Medicine, Culture and Ethics, Autonomy.

AND

INSTITUTE FOR CONTINUING

PROFESSIONAL DEVELOPMENT AT

TOURO COLLEGE

NATIONAL JEWISH INSTITUTE

FOR CONTINUING PROFESSIONAL

EDUCATION

AUTONOMY

MEDICINE, CULTURE AND

ETHICS

CASE STUDY

PARAMETERS OF CHOICE

CAN WE CHOOSE TO

REFUSE?

Similarly, it is a positive

commandment to remove any

obstacle that could pose a danger

to life, and to be very careful

regarding these matters, as it

states (Deuteronomy 4:9) ‘Be

cautious and guard your life.’”

Maimonides (1135-1204), Mishneh

Torah,

Laws of the Murderer and Guarding Life

11:4

SAFEGUARDING ONE’S LIFE

RISKY BEHAVIOR VS. “ACT OF G-D”

FAITH VS. HEALING

DOES PURSUING A

CURE DEFY G-D’S WISHES?

FAITH VS. HEALING

“I am the Lord your healer.” – Exodus 15:26

“See now that it is I!

I am the One, and there is no god like Me.

I cause death and grant life.

I strike and I heal, and no one can rescue from My Hand.” – Deuteronomy 32:39

SEEKING CURE: INTERFERENCE WITH G-D’S PLAN?

FAITH VS. HEALING

And Asa suffered from a foot ailment in the 39th year of his reign until his ailment spread upward; and even in his illness, he did not seek the Lord, but the physicians.”

– Chronicles II, 16:12

SEEKING CURE: INTERFERENCE WITH G-D’S PLAN?

DOES JUDAISM REJECT MEDICAL INTERVENTION?

Should man withdraw from attempts at healing self or others?

OBLIGATION TO SEEK HEALING

“And if men quarrel, and one strikes the other with a stone or with a fist, and the victim does not die but is confined to bed, if he gets up and walks about outside on his staff, the assailant shall be cleared;

He shall only pay for the victim’s idleness and he shall provide for his cure.”

– Exodus 21:18-19

OBLIGATION TO SEEK HEALING

“The school of Rabbi Ishmael taught, ‘He shall provide for his cure’ – from this verse we learn that permission is granted to physicians to heal.”

– Talmud, Bava Kama 85a

He shall only pay for the victim’s idleness and he shall provide for his cure.”

– Exodus 21:18-19

“And we do not say, ‘God has struck, will the physician then go and heal?!’”

– Rashi (1040–1105), ibid.

OBLIGATION TO SEEK HEALING

Obligated

Obligated

Physical assault

Illness not imposed by human

OBLIGATION TO SEEK HEALING

And heal, he shall heal.

– Exodus 21:19

� א ְו ֹּפ�� �ַר� ֹּפ��אְי . ַר�

From the word “and heal,” we understand that there is permission to heal. What is the purpose of the doubling, “he shall heal?”

Without it, one might think that only wounds inflicted by humans may be healed, but that healing illness caused by God could be seen as defying His edict. Therefore the word is repeated, to teach us that it is permitted to heal all illnesses.”

– Tosafot (1200 – 1300), ibid.

SUMMARY

Seeking the care of physicians is

• Morally permissible

• Obligatory

• Even to cure illnesses that have no discernible human cause.