In this chapter, I consider the idea that physician-assisted death might come into question in the cases of psychiatric patients who are incapable of making autonomous choices about ending their lives. I maintain that the main arguments for physician-assisted death found in recent medical ethical literature support physician-assisted death in some of those cases. After assessing several possible criticisms of what I have argued, I conclude that the idea that physicianassisted death can be acceptable in some cases of psychiatric patients (...) who lack autonomy ought to be taken into account in assessing the moral and legal acceptability of physician-assisted death. (shrink)

End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping. Our paper confronts the bioethical expert discourse with public moral attitudes. The paper is based on (...) a qualitative study comprising 12 focus group discussions with religious and secular persons in the USA, Germany, and Israel. Considering the respective socio-political and legal frameworks, the thematic analysis focuses on moral attitudes towards end-of-life decision making and explores the complex interplay between individual preferences, culture, and religion. Our findings draw attention to the variety and complexity of cultural and religious aspects of end-of-life decision making. Although there is local consensus that goes beyond radical individualism, positions are not neatly matched with national cultures or religious denominations. Instead, the relevance of the specific situatedness of religious beliefs and cultural communities becomes visible: Their status and role in individual situations, for example, as consensual or conflicting on the level of personal perspectives, family relationships, or broader social contexts, e.g., as a majority or minority culture within a political system. As the group discussions indicate, there are no clear-cut positions anchored in “nationality,” “culture,” or “religion.” Instead, attitudes are personally decided on as part of a negotiated context representing the political, social and existential situatedness of the individual. Therefore, more complex theoretical and practical approaches to cultural diversity have to be developed. (shrink)

This essay explores what Jewish ethics has to say about globalization in relation to the AIDS crisis. Special attention is paid to the consequences in affirming current intellectual trends to transcend traditional limits in both society and thought for rethinking traditional Jewish values. The discussion proceeds from two presuppositions. The first is that there is an intimate connection between ethics, science, and politics. The second is that the history of Jewish ethics involves three distinct forms that are generally correlated but (...) rarely identical in content and moral judgment. These three forms are law, wisdom or virtue, and covenant. The discussion considers related issues of accidental connections in time between the bubonic plague and Zionism and between AIDS and homosexuality in relation to moral–theological issues related to divine providence and distributive justice. (shrink)

Research and writing at the intersection of faith and medicine by now include thousands of published studies, review articles, books, chapters, and essays. Yet this emerging field has been described, from within, as disheveled on account of imprecision and lack of careful attention to conceptual and theoretical concerns. An important source of confusion is the fact that scholarship in this field constitutes two distinct literatures, or rather meta-literatures, which can be termed faith as a problematic for medicine and medicine as (...) a problematic for faith. These categories represent distinct theoretical lenses for viewing the intersection of faith and medicine. Observations about these two approaches are offered, along with insights about why the discourse on faith and medicine should become better integrated into discussions of religion and science. (shrink)

This essay aims to elucidate how multiple voices and traditions should interact with one another in the practice of ethics. First, it explores some of the major ways in which questions of bodily autonomy function in secular feminist and Jewish bioethical discourses. It then uses case studies to illuminate ways each discourse's concepts of bodily autonomy can be deeply problematic, and argues that the strengths in each discourse can serve as important correctives for the weaknesses in the other. It suggests (...) that some formal features of rabbinic texts can serve as a model for a discourse of constant and animated mutual correction. Finally, it examines two case studies in light of this model. (shrink)

Common arguments from the abortion debate have set the stage for the debate on stem cell research. Unfortunately, those arguments demonstrate flawed reasoning—jumping to unfounded conclusions, using value laden language rather than careful argument, and ignoring morally relevant aspects of the situation. The influence of flawed abortion arguments on the stem cell debate results in failures of moral reasoning and in lack of attention to important morally relevant differences between abortion and human embryonic stem cells. Among those differences are whose (...) interests are at stake and the difference between an embryo in and out of the womb. Stem cell research differs from abortion in morally relevant ways and should be freed from the abortion debate and its flawed reasoning. (shrink)

Japan's Buddhists view bodily enhancement neither negatively in terms of sin nor positively as repairing the world. They prefer prudence, however, due to the fact that human desires will be enflamed by proffered new biotechnologies and ironically increase psychosocial dissatisfaction. In spite of great pressures for bodily enhancements within in East Asian societies, bioethicists issue strong cautions.

In what follows, I draw on things I have found in Japanese discussions of bioethics in order to clarify some aspects of the ethics of biotechnological enhancement. In doing so it will, I hope, become evident that what we might call a “religious” component is in Japan somewhat differently construed than in the contexts with which we are more likely to be familiar in North America. And in the end an attempt will be made here to show that the materials (...) considered give us all – not just the Japanese – reasons for going forward with biological enhancement technologies only on condition that extreme caution be exercised. The fast-moving, oncoming traffic in this domain ought to be forced, these materials suggest, to come up to a caution-demanding signal – not a green light but one that is unambiguously amber. Caution and perhaps even a full stop appear to be in order. (shrink)

The purpose of this essay is to show how, on a wide variety of issues, Rabbi Moshe Feinstein broke new ground with the established Orthodox rabbinic consensus and blazed a new trail in Jewish medical ethics. Rabbi Feinstein took power away from the rabbis and let patients decide their treatment, he opened the door for a Jewish approach to palliative care, he supported the use of new technologies to aid in reproduction, he endorsed altruistic living organ donation and recognized brain (...) death (thus laying the groundwork for Orthodox Jewish acceptance of heart transplantation), he downplayed the value of social worth in triage decisions, and was a fierce defender of the rights of the fetus. I develop broader theological principles from Rabbi Feinstein's ethical positions and compare them to those of his Jewish and Christian contemporaries. (shrink)

: According to Jewish law, there is a clear obligation to try to heal, and this duty devolves upon both the physician and the society. Jewish sources make it clear that health care is not only an individual and familial responsibility, but also a communal one. This social aspect of health care manifests itself in Jewish law in two ways: first, no community is complete until it has the personnel (and, one assumes, the facilities) to provide health care; second, the (...) community must pay for the health care of those who cannot afford it as part of its provision for the poor. The community, in turn, must use its resources wisely, which is the moral basis within the Jewish tradition for some system of managed care. The community must balance its commitment to provide health care with the provision of other services. (shrink)

Prayer has long been a staple in the proverbial Jewish medical toolbox. While the vast majority of relevant prayers seek renewed health and prolonged life, what might prayers for someone to die look like? What ethical dimensions are involved in such liturgical expressions? By examining both prayers for oneself to die and prayers for someone else to die, this essay discerns reasons why it may be good and even necessary to pray for a patient's demise.

This article seeks to examine how religious ideas that are not the focus of a particular halakhic question become the crux of the ruling, thereby molding it and dictating its bias. We will attempt to demonstrate this through a study of Jewish medical ethics, based on some of the rulings of one of the greatest halakhic decisors of the previous generation: Rabbi Eliezer Yehuda Waldenberg (1915–2006). Rabbi Waldenberg molds his rulings on the basis of a religious principle asserting that the (...) legitimacy of any medical procedure is qualified and limited. Rabbi Waldenberg rejects certain accepted medical practices, including plastic surgery, in vitro fertilization, and organ transplants. Even if these procedures are regarded by other halakhic decisors as being legitimate, for Rabbi Waldenberg they are ethically and religiously improper, and therefore they are halakhically forbidden. (shrink)