In both the Ashkenazi and Sephardi Jewish communities, there is an increased rate of a number of genetic disorders such as Tay–Sachs disease, an autosomal recessive disorder that goes unnoticed in carriers, but is fatal within the first few years of life in almost all homozygotes. Orthodox Judaism generally opposes selective abortion. Although preimplantation genetic diagnosis is often approved by Halakha, it is a difficult and costly process. By avoiding marriages between "carriers", the incidence of the disorders decreases without having to resort to such methods. Dor Yeshorim was founded in 1983 by rabbi Josef Ekstein in Brooklyn. Its name, meaning "upright generation," comes from Psalms 112:2. In a 2006 interview, Ekstein said that while four of his first five children died of Tay-Sachs disease, none of his children born subsequent to the founding of Dor Yeshorim suffered the condition. The same interview quotes a New York neurologist who credits the near-total disappearance of the condition from the ultra-orthodox community due to Dor Yeshorim's involvement. In 2005, Dor Yeshorim created a new program for the collection and storing of umbilical cord blood. Called Kehila Cord, the program operates in the US and in Israel. In 2016, Dor Yeshorim received media attention when a rap video of two schoolgirls beat-boxing about their marriage prospects was shared in the Orthodox Jewish community. The organisation claimed to be "very disturbed by the whole thing" and that "...it is below our dignity as an organization to promote such a thing". Subsequently, Dor Yeshorim also issued an official statement distancing itself from the video.
Operations
Dor Yeshorim screens only for recessive traits that give rise to lethal or severely debilitating disorders, providing prophylactic, rather than diagnostic services. They do not screen for disorders arising from dominant gene mutations, as these cannot be prevented by informed mate selection.s, are used to illustrate the method of trait transfer to offspring according to classical Mendelian genetics. In the Punnett squareto the left, two heterozygous individuals can potentially form three types of offspring: homozygous positive, heterozygous carriers and homozygous negative, in the ratio of 1:2:1. Homozygous positive offspring will completely express the particular recessive trait, in this case the genetic disorder. In the Punnett square to the right, a heterozygous carrier individual and a homozygous negative individual can potentially form two types of offspring: heterozgous carriers and homozygous negative, in the ratio of 1:1, and are necessarily unable to produce any affected offspring, barring a new random mutation. It is the situation depicted on the left, in which couples have the potential of producing affected offspring, that Dor Yeshorim attempts to prevent. Dor Yeshorim advocates anonymous testing. Individuals are tested during large sessions in Jewish schools and processed anonymously with only a PIN linking the sample with the candidate. It offers three panels of testing: the original Standard Ashkenazi Panel, the Sephardi/Mizrahi Panel, and the Optional Ashkenazi Panel. Since January 2016, people who indicate that they are of Sephardic descent are automatically tested with both the Ashkenazi and Sephardi panels. The Standard Ashkenazi Panel includes testing for the following diseases:
Dor Yeshorim does not directly tell individuals which diseases they are a carrier for, in order to "avoid unnecessary emotional burden". When two members of the system contemplate marriage, they contact the organization and enter both their PINs and dates of birth. When both carry a gene for the same disorder, the risk of affected offspring is 25%, and it is considered advisable to discontinue the plans. In the context of shidduchim, the "carriership check" is often run within the first three dates, to avoid disappointments and heartbreak. In the United States, testing costs range from $225 to $500. One-half of the actual testing costs is subsidized by private donors and governments.
Reception
The system has received praise and criticism from both within as well as outside the community. There has been criticism leveled against the method used by Dor Yeshorim by Moshe Dovid Tendler, a professor of medical ethics at Yeshiva University.
The question arises, when do you stop? There are close to 90 genes you wouldn’t want to have. Will this lead to people showing each other computer print outs of their genetic conditions? We’ll never get married.
Tendler feels the system is "affirming eugenics" which he sees as "the idea that Jews are the repository of bad genes". Fred Rosner, a professor of medicine at Albert Einstein College of Medicine, said that "I think Dor Yeshorim performs a tremendous service...screening is a wonderful thing to do, and if you can avoid the birth of a potentially lethally affected child, that is a good thing." Dor Yeshorim has been criticised for withholding patient results, for declining to publish its financial records and for not testing anyone who has already been tested elsewhere, by Geoffrey Alderman, who says that Dor Yeshorim fails some fundamental tests itself. Critics including the Association for the Prevention of Jewish Genetic Diseases, have described Dor Yeshorim in the UK as a "Wedding tax". Dor Yeshorim was also criticised for allegedly seeking to convince the Jewish community it must, for “religious reasons,” use its service, by circulating a letter from Bezalel Rakow. Rakow was a signatory to a subsequent letter stating that "Every individual has the privilege to perform the test in a manner consistent with his desires.” In 2012, the Jewish Chronicle published a letter by a Tay–Sachs carrier, who was hurt by a Dor Yeshorim organiser's insinuation that there was stigma attached to being a Tay–Sachs carrier.
