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The use of Halakhic material in discussions of medical ethics.

In this paper questions are raised about the use of Halakhic material in discussions of medical ethics. Three ways in which one might use Halakhic material in such discussions are distinguished: (a) as a source for ideas about medical ethics which can be defended independently of their origin; (b) as a basis for mandating certain forms of behavior for members of the Jewish faith; (c) as the basis for claims about the Jewish view on disputed topics in medical ethics. The first two raise no methodological problems. The third use raises a number of theoretical and practical issues, with which the paper is concerned. The problems stem from the fact that Halakhah distinguishes between obligations, the fulfillment of which is required of the Jewish people, and obligations, the fulfillment of which is required of all people. With rare exceptions, the obligations imposed upon the Jewish people are more stringent. The pitfall lurking in the third of the three uses is that authors using Halakhic material may incorrectly conclude that obligations that are supposed to fall only upon the Jewish people fall upon all people. An analysis of this problem follows, along with a plea for a responsible use of Halakhic material in the third way, so as to avoid certain real pitfalls.

Ethical Relativism

Chorionic villi sampling for early prenatal diagnosis: an option for the Jewish orthodox community.

The Jewish religion permits abortion up to 40 days after conception. To accommodate the Jewish orthodox community, prenatal diagnosis in the eighth gestational week may be a feasible goal with clear benefits. We present our experience with chorionic villus sampling (CVS), wherein out of 144 patients requesting CVS, 125 were found to be suitable for the procedure. Excluding patients with fundal placenta and cervical or uterine myoma, chorionic sampling was successfully performed on 102 out of 106 patients (96.2%) and a chromosome result was available for 98 of those patients (96%). Fetal losses, within 14 days following procedure, were 2 out of 125 (1.6%). No complications were encountered following the procedure. The cytogenetic analysis was improved by culturing CVS fragments for 48 h, after which clearer banding patterns could be observed. One of the CVS preparations, from a 7.2/7-week-old embryo was successfully examined. Short-term (6 days) cultures were used as an additional method for chromosome analysis, to extend and confirm results obtained by the direct method.

Abortion, Spontaneous

Euthanasia.

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Christianity

Medical ethics--a Christian view.

All ethics has a religious dimension. This paper considers how specific Christian insights concerning death, suffering, human nature and human creatureliness can help to expose more fully the moral issues at stake in some of the dilemmas faced by doctors. It ends by acknowledging the crushing burden of decision-making which rests on many in the medical profession, and indicates the importance of religious resources in dealing with this.

Bioethical Issues