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RABBI LORD IMMANUEL JAKOBOVITS SPEAKS AT CONFERENCE ON MEDICAL ETHICS

By: Phyllis Woloshin/Lerman

Lord Immanuel Jakobovits spoke to a group of more than 400 health care providers at an international conference on Jewish Medical Ethics in San Francisco. The conference was the 7th Institute for Jewish Medical Ethics of the Hebrew Academy of San Francisco sponsored jointly by the Stanford University School of Medicine. Dr. Jakobovits is the author of a seminal work in English, Jewish Medical Ethics, which although published in 1959, is still widely used as a reference in the field.

Dr. Jakobovits' life work has involved issues concerning the interface between Jewish Law and modern medical problems. While new technologies force us to rethink ideas concerning nature and natural law, the major thrust of Jewish Law has always been, and always will be the concern for human life. Thus, questions concerning the manipulation of genetic material are addressed by Jewish Medical Ethics. For example, a new procedure called "spinning" is a process by which human sperm are separated by centrifugal force. This separation allows the scientist to identify which genes are string and which sex the sperm carries. This identification may be useful in determining the possibility of Tey Sachs in the resulting offspring. It also allows us hope in determining whether or not the genetic material carries sex-determined problems such as hemophilia. Rabbi Jakobovits was clear that these breakthroughs concerning the mysteries of life are given to us in order to do good and for the betterment of human life. He is quick to add that the skills we gain through the advancements in scientific manipulation should not be used for frivolous or vain reasons. If the sex-linked characteristics involves a choice of a child who will not be bald, for example, this would be an unacceptable use of genetic therapy. The same would be true regarding the choice of a preferred sex for the child as well as for eye color, etc. Procedures of this kind are acceptable only when the therapy improves an abnormal condition.

When asked about why he thought so many physicians and allied health professionals come to a conference on religious medical ethics, Rabbi Jakobovits responded that there is a need today for science to be tempered with moral considerations. When the daily lives of professionals push them to make the kinds of decisions that both technology and economics force them to make, they have a need to be grounded in a carefully thought out tradition. Knowing that one struggles with new issues that can also be morally defined helps the physicians work through them. Various literatures, forums and responsa help frame questions about developments that just a few months ago were unthinkable. No court in the land today has awarded full custody of a child to its surrogate parent. Surrogacy also raises questions about paternity, inheritance, and incest. Knowing that there are ways to frame questions about new technologies helps the professional feel less isolated, less solitary. It offers the guidance of a rich legacy.

Judaism offers careful deliberation about psychological as well as physical well being. Judaism also concerns itself with the care and well being of the body. "We concern ourselves with washing and caring for the body, with food and its preparation, with rest, with those things that enhance life and health." Dr. Jakobovits believes that is why each case must be resolved individually.

Removing life support and hydration from a patient who is running out of insurance is strictly un-Jewish. Discussion at the conference included the recent Oregon initiative to limit the amount of medical intervention and therapy based on the type of illness and age of the recipient. Oregon's initiative is a purely economic reaction to the extended lives people enjoy in this country. Extended life expectancy brings us face to face with degenerative illnesses people didn't live long enough to contract in the past. There was some suggestion that California is also on its way to passing similar legislation concerning limitation of medial care. Requesting removal of life support is also un-Jewish. Managed Health Care plans and HMO's cause physicians much stress. Capitation, that is counting how many patients per hour and their fees move physicians to serve their patients less thoroughly. One 90 year old doctor from san Francisco who still practices said she practiced better medicine in the days she charged three dollars for a house call and two dollars for an office visit. Saving a life is a paramount consideration for the Jewish practitioner. "Preserving the life of a human being should never be an issue of economics," said Jakobovits. "We have to preserve our humanity."

Rabbi Jakobovits was just what the doctor ordered. He spoke on three occasions at the three day conference. After each address, the ballroom packed with physicians, nurses, geneticists, biologists, researchers and other health care professionals rose to their feet to applaud him. The rabbi is now retired from his position as chief rabbi of the British Commonwealth but continues his work of relating Judaism and Medical Ethics. Usually, he ends on a note of humor. He ends this interview with the following:

Three patients were told by their respective doctors that each had only two months to live. When asked what he would do in his remaining two months, the first man, who was a miser said, "All the money I have saved I will now spend and enjoy". The second one was a philanderer. When he was asked what he would do with his remaining time, he said, "Until now there were certain lecheries and indulgences, things I couldn't permit myself. Now that I have only two months left I can let myself go and enjoy them." The third patient was a Jew. When he was asked, "What will you do with your two months?", the man responded, "I will look for another Doctor and get a second opinion!"

"Jews have never accepted a single opinion," explains the Rabbi. "When someone tells Jews there is a final solution we do not accept it. When the Romans thought they destroyed us, we said we will survive long after you. The Nazis also attempted to destroy us with their final solution. Well, the Romans don't exist anymore, and the Third Reich doesn't exist anymore and we still persist and exist as a people. In order to maintain that strength as a people, the message is not to accept finality. The Jewish People have a heritage supporting their existence. And so there is more than a joke in this story - survival depends on connection with a rich tradition which is there for those who wish to find it."

This particular conference on medical ethics is in its 7th year. Lord Jakobovits has spoken at every one.

Bio of Author
Dr. Phyllis Woloshin/ Lerman is Professor of Philosophy at Oakton Community College in DesPlaines, Illinois since 1972. Dr. Woloshin/Lerman received her B.A. in philosophy at the University of Illinois, her M.A. from Roosevelt University, and her Ed.D. from Nova University in Medical Ethics. She was a post doctoral fellow at UCLA. She interviewed Dr. Jakobovits at the Institute for Jewish Medical Ethics of the Hebrew Academy of San Francisco in February, 1996