high statistical risk of developing one of the BRCA-1 and BRCA-2 related diseases, including breast, uterine, and ovarian cancers.
Due to the stigma associated with infidelity within a marriage, and moreover, being deemed as impure following premarital or extramarital sexual activity, there is also a risk of developing cervical cancer from an undiagnosed HPV infection for some individuals.
Social factors, including the aforementioned fear of persecution and stigmatization, as well as the hierarchy of decision-making within the family dynamic prevent women from freely visiting with a gynecologist.
This paper explores solutions on how to both respect the religious foundations of these individuals while preventing harm to their health. The health effects discussed within this paper are not exclusive to women; men in this lineage are also at an increased genetic risk of developing prostate cancer, and socially implied risk of penile or throat cancer when HPV is involved. With a primary focus on women’s health, other conditions associated with the strict reproductive requirements include endometriosis and polycystic ovarian syndrome, which often require pharmaceutical intervention in the form of birth control pills in order to prevent infertility. This paper utilizes an anthropological lens in order to develop ethical public health recommendations so that these religiously observant women do not have to sacrifice their health and reproductive capacity in order to observe and respect their faith.