Matters of Life and Death: A Jewish Approach to Modern Medical Ethics By Elliott N. Dorff (review)

Matters ofLife and Death: Afewish Approach to Modern MedicalEthics. By Elliott N. Dorff. Philadelphia: The Jewish Publication Society, 1998. Pp. 456. $51.00. "I seek to articulate nothing less than what I take to be the import ofJudaism for critical decisions in our lives." With these words bioethicist and rabbi Elliott Dorff begins a tradition-based discussion on a wide range of topics. Each subject is related to what Dr. Dorff identifies as seven fundamental beliefs in Judaism that provide a "coherent worldview" for Jews to guide ethical health behaviors. They are: 1) the body belongs to God; 2) human worth stems from being created in God's image; 3) the human being is an integrated whole; 4) the body is morally neutral and potentially good; 5) Jews have a mandate and a duty to heal; 6) the community must balance its medical and non-medical needs and services and 7) Jews must sanctify God's name. In keeping with the Jewish tradition Dr. Dorff links person and society to such concerns of lifestyle as lesbian families and cosmetic surgery and the more familiar life-generating and death-delaying issues detailing the legal and moral concerns arising from insemination with donated genetic materials and prevention of pregnancy as well as the legal and ethical behaviors from the moment a potential for dying exists to the treatment and disposition of the body and its parts after death. Some readers will be surprised that Dr. Dorff strongly supports organ donation and hospice and may be even more surprised to learn that these are the normative positions of ConservativeJudaism, evolved from rabbinic discussion and interpretation and approved by its Committee on Jewish Law and Standards. Dr. Dorff, who is vice-chair of the Committee, is careful to point out which of his interpretations have been approved by the committee and which have not. His position on homosexuality is that of a minority, yet its compassion, articulateness and adherence to the law and the tradition for interpretation make it the most compelling religious argument for acceptance of homosexuality and the legal union of homosexuals that I have ever seen within Judaism. Dorff reminds us that the Torah does not directly address the issue of female homosexuality and, of course, the command to procreate is addressed to the male and not the female. Arguing thatJewish interpretations of the Torah and Talmud are based on assumptions about homosexuality that we now know to be false, he writes compassionately for the inclusion of male and female homosexuals in every aspect of Jewish life through reinterpretation of the law based on basic beliefs about the nature of God: I, for one, cannot believe that the God who created us all produced a certain percentage of us to have sexual drives that cannot be legally expressed under any circumstances. That is simply mind-boggling and, frankly, un-Jewish.Jewish sources see human beings as having conflicting urges that can be controlled and directed by obedience to the wise laws of the Torah; it is Christian to see human beings as endowed with urges that should ideally be forever suppressed. To hold that God created homosexuals to be sexually frustrated all their lives makes of God a cruel playwright and director in this drama we call life, and our tradition knew better. It called God not only merciful but good. God's law, then, must surely be interpreted to take those root beliefs of our tradition into account. Jewish theology and law are not two disparate realms; here, as always, they must be interpreted to reflect each other. There are many interesting sources quoted throughout that help illustrate the Perspectives in Biology and Medicine, 43, 1 ¦ Autumn 1999 147 basic principles of rabbinic interpretation. I knew that Jews may not injure or kill themselves except when faced wiür the alternatives of idolatry, murder or adultery/ incest, but I did not think through the extension of that reasoning to the popular conundrums that typically begin "Two men in the desert have water for only one to survive". In this circumstance (and any others like it), when the knowledge of the problem is first known, the person who has possession of...