Aaron L. Mackler

Judaism, justice, and access to health care.

This paper develops the traditional Jewish understanding of justice (tzedakah) and support for the needy, especially as related to the provision of medical care. After an examination of justice in the Hebrew Bible, the values and institutions of tzedakah in Rabbinic Judaism are explored, with a focus on legal codes and enforceable obligations. A standard of societal responsibility to provide for the basic needs of all, with a special obligation to save lives, emerges. A Jewish view of justice in access to health care is developed on the basis of this general standard, as well as explicit discussion in legal sources. Society is responsible for the securing of access to all health care needed by any individual. Elucidation of this standard of need and corresponding societal obligations, and the significance of the Jewish model for the contemporary United States, are considered.

Spiritual and Religious Concepts of Nature

The Introduction to this volume addressed the difficulties involved in speaking of “religion” in connection with biotechnology. That discussion concluded by noting both the substantive and methodological limitations of this volume with its focus on theological, ethical, and legal discourses largely within the traditions or metatraditions commonly characterized as “world religions.” These limitations should be kept in mind in what follows, which is a selective overview of the religious traditions most discussed throughout the volume along with a treatment of indigenous religions, which are often invoked in debates over biotechnology. This overview has two aims in mind. First, it is meant to provide, in introductory fashion, certain conceptual, historical, and methodological “touchstones” by which to identify and situate these particular religious traditions. This summary is directed toward readers who may desire basic information about religious traditions with which they may be unfamiliar. It also provides a more general background for many of the more nuanced analyses found in particular chapters. Second, while our summary depicts those characteristics that are distinctive within traditions, in the interest of our larger conceptual and policy research agenda, it introduces themes that may suggest areas of common understanding, if not convergence among traditions. The hope is that attention to these themes will stimulate conversations across traditions. While the modes of presentation differ somewhat among the various sections below, each discussion provides some overview of basic features of the tradition itself (including its ethical aspects), treats the meaning of “nature” or “natural” in that tradition, and offers some indications of how the alteration of nature is or might be regarded.

Jewish and Roman Catholic Approaches to Access to Health Care and Rationing

In addressing issues of access to health care and rationing, Jewish and Roman Catholic writers identify similar guiding values and specific concerns. Moral thinkers in each tradition tend to support the guarantee of universal access to at least a basic level of health care for all members of society, based on such values as human dignity, justice, and healing. Catholic writers are more likely to frame their arguments in terms of the common good and to be more accepting of rationing that denies beneficial and needed health care to some persons. Jewish writers are more likely to consider individual responsibility for illness in allocation decisions and to accept differences in the health care that different members of society receive. The article considers the relevance of both shared and complementary perspectives for deliberations in nations such as the United States.

Letters, Notes, & Comments

Comment by Aaron L. Mackler on “‘Through Her I Too Shall Bear a Child’: Birth Surrogates in Jewish Law” by Elie Spitz Reply by Elie Kaplan Spitz Research Note by G. Scott Davis