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November 19, 2012

Judaism and Nuts: Ethics and Allergies

http://www.jewishjournal.com/blog/item/judaism_and_nuts_ethics_and_allergies/

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It is one of the most dramatic moments in the entire Torah. There is no lightening or thunder, no plagues or parting of the sea, just an elderly statesman appearing before his people one more time, to teach one more lesson before they part from each other, the people to cross the river and the old man to enter eternity. Having led for so many years with the assistance of signs and wonders, now he simply speaks words, hoping to refresh their recollection and inspire them. He reminds them of their history in order to set the stage for their future. He tells them again what they should and should not do, emphasizing that they will have to make choices, choices that will lead to prosperity or adversity, choices that will enhance life or bring death. This leader, this teacher, this Moshe urges them: “Choose life, that you and your children should live . . . .” (See Deut. 30:19; see also Lev. 18:5.) Not for nothing is the Torah known as Etz Chaim, a tree of life. (See Prov. 3:18; Ezek. 20:11.)

This reverence for life is more than some gauzy good feeling. Judaism at its best is grounded in experience, rooted in reality. Centuries after the biblical authors first put quill to scroll, the rabbis in the Talmudic period considered situations where observance of biblical ordinances on the sanctity of the Sabbath might adversely, perhaps fatally, affect real people – a wall that had collapsed on a child but could be removed, a fire that could be extinguished. (See  Yoma 84b, see also, Yoma 83a.) Referring to an obscure statement in the Holiness Code which seems to prohibit standing by or upon the blood of your neighbor (Lev. 19:16), the rabbis formulated the doctrine of pikuach nefesh (the preservation of human life), the principle that all of the laws, all of the rules, and all of the regulations which are in Torah can be abrogated to save a life. There are three major exceptions, essentially related to idolatry, murder and adultery, but the bias is otherwise comprehensive in favor of saving the life of another: “Whoever saves a life is considered to have saved the entire world.” (See Sanhedrin 37a.) 

And if someone should fall ill, Jewish tradition seeks healing. In the Torah, God was conceived as Rofeh Cholim, the Healer of the sick. (See, e.g., Gen. 20:17, Num. 12:13; see also, 2 Kings 20:1-5, Jer. 17:14.) Not surprisingly, the traditional prayer service contains a prayer for the sick, the Mi-Shebeirach. Even for those who cannot accept the notion of an intervening Divine Doctor, the expression of concern, of desire, of hope for a r’fua shleima, literally a complete cure, resonates with great power.

The biblical authors also knew that it was not enough just to revere life or treat illness. Prevention of harm was seen as crucial. So the Torah warns us not to place a stumbling block in the path of the blind (Lev. 19:14), and we understand that we are responsible for the welfare of others – especially those whose circumstances or condition place their health or safety at risk.

And what does all of this have to do with nuts, the delicious treat that can lower bad cholesterol and provide heart healthy nutrients?  The short, if not simple, answer is that for many people, and an increasing number of them, nuts can be deadly. They can, for instance, as Tablet columnist Marjorie Ingall has written, turn charoset into the Mortar of Doom. 

Researchers estimate that 15,000,000 Americans have food allergies. These allergies affect 1 in 13 children under the age of 18 (about two children in the average classroom).  And the problem is getting worse. As the National Center for Health Statistics has reported, food allergies in general are increasing rapidly among children. Moreover, children in large urban centers have significantly greater incidences of food allergies than do children in rural communities. Summarizing the statistics, ScienceDaily reports that almost ten percent of urban children have food allergies.

Ninety percent of allergic reactions to food are caused by eight particular allergens. Two of the primary triggers are peanuts and tree nuts. Rates of peanut allergies specifically have tripled between 1997 and 2008. Today almost three percent of children in urban areas are allergic to peanuts.

Distinguishable from food intolerance, a food allergy involves the immune system. When an allergic person eats an offending food, that person’s immune system perceives the food as a foreign invader and attacks it, releasing a number of chemicals in the process. Dr. Sarah Boudreau-Romano concisely explains the science behind the storm of these adverse reactions in her blog “The Allergist Mom.”

Symptoms may be relatively moderate such as a tingling sensation in the mouth, hives or cramps, but also may include swollen lips, difficulty in breathing or swallowing, reduced blood pressure, and loss of consciousness. When a person’s blood pressure drops to a dangerously low level, anaphylactic shock occurs. Even a very small amount of allergen can result in life-threatening anaphylaxis.

Injection of epinephrine (adrenaline) is both the first line of defense and the only available treatment for anaphylaxis, but its use is not really a cure. Rather, if administered quickly enough, it merely buys a few minutes of time to get to a hospital emergency room for further treatment. To really avoid allergic reactions, a person with a food allergy must avoid the allergy causing food.

So, as important as it is to be able to recognize and treat an allergic reaction, prevention, in the form of avoidance, is truly the best medicine. The good news is that congregations, temples, synagogues and shuls, as well as Jewish federations, centers and other organizations, can respond to the growth of food allergies by adhering to the principle of pikuach nefesh.

One such policy is to become a nut-free facility, that is, prohibit any food containing peanuts or other nuts from being brought into or being cooked or served in the facility. This approach is especially helpful in protecting young children who cannot read food labels or otherwise guard against their own allergic mishap. Allergies aside, some organizations already ban any food that is not prepared in their own kitchens or under certain religious supervision. Groups that do allow food to be brought in, E.G., for pot-luck meals,  need to recognize that for some people with food allergies luck is not a good policy.

A number of congregations across the country already strive to be nut aware and nut free, for example, Woodlands Community Temple in White Plains, New York (Reform) and Congregation Beth Shalom in Seattle, Washington (Conservative). Here is a protocol based on what some groups are doing now to implement the principle of pikuach nefesh.

  1.  Pikuach nefesh, the saving of life, is a core Jewish value. We, as a community, take this value seriously and are committed to making our home a safe environment for our members and guests.
  2. We recognize the danger that certain foods may pose to those who would pray, study or just gather together with us. So we seek to remove the stumbling blocks.
  3. PEANUTS AND TREE NUTS AND FOODS CONTAINING OR DERIVED FROM NUTS (including peanut paste, peanut butter, Nutella, Bamba, cooking oil containing peanut oil, as well as nut granola bars, Reese’s candies, food processed on equipment or plants that process nuts ) ARE NOT ALLOWED ANYWHERE IN OUR FACILITY.
  4. This policy applies to all meals, Ongei Shabbat, snacks, in-school events or parties in our facility and on field trips and congregational outings.
  5. Congregants are and will be advised to read labels on all foods in order to identify peanut and tree nut ingredients “hidden” in foods to avoid bringing or sending prohibited foods to our building.
  6. Notices of pot-luck and other similar events will include a reminder that no peanuts or tree nuts or any food containing peanuts or tree nuts are allowed to be brought to the building.
  7. Caterers may not serve peanuts or tree nuts or foods containing or derived from them in the building.
  8. The School Board and Principal will develop procedures for implementing this policy in the religious school. As an additional precaution, teachers will be trained in preventing and recognizing allergic reactions and in the use of injectable epinephrine.
  9. This Peanut and Tree Nut Policy will be communicated to the congregation each year, and the policy will be posted on the community website.

 

Yes, yes, some will feel that such a policy inconveniences them. But L’Chaim is not just a toast with a click of the glass. It is a core value and a promise. And, so, Jewish tradition has not recognized an inconvenience exception to the principle of pikuach nefesh at any time or in any place. Rather, across time and space, Jews have consistently opted to protect those in need and preserve life.  So, too, now. All together:   L’CHAIM! TO LIFE!


     Note: This post appeared previously at www.judaismandscience.com.

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