Daniel Sperling

Commanding the “Be Fruitful and Multiply” Directive: Reproductive Ethics, Law, and Policy in Israel

The article provides an up-to-date overview of reproductive ethics, law and policy in Israel and discusses cultural and social factors explaining the fact that Israel has one of the highest fertility and birth rates in the World, especially within the developed countries. The article concludes with three observations on the future of reproductive law and policy in Israel.

Maternal Brain-Death

Medical technology and scientific knowledge enables health-care providers to maintain a brain-dead pregnant woman on life-support for the successful delivery of her fetus. However, the legality of such practice as well as its ethical implications remain unclear. The article examines the various aspects of this postmortem procedure. First, the permissibility of such an action is analyzed through discussion of other legal situations dealing with some similar aspects, namely abortion-law and Human tissue gift law. Following this, the major issues arising in this dilemma are being discussed. These issues include the moral and legal status of the fetus, on the one hand and of the dead, on the other hand; interest to life; pragmatical obstacles derived from the proposed procedure, the legal requirement of consent, physician-patient relationship and the status of next-of-kin in such situation. The article concludes with some practical guidelines for health-care providers, lawyers and other interested people at large.

From Iran to Latin America: Must Prenatal Diagnosis Necessarily Be Provided with Abortion for Congenital Abnormalities?

The article examines the question of whether it is ethical to introduce and provide prenatal diagnosis and antenatal screening in areas where termination of pregnancy for congenital abnormalities is legally prohibited. The article explores the various reasons according to which people seek prenatal genetic information and the factors affecting their decision to continue pregnancy despite congenital abnormalities. It concludes that with a proper emotional support and cultural sensitivity it is ethically justifiable to introduce prenatal diagnostic tests and screening, and that taken as a whole, the benefits of such an introduction outweigh the general harm already associated with restrictive abortion laws.

Management of post-mortem pregnancy : legal and philosophical aspects

Abortion law Bodily interventions during pregnancy Pregnancy clauses in advance directive legislation Human tissue gift law Maternal brain-death: the main issues Relational feminism analysis Ethical duties of the pregnant mother Conclusions and suggestions Bibliography Index.

Needs, expectations and public knowledge concerning services outside the medical basket: A lesson from Israel

Quality of and access to medical care are strongly related to the medical basket, the set of services covered under the national health insurance system. Various health systems offer institutional solutions to cover services that are not included in the basket in rare cases. In Israel, patients whose medical needs are not covered under the medical basket may apply to committees for exceptional cases which are run by all health funds. The article presents the findings of a cross-sectional telephone survey which was conducted to explore the publics familiarity with the committees for exceptional cases and their workings, eligibility, and reporting of treatment required outside the basket. Almost 25% of respondents reported that during the past ten years they or their close relatives needed medical care, physical examination, or drugs that were not included in the medical basket. The survey demonstrates the publics unfamiliarity with the committees and uncertainty as to entitlement of services which are out of the basket, as well as a tendency to prefer self payment and private insurance. Familiarity with committees is strongly related to education, race (nationality) and socio-economic status. The treating physician is the major source of information on the committee. In case of a need, preference is given to private purchase of drugs/services.

The right to know one's genetic origin: are gamete donations and misattributed paternity cases alike?

accidental pregnancy or rape, thereby reducing the control women have over circumstances that may place them and their children in harm’s way if it is disclosed. This lack of voluntariness in misattributed paternity cases is a morally relevant difference that might provides reason to treat disclosure differently in misattributed paternity cases than in gamete donation and adoption. Though misattributed paternity and gamete donation are more similar than they may initially appear (with respect to disclosure), there are significant moral differences that must be considered before concluding that if disclosure is appropriate in one, it is also appropriate in the other. REFERENCES

Israel's new brain-respiratory death act: one step forward or two steps backward?

Although the legalization of the concept of brain death in Israel may be similar to that in other developed countries, much doubt surrounds its wisdom and practical effect. The new Israeli act raises theoretical and practical concerns, which were not fully anticipated by lawmakers. The article describes the new law and elaborates on key issues deriving from the regulation of brain death. Its main argument is that the new legislation of brain-respiratory death suffers from some major problems that need to be addressed so that it will have some meaningful, let alone less detrimental bearing on the acceptance of brain death in Israel and the practice of its determination.

'Male and Female He Created Them': Procreative liberty, its conceptual deficiencies and the legal right to access fertility care of males

In recent years, assisted reproductive technologies have played an important role in shaping the lives of many individuals throughout the world. Their promise to make people become parents is believed to fulfill the most elementary interests a person may have. It is argued and legally acknowledged that such interests constitute with much significance a person’s self-identity and sense of belonging to the living society, also constituting her reproductive liberty or the right to procreate. Despite their significance and importance, access to these technologies and to fertility care specifically may not always accord with the principle of equality and justice. It will be argued that, in some cases, such unequal access reflects various forms of discrimination between different groups in society. It is the purpose of this article to show that such a phenomenon is the result of an underdeveloped and unregulated area of law, characterising many Western countries. Specifically, it demonstrates conceptual deficiencies in so-called ‘procreative liberty’ with regard to the content and scope of the right to procreate, the values underlying such a right, and the legal and social institutions supporting and securing it. The article highlights these deficiencies, making them more evident when the notion of ‘reproductive liberty’ applies to positive and modern attempts to become parents, especially but not exclusively those brought by men.

Socializing the public: invoking Hannah Arendt’s critique of modernity to evaluate reproductive technologies

The article examines the writings of one of the most influential political philosophers, Hannah Arendt, and specifically focuses on her views regarding the distinction between the private and the public and the transformation of the public to the social by modernity. Arendt’s theory of human activity and critique of modernity are explored to critically evaluate the social contributions and implications of reproductive technologies especially where the use of such technologies is most dominant within Western societies. Focusing on empirical studies on new reproductive technologies in Israel, it is argued, powerfully demonstrates Arendt’s theory, and broadens the perspectives through which society should evaluate these new technologies towards a more reflective understanding of its current laws and policies and their affect on women more generally.