Introduction to Jewish and Catholic Bioethics: A Comparative Analysis (review)

What first struck me about this book was its title: It claims to be both an introduction to Jewish and Catholic bioethics and a comparative analysis of both. Because an introduction is usually aimed at beginners in a field and a comparative analysis—especially of book length—is generally intended for more advanced readers, I frankly did not know what to expect.

And yet Aaron Mackler has indeed accomplished both purposes. In a style that is eminently clear, with little if any jargon and plenty of examples, he manages to introduce readers not only to the substance of Jewish and Catholic bioethics on a number of topics —euthanasia, assisted suicide, treatment near the end of life, abortion, in vitro fertilization, access to health care, and rationing—but also to the even harder thing to explain, namely, the methods each tradition uses in order to make medical decisions. I came to this book after considerable reading in bioethics and in Jewish and Catholic writings, and so I may not be a good barometer for real beginners in this field; but I have taught introductory as well as advanced courses in all these fields for more than three decades, and so I do still have a feel for what works as an introductory text and what does not. This one certainly does: it is clear, interesting, respectful, and accurate in its depiction of both traditions.

At the same time, this book is well worth reading by scholars in the field. That is because his "comparative analysis" is both rich and penetrating. Mackler brings multiple sources from each tradition to justify his comparisons. One of the great strengths of this book, in fact, is that he does not content himself with only one spokesperson for each tradition—even it that happens to be the current Pope. He rather demonstrates that sources from each tradition's past can be read and have been read to produce a range of positions on many of these issues. He then characterizes those ranges comparatively, showing that while some Jewish opinions on end-of-life issues are more restrictive than any Catholic position, Catholics often tend to be more restrictive than Jews on beginning-of-life issues.

He explains this difference both methodologically and historically. Methodologically, Jews tend to treat these issues in largely legal terms, basing themselves on Jewish legal sources from the Torah to our own day. Texts in Exodus 21 and the Mishnah provide ample basis for seeing the fetus not as an independent being but rather as part of its mother. As a result, when the life or even the health of the mother is threatened by the fetus beyond the risks of normal pregnancy, Jewish law clearly prefers to save the life of the mother, who is a full-fledged human being by all accounts, in contrast to the fetus, who legally becomes a human being only at birth. Once born, however, Jewish sources see a person as fully human until death is clearly established by cessation of breath (and, for some, by cessation of heartbeat as well), and the classical Jewish aggressiveness with regard to health care has led many Jewish authorities to be reluctant to let go.

In contrast, the Catholic tradition puts greater emphasis on theological doctrines. "A good death," a phrase that ironically appears in the Talmud as well, plays a much greater role in Catholic thought about withholding or withdrawing life-support systems, making most Catholic spokespersons fairly liberal about letting nature take its course without aggressive human interventions to try to stave off death (although for most this does not extend to giving assistance in suicide). At the beginning of life, though, Catholics are much stricter than Jews about maintaining even a pre-embryo in a petri dish, for most (but not all) Catholic sources see that as a full-fledged human being and one that cannot attain salvation unless baptized. That leads...