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Although modern science and medicine raise many questions unknown to the authors of the classical Jewish sources, many of the issues are not entirely new, and some are particularly ancient. (In a sense, the Bible teaches us that God performed the first medical operation in history when He took Adam's rib to form Eve.) While recent advancements in reproductive technology have opened gates unknown to previous generations, reproductive issues have always been of basic concern for a people that highly valued its biological and spiritual continuity. The Book of Genesis is full of issues of fertility: the first biblical command is to "be fruitful and multiply," and the anguish felt by the barren matriarchs, Sarah, Rebecca, and Rachel, is a central feature of biblical narrative. Some of the matriarchs even used their maidservants in a form of surrogate motherhood. The Rabbis of the Talmud, and their medieval and modern successors, were well versed in the issues of conception and contraception, miscarriage and birth, at least in terms of the medicine of their day.
The Bible and Jewish tradition are also concerned with questions raised by the end of life, a period for which the Psalmist pleads: "May we not be abandoned as our strength diminishes." Other biblical passages contain graphic descriptions of the aging process and old age, another issue in modern bio-ethics. Noteworthy is the Jewish tradition's concern for human life and well-being. This concern is paramount, such that saving human life takes precedence over almost all of Judaism's commandments (the exceptions are the prohibitions of idolatry; murder; and adultery and incest), and, in the case of a mortal threat, medical treatment is obligatory and mandated by law.
It should not, therefore, surprise us that medical issues represent a major concern in the Jewish tradition. Yet, we moderns like to think we are different than the ancients; that the human race has changed over time. Nonetheless, I would maintain that new technology solely gives new twists to old problems. There are new ways of becoming pregnant; neonatal medicine helps fetuses survive after shorter gestations; the abortion pill can help terminate a pregnancy without surgery; soon there may be human clones; life can be extended almost indefinitely on life-support systems. Yet, now as in the past, there is no such thing as being a little bit pregnant; now, as in the past, there is no escaping death. The issues of conception and abortion, birth and death, have not become any easier just because we think we are smarter or more advanced than our predecessors.
Even though new discoveries and procedures are not mentioned in the traditional literature, there are usually enough sources to inform Jewish treatments of the issues raised. In many cases, however, there is, as of yet, no unanimous opinion as to what the Jewish response to them should be. Partially, this is because the issues are not easy. A moral dilemma is when one has to choose between two competing values; when an issue is easy, it is not a moral dilemma anymore. How does one choose between two goods? There is a new field of philosophy called bio-ethics or medical ethics where thinkers try to work out the most ethical answers to the new dilemmas posed by modern medicine. They develop their own moral theories or rely on new scientific understandings. Rabbis, however, work within the framework of an ancient tradition and they look to the Jewish sources, both the legal and the extra legal sources, to solve the new problems. This lecture, therefore, will deal with the following question: How are moral and legal decisions made in Judaism? After establishing the theoretical framework of decision-making, a few concrete examples will be provided.
Ben-Gurion University of the Negev, Israel