Alternatives in Jewish Bioethics (review)

Book Reviews 145 the author has presented a strong case for his thesis that the resources of the Jewish religious tradition, if integrated with the fmdings of contemporary academic scholarship , yield invaluable, practical insights for the solution of numerous agonizing problems confronting the contemporary business world. Walter S. Wurzburger Yeshiva University Alternatives in Jewish Bioethics, by Noam 1. Zohar. Albany: State University ofNew York Press, 1997. 165 pp. $16.95. This book is not an overview ofJewish positions on the stock issues ofbioethics-those covering the beginning and end of life and the distribution of health care. Thus those looking for such a book will not be well served by this one. This book is on a different plane of discussion, and on that plane it makes a real contribution. Aptly named "Alternatives in Jewish Bioethics," this book examines two differing perspectives on bioethical issues that have pervaded the Jewish tradition from at least the Middle Ages and arguably from even earlier periods. These are the views of religious naturalism andreligious humanism. While a number of statements in the Bible and a number of concrete decisions in the Talmud seem to reflect one or the other of these approaches, Zohar uses Nahmanides and Maimonides to present these two views. Religious naturalism holds that because God controls sickness and health, we should bow piously to the divine will. The Torah says many times that God inflicts illness as one of the punishments for sin (e.g., Leviticus 26: 16; Deuteronomy 28:59-61), and, conversely, God is our Healer (e.g., Exodus 15:26; Deuteronomy 32:39). This might lead one to say that illness and healing are God's domain, that it would be hubris for human beings to intervene. The Rabbis of the Talmud (Bava Kamma 85a), though, interpret Exodus 21:19, "and he shall surely cure him" (or "and he shall pay for his idleness and cure") to justify the practice of medicine. While Nahmanides must, in the end, accept that, he interprets this rabbinic ruling as a compromise with human frailty. For him, the perfectly righteous should know no illness; ifthey do get sick, they should not search for natural causes but rather examine their personal behavior, seeking repentance rather than medicine. Indeed Nahmanides understands the Talmud's justification for medical practice to apply to the physician alone: the patient does not have the right to seek medical cure; it is only the physician who, if asked,·has the right to provide it. Religious humanism also affIrms God's role in bringing sickness and recovery, but it puts more emphasis on the legitimacy of human beings to aid God in that process. Doctors function, on this view, as God's agents to bring healing, or, to use another of 146 SHOFAR Winter 1999 Vol. 17, No.2 the Talmud's phrases, as God's partners in the ongoing act of creation. Indeed, Maimonides (quoted on p. 30) deems the view of the religious naturalists as downright foolish. After spelling out these two underlying Jewish approaches to medicine, Zohar applies them to specific issues in contemporary medicine, showing how a number of recent rabbinic rulings depend on one or the other of these two perspectives. The title ofPart I ofthe book, "Authority in Nature," suggests that the topics covered under iteuthanasia , suicide, and assisted reproduction-fall best, in his view, under the Nahmanidean perspective. This impression is reinforced by the fact that Part II, where Zohar discusses triage, autopsies, and the distribution of health care, is entitled "Religious Humanism," and it begins with an amplification of the earlier discussion of religious humanism. This division of the book is misleading, however, because throughout the book Zohar clearly favors the Maimonidean point of view. Indeed, he explicitly admits as much in his discussion ofparenthood (p. 81), one of the topics in Part I. Why, then, did he divide the book this way? In spite ofthis confusing organization, Zohar's specific discussion of the topics he treats is most suggestive. For example, in discussing autopsies, he rightly says that "what is missing [in traditional Jewish legal decisions] is a conceptual scheme geared to the workings of the collective long-term practice...