LAUSR

Introduction Peter Berger, a sociologist of religion, once stated that “the theme of individual autonomy is perhaps the most important theme in the worldview of modernity”. Although modern bioethics was relatively late in accepting the value of personal autonomy in medical decision making, this autonomy is now universally recognised as the core value of western medical ethics. Principilism, as proposed by Beauchamp and Childress, lists autonomy along with beneficence, non-maleficence, and justice as the four cardinal principles of bioethics. A large number of western medical organisations have ratified the Charter on Medical Professionalism, which states as one of its cardinal principles that “physicians must be honest with their patients and empower them to make informed decisions about their treatment”. However, some theologians would challenge a bioethics framework that is based on personal autonomy and human rights. Writing from a Jewish perspective, the legal scholar Robert Cover explains: “Every legal culture has its fundamental words. [...] The word ‘rights’ is a highly evocative one for those of us who have grown up in the post-enlightenment secular society of the West. [...] Judaism is, itself, a legal culture of great antiquity. [...] When I am asked to reflect upon Judaism and human rights, therefore, the first thought that comes to mind is that the categories are wrong. I do not mean, of course, that basic ideas of human dignity and worth are not powerfully expressed in the Jewish legal and literary traditions. Rather, I mean that because it is a legal tradition, Judaism has its own categories for expressing through law the worth and dignity of each human being. [...] The principal word in Jewish law, which occupies a place equivalent in evocative force to the American legal system’s ‘rights’, is the word ‘mitzvah’ which literally means commandment but has a general meaning closer to ‘incumbent obligation’.” This duty-based ethic, which differs fundamentally from an ethic that is based on human rights, has obvious implications for bioethics and is highly relevant to controversial issues such as abortion and euthanasia. An ethical framework that is based on human rights and unlimited personal autonomy naturally values highly full disclosure to all patients, a practice that is scrupulously avoided in many traditional societies. Many religious traditions also maintain a healthy scepticism towards the limits of scientific progress and are hesitant about human beings interfering with what they view as God’s exclusive purview. Israel, in its short history, has experienced all of these conflicts. In this Essay, we explore how a multicultural, modern society steeped in monotheistic tradition has navigated through most of these conflicts to create a mostly satisfactory and pragmatic consensus on contemporary bioethical dilemmas. In reaching this consensus, Israeli bioethics had to accommodate both Jewish and Muslim traditions as well as the secular perspective on human rights and dignity.