Jewish Medical Ethics

Where did the term Jewish come from?

20240214

The practitioner or patient understands the bible, and religion of Jewish tradition. If it is relevant, what requirements and expiations are.

Every person has an equal life, you can sacrifice one to save five.

Give birth to a baby, once the legs Are out, it is a life. Is the child trying to kill his mom’s life?

Preventing the accidents is your obligation, like building a fence around your house.

20240221

4 principles of secular

1. autonomy

• 1914, the first Jewish supreme judge. Every human body has the right to do with their own body.

2. Doing Good

• Jewish principle: having kindness

3. Do no harm
4. Justice

It is important how you coming to this, manage the way you treat different patient.

Past experience:

In the ICU, dealing with a Chinese woman who is going to die. She can't speak English, she doesn't know the diagnosis. Should I find a translator or let her daughter tell her (not telling her the truth)?

Tradition / culture of her family, use the daughtor as translator, she felt this is inappropriate. But the doctor decide to respect the culture.

In ER, sesure, immune compromise, gay, not safe sex. 1990. At that time it was a dead sentence. The doctor at that time was an intern. The patient asked to change doctors, without health insurance, he has the right.

Ask the patient if she can give her more time. The doctor felt a sence of selfish but she also want him better.

One woman has AIDS, African, and she and her husband share the same middle. Asked about her code status, when she needed a breath machine. The patient wants every treatment as long as she is alive.

The doctor decide to wait, build better relationship (trust) for 7 months. Considered she don't have control with her body whil in prison. no autonomy

Woman stroke, based on the doctor's knowledge, the patient's condition is severe. No code status since he thinks every patient should get every treatment. Should we discuss this further (ask other doctors)? 2 doctors hold different opinions.

The patient is out of her charge, he is leaving the hospital soon. His heart stopped, but since the patient has no code. The hospital didn't give him the shot. The doctor is gonna do what is not written.

The doctor will give him a shot, if it is easy and can save a life.

39 Vienem woman, done plastic surgery on her belly she is not satisfied with though she is slim. The doctor insisted on finishing the surgery. The air tube is given to her stomach instead of her lungs. This mistake causes the woman to die. Do an EEG to see if she is brain-dead or not. The patient insists on finishing the surgery even with this condition.

Ended brain dead, the doctor finished the surgury and his license is suspended forever. Since the doctor don't know what to do.

Brother has Don syndrome, the doctor needs to shoot something to check if he has a heart attack. However, the doctor considers her brother doesn't need to do the check since he has Don syndrome. No need to do further investigation. Bias in making decisions.

20240320

Dr. Benor (OBGYN)

A patient will come to a doctor asking what they should do.
4 models of the Physician-Patient Relationship (individualized based on Rabai)

• informative
• interpretive
• deliberative
• paternalistic

principles of secular medical bioethics

• autonomy
• beneficence
• nonmaleficence
• justice

Jewish medical ethics

• value of human life is supreme
  • all laws may be waived to save human life
• the patient is commanded to seek healing and to prevent illness; prohibited from replying to miracles
  the physician is considered...

basics of reproduction

• day1 to day5

once the embro look like human, you are not able to terminate

• case 1:

  • 16 y/o with primary amenorrhea (absence of menses)
  • diagnosed with primary ovarian insufficiency
  • can she use donor eggs to conceive?
    • permissible?
  • does the egg donor need to be Jewish?

• case 2:

  • 16 y/o w/genetic mutation that predisposes her to serious comorbidities (recurrent infections, cancer)
    • she wants to preserve eggs for chemotherapy
    • she wants to select embryos that don't have her mutation
    • heavily infected, miserable. put her at risk of getting cancer, a rare

• case 3:

  • couple with infertility
  • male with azoospermia (absence of sperm)
  • does the sperm donor need to be Jewish?
  • is it ethical to screen on things like IQ level, skin, appearance...
  • the Netflix documentary gave birth to over 100 children

• case 4:

  • 45 y/o with fibroids and heavy menstrual bleeding
    • anemia, fatigue, diminished quality of life
    • failed medical mgmt
    • desires surgical mgmt (hysterectomy)

• case 5:

  • 25 y/o w/excessive bleeding after delivery
    • requires blood transfusion
    • failed conservative mgmt
    • require hysterectomy
    • the patient might be able to respond, but the doctor wants to what's right for the patient
      • sign waivers for emergencies

• case 6:

  • couple with recurrent pregnancy loss
  • fetus is diagnosed with severe anomalies incompatible with life
  • is termination considered acceptable?
  • every case is individualized

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