Saturday, April 01, 2006

Searching For A Progessive BioEthics Agenda: A Jewish Perspective

[A guest post from Rabbi Richard F. Address, D. Min, Director of the Department of Jewish Family Concerns, Union for Reform Judaism] Reflections from a talk at the NYU Conference on Medicine and Morality, March 10, 2006:

The religious approach to issues involved with medical ethics begins by asking, in many ways, a different set of questions. The religious quest asks the "why" questions, not the "how" questions. These questions of "why was I born?", "why must I die?" and "why am I here?" form the basis of religion. They stem from an understanding of Genesis chapter 3 and give rise to what we call a "theology of relationships". This key idea understands that the most powerful aspect of our existence are the relationships we develop; and that we all seek to be in relationship with people, communities etc, as we seek to counter the ultimate alone-ness of death.
An look at the wealth of Jewish texts that speak to issues of medicine yield several facts. One is that Judaism is a holistic medical system. It understands the important linkage between the mind, the body and the soul and important this harmony is to the healing process.
Secondly, a look at the texts suggests a basic "fundamental ethic" which can be expressed as the "dignity and sanctity of human life and the preservation of human life in dignity and sanctity". The application of this ethic to making sacred decisions is impacted by what we call three "wild cards". These "wild cards" impact how people make decisions. These are autonomy, technology and a person's own spirituality. These wild cards impact every person and family and can yield a theory of decision making that has three aspects:
value, context and choice.
What is the value impacting the decisions? What is the context? Judaism is a "case by case" system. It teaches that we are commanded to look at each case on its own merits. Thus, context is key. Also, there are Jewish legal boundaries (especially as life ebbs) that allow for changes in how decisions may be made. Again, this stresses the context of each case.
Applying the value to the context and taking into consideration all the aspects of the case will yield an appropriate choice. Judaism knows that sometimes these choices are not between good and bad, rather they may be between bad and worse.
We recognize the tensions between the community and an individual. This is especially present as Judaism's basic truth that body and life are gifts from God and that we do not have absolute control over either. There is a higher value here and this produced much tension in our world (wild card of autonomy). Quality of life , as a result of technology has become a major issue in decision making across the denominational line.
Texts can continue to be a guide for developing a progressive agenda.
On the issue of health care and health acre reform we can see guidance from some basic Jewish texts. Deuteronomy 22.2 commands us to restore that which has been lost to a neighbor. Illness implies lost health and thus one can make an argument (as some have done) that it is incumbent on society to help restore that which has been lost (health).
Likewise, in Leviticus 19 we are commanded not to stand idly by the blood of one's kinsman. From this many commentators interpret the text to remind us that not to seek healing is to "shed blood". Thus, we should favor a social policy that allows access to health acre for all. Not to allows people to suffer and "shed blood" and thus implicates the entire society.
Another concept that comes into play is that of the "ger" (stranger). We are ethically mandated to welcome the stranger into our midst. We are mandated to not allow people to be seen as or treated as the "stranger" or the "other" within society. Thus, to allow people to exist outside the tent of access to basic health care is to further demean their humanity. Such denial contributes to their status as "stranger" and "other". Such a reality allows for the potential of shedding blood. It reinforces the barriers restore lost health and, it ultimately denies the ability for us to model our fundamental basic relationship that we have with God.

1 comment:

Rutledge said...

Women's Bioethics writer,

I wanted to let you know that I accidentally forgot to backup an important file to my old blog "Bioethics & law..." I was screwing around with switching to a FTP server. But the good news is, I managed to send enough emails out to inform those who added to their blogroll. And to keep you all from having broken links...

I started a new blog, similar focus, and I hope to make it'll also include clinical cases that I come across while working at the Kettering Wallace Neuroscience Institute. But I was warned about patient confidentiality, so I'll have to be real careful with that.

here's the link....