The Obligation to Heal and Patient Autonomy

Abstract

This chapter argues that the obligation to heal in Jewish law is not an absolute one: in certain cases, it is possible to follow the wishes of a patient who does not wish to receive medical treatment. A significant part of this argument is based upon the influence of biblical theology according to which human healing is not a religious desideratum. This position influences both the legal approach to the binding status of medical therapy, and the halakhah governing the refusal of a terminal patient to receive life-sustaining treatment. The chapter begins with a discussion of the theological validity of the practice of medicine in the Bible, and the subsequent theological developments in this area. This is followed by a section on the influence of this theology upon the halakhah. The remaining sections deal with the nature of the halakhic obligation to heal, coercive life-saving therapy, the situations in which there is no mandate to compel life-saving medical therapy, and the concept of limited autonomy in Jewish biomedical law. The chapter concludes with two comparative sections. The first compares the position under Jewish law with that under the Common law. The second investigates the influence of the halakhah on Israeli law and the attempt by Israeli judges and legislators to combine Judaism and democracy in this area.