LEV212 Desta is a 38-year-old new patient for me, asking for help getting pregnant. … The workup and testing I do show Asherman’s syndrome: the front and back walls of the uterus have scarred together… Desta’s risk of death in pregnancy is somewhere between 10 and 50 percent because her heart disease is now severe. .... Desta is very clear that she is willing to die to get a child far enough along in gestation to survive, even if it means that the child will face serious challenges due to prematurity and/or losing his or her mother. I look at my hands. It is not unreasonable to surgically correct her Asherman's. I have the know-how, training, and setting to do it relatively safely. Desta cannot do it for herself. As a member of the medical community, do I have an obligation to restore Desta’s uterus to a relatively normal state? I know I am obligated to return “lost property,” (Deuteronomy 22:2); I see myself as morally obligated to heal people. These are expressions of tikkun olam, the way to be God's partner in the ongoing act of creation. But the sole purpose of the surgery in her mind is to get her pregnant, a much more life-threatening condition for her than it normally is for most women. What would God want me to do? Who am I to judge what is right for her? I believe she clearly understands the risks of pregnancy to herself and her potential child. In general, I like to think of myself as a guide to the complex medical world for my patients. For me, “Love your neighbor as yourself” means respecting an individual's desires, hopes, and dreams, even if they differ from my own. In the end, a patient gets to decide for herself if she wants a treatment or therapy. A patient can choose surgery and chemotherapy or just let the cancer take its course.... If she gets pregnant and dies, I will feel my surgical actions aided and abetted her death. Although it would be with her permission and blessing--even fulfilling her greatest hope--I will know I hastened her death. In medical ethics the rule is nonmaleficence, “first do no harm.” Even though harm is far from guaranteed in this case, the risk is high enough that I believe by refusing to do the surgery I am protecting her life. Judaism clearly mandates the protection of life over nearly all other commandments, based on the Rabbis’ interpretation of Leviticus 18:5. I tell Desta I will not do the surgery. … Rabbi Akiva’s classic scenario with the water and two men in the desert does not fit from whether either one of us stand. I see her life versus a life that does not yet exist and hence cannot be snuffed out. Of course she gets the water. But she can already see her not-yet-conceived son or daughter and, like any mother, will of course give the water to her child. ... Nearly ten years have passed since this encounter.... I stole possibility, hope, and dreams by saying no. Those too are a part of being made in God's image, hence a part of what I am charged with caretaking. I still wonder if I did the right thing. (By Judith Levitan)