Was Adam imparted free will from the beginning of Creation?
Just a matter of time-
Jewish Aspects
Amongst the ancient Jews three sects were segregated on the
basis of fundamental theological disagreements: the Essenes were
extreme proponents for an absolute fatalistic theory. Acceptance of
this position precludes the very basic right and need for seeking
medical help; the Sadduceans believed in absolute free will with no
divine providence, thus ascribing every action to mere chance; the
Pharisees accepted a theory that combines human free choice
together with divine providence, which is a form of determinism.
According to this theory, God determines the rules and actions in
the universe and supervises human deeds,
but there exists a definite
and extensive range of human freedom of mind. This approach is
.
5. Wolff RP (1970). In Defense of Anarchism. New-York: Harper & Row, p.14.
6. Dworkin G (1982). Autonomy and informed consent. In: President’s Commission for
the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Making Health Care Decisions, Vol. III, Washington, DC, pp. 63-81.
Free Will vs. Determinism in Bioethics 91
beautifully and concisely summarized by the Sages: “All is foreseen,
but the choice is given.”7
This idea was further elaborated upon by
the Jewish sages in the Talmud,8
and extended in depth by the
Medieval Jewish philosophers and legalists.
The vast majority of
them expressed their profound belief in the free will of man,
considering this to be an essential prerequisite for moral conduct
according to Judaism.
Maimonides, for instance, stated that every
person can choose to be good or evil, with no divine predeterminism. If it were not so, he stated, the entire Torah would be
purposeless, with no justification to punish the wicked or reward
the righteous.
However, Maimonides and other Jewish scholars,
realized the inherent religious conflict between human freedom
and God’s knowledge and providence.
Various ways to reconcile
between these ideas were proposed, and several attempts were
undertaken to assess the quantitative input of each of them into a
given action or behavior. These deliberations, however, are beyond
the scope of this article [for further details see reference 9,9 pp.71-
73].
The Jewish point of view can be summarized in the following
way: free will need not be interpreted as absolute libertarianism,
whereas determinism need not be comprehended in an absolute
fashion.
So that human behavior and actions are not either free or
determined; rather they are both free and determined, in a relative
admixture.
Thus, Judaism acknowledges the ability of freedom of
the mind.
The approval of medicine in normative Jewish law is
based on the rejection of absolute determinism. According to the
Talmud and its main interpretor,10 the engagement in medical
practice is permissible, disclaiming the notion that by doing so one
is abrogating God’s deeds.
The right to execute autonomous decisions, however, has
several restrictions and limitations.
Indeed, one of the most significant differences between current
secular and Jewish medical ethics concerns the principle of autonomy. Current general medical ethics has overwhelmingly shifted
the focus of decision-making from the physician to the patient, thus
.
7. Mishna Avot 3:15.
8. Urbach EE(1976). The Sages – Their concepts and Beliefs (Hebrew), Jerusalem:
Magnes, pp. 227-253.
9. Steinberg A (1988). Encyclopedia Hilchatit-Refuit. Vol. I, Jerusalem.
10. Baba Kama 85a, and Rashi there.
92 Jewish Medical Ethics
ascribing the primacy of autonomy in the physician-patient
relationship to the patient. The principle of autonomy has become
absolute, taking precedence over all other values such as life and
beneficence.
It is pertinent to cite some of the critique of this approach by
Pellegrino and Thomasma.11 They suggest that the practical
question in clinical decisions is not whether or not we have a right
to autonomy; we most certainly do. Rather, the question focuses on
the proper exercise of autonomy.
Do we have a right to exercise
autonomy when the decision we wish to make is not morally good?
Are we free to make morally wrong decisions? Have we lost a
common consensus on morals to such a degree that there is no
longer any community of values? Are there any other values in
common other than autonomy?
By promoting autonomy to the
extreme overriding power, are we not promoting a degradation of
moral life and principles? Does this approach not educate to
amoral or even immoral life? Can a society survive such radical
pluralism in which there are no longer any shared values?
Engelhardt12 argues that full freedom and autonomy must be
guaranteed, even if these appear wrongheaded or downright offensive and evil to others, in order to maintain a peaceable society.
The right of autonomy in this libertarian view takes precedence
over the good. This retreat to private morality eventually leads to a
moral atomism in which each individual’s moral beliefs and actions
– unless they disturb the peaceable community – are unassailable.
Moral debate thus becomes futile, since each person is his/her own
arbiter of right and good. The traditional notion of ethics as
reasoned public discourse in search of the common good is
discarded.
Pellegrino and Thomasma11 argue that the approach of Engelhardt is wrong, and autonomy cannot and should not overrule all
other values.
In their view, an ethic based on beneficence more
fully embraces the nuances of the patient’s best interests.
Judaism ascribes to a higher order of moral conduct, which
obligates the individual and society. Autonomy as a concept of
respect for others is highly valued and demanded. However,
.
11. Pellegrino E, Thomasma DC. For the Patient’s Good. Oxford University Press, NewYork, 1988.
12. Engelhardt HT. The Foundations of Bioethics. Oxford University Press, New-York,
1986.
Free Will vs. Determinism in Bioethics 93--
autonomous decisions that do not comply with the required moral
standard are overridden by higher moral values, as determined by
the halacha and a value system which governs the life of each
individual, patient and physician alike.
Judaism restricts the notion of autonomy to actions that are
morally indifferent. Where conflicting values arise each individual
is bound to act in order to achieve self-fulfillment. Thus, everyone
is duty-bound to act according to that standard and to relinquish his
temporary wishes.
Therefore, in medical situations that involve
ethical conflicts, the solution is based on the appropriate Jewish law
which governs both the physician and the patient. This approach
can be termed a Moral-Religious Paternalism as oppossed to the
Hippocratic Individual-Personal Paternalism of the physician.
The enhancement of individual freedom to the point of
destroying moral values in medicine cannot be considered as the
best resolution to complex ethical dilemmas in medicine. There
need be a set of common and shared values which both the patient
and the physician will obey, and this is what Judaism offers those
who follow this way of life.
Thus, the right of free will is waived
when in conflict with certain other values.
Judaism places great
importance on self-fulfillment and refinement in the spirit of moral
and religious commandments. Therefore, values directed to achieve
this goal are superior to the principle of autonomy when in conflict.
On the other hand, the basic principle of self-determination, and
particularly the moral and religious demand to respect other human
beings, is highly advanced in Jewish thought. This was stated in
several epigrams: Do not do unto others what is hated upon
yourself;13 Respect your fellowman as you would have him respect
you.14
According to one of the talmudic sages, the biblical verse:
Love thy neighbor as thyself – is the essence of the whole Torah.15
Free Will vs. Determinism
in Bioethics:
Comparative Philosophical and
Jewish Perspectives
Avraham Steinberg, M.D.
I am all for-"we did not choose God or Christ" but AFTER regeneration we have free will to make daily choices-we are going to give an account based on our words, thoughts and actions brother-preach the Gospel.
J.