On the 50th anniversary of the Willowbrook experiment's inception, in which Dr. Saul Krugman intentionally infected cognitively disabled children with hepatitis, it is worth reflecting on how our attitude toward research ethics of the past informs our current practices. In examining ethical violations in postwar medicine, we frequently turn to examples that shock and appall, thereby offering concomitant comfort as we measure their safe distance from our own medical context. And yet, which modern medical student has not heard a variation (...) of the phrase "This study would never have passed an ethics committee today" in reference to a classic experiment or a professor's very own work? Even with Nuremburg fresh in the .. (shrink)

A few years ago, a Yemenite patient came to Maimonides Hospital in Brooklyn. The friendly, diminutive gentleman apologized for visiting the clinic in the first place because, as he explained, he was a devotee of Maimonides and invariably used the medical treatments recommended by him rather than current Western medicine. But for this patient’s problem, Maimonides had prescribed garlic. The patient told his doctor that if he ingested garlic, his wife would refuse contact with him. So, having no alternative, he (...) came to our clinic for consultation and to see if there were any other appropriate treatments.Moses Maimonides was one the most important Jewish scholars of all times. A popular folk saying.. (shrink)

The Groningen Protocol allows active euthanasia of severely ill newborns with unbearable suffering. Defenders of the protocol insist that the protocol refers to terminally ill infants and that quality of life should not be a factor in the decision to euthanize an infant. They also argue that there should be no ethical difference between active and passive euthanasia of these infants. However, nowhere in the protocol does it refer to terminally ill infants; on the contrary, the developers of the protocol (...) take into account the future quality of life of the infant. We also note how the Nazi Euthanasie Programm started with the premise that there is some life not worthy of living. Therefore, in our opinion, the protocol violates the traditional ethical codes of physicians and the moral values of the overwhelming majority of the citizens of the world. (shrink)

In 1964, the American Medical Association invited liberal theologian Abraham Joshua Heschel to address its annual meeting in a program entitled “The Patient as a Person” [1]. Unsurprisingly, in light of Heschel’s reputation for outspokenness, he launched a jeremiad against physicians, claiming: “The admiration for medical science is increasing, the respect for its practitioners is decreasing. The depreciation of the image of the doctor is bound to disseminate disenchantment and to affect the state of medicine itself” [1, p. 35]. Heschel’s (...) reference to “disenchantment” suggests that he may have been familiar with the work, or at least the outlook, of sociologist Max Weber, whose 1917 address “Science as a Vocation” portrays the modern world as disenchanted by the progress of rationalism. Heschel’s life’s vocation had been to uncover the inner meaning of religious faith and to translate that faith into principled action. Heschel saw disenchantment not as an inescapable aspect of modern life but rather as the byproduct of physicians’ conscious choices to seek worldly success and material comfort. Yet, because of their privileged position as witnesses to human vulnerability, physicians possess an obligation to develop their own personhood, to re-enchant medicine, and through medicine to spark a positive transformation in all of modern life. As Heschel says, “The doctor must realize the supreme nobility of his vocation, to cultivate a taste for the pleasures of the soul. … The doctor is a major source of moral energy affecting the spiritual texture and substance of the entire society” [1, pp. 34, 38]. While Heschel’s conception of the physician’s role is romanticized and idealized, changes in the organization and practice of medicine have validated his concerns. (shrink)

This passage from the most important of all our textual sources on Ancient-Egyptian shipbuilding has been discussed by me in my newly published Commentary. There I followed the traditional view whereby is translated as ‘thwarts’’, is taken to describe thwarts passing from one gunwale to the other in such a way that each end was placed ‘on top of the gunwale, and the sentence is understood to refer to caulking with papyrus. J. S. Morrison has in recent years on several (...) occasions offered a radically different translation under the influence of the Fourth-Dynasty boats interred beside the Great Pyramid of Gîza . His criticism of the old rendering seizes upon three points. (shrink)

The problematic nature of the relation between a politicized historical rhetoric and the presumed authority of brute fact was starkly outlined in the irreconcilable interpretations of the purge trials that tore apart the political Left in the 1930s. The conclusions of the Commission, headed by John Dewey, on the mock trial of Leon Trotsky in Mexico City in April 1937 rested on the evidence of the factual fabrications of key confessions. The critical contemporary responses were more or less predictable in (...) light of political partis pris. They either disparaged the entire procedure as a Trotskyite "court," where the driving purpose was to acquit Trotsky of guilt, deftly disposed of the key factual allegations, or saw the trial as attacking the Soviet system of justice itself, thus making irrelevant Trotsky's actual guilt or innocence. We now find the Commission's conclusions more persuasive than those of William Z. Foster, Malcolm Cowley, or F. L. Schuman not because of their superior tropological strategies, nor because of a skillful parade of rhetorical figures, nor because of the hermeneutic fusing of historical horizons, but because they satisfy familiar criteria of empirical inference and rational discourse. (shrink)

Looks at the life and historical role of Louis Auguste Blanqui. Studies his philosophy, economic theories, and socialism.

In lieu of an abstract, here is a brief excerpt of the content:270 HISTORY OF PHILOSOPHY The Prophets of Paris. By Frank E. Manuel. (Cambridge: Harvard University Press, 1962.) This perceptive and sophisticated contribution to the history of ideas is organized around the intellectual biographies of Turgot, Condorcet, Saint-Simon, the Saint-Simoniarts, Charles Fourier, and Auguste Comte. Professor Manuel's prophets were all Frenchmen and all, he believes, can be placed in a common tradition marked by their conviction that Paris was the (...) mount from which the new gospel had to be delivered, that love was the key to social organization, and that social and religious relationships were more significant than political forms. He presents them as prophets in the Old Testament sense--as unsparing moral critics, teachers and the "revealers of a divine historical design." They were philosophers of an age of crisis, convinced that theirs was the instant of a great human divide and therefore victims "of the anguish of futurity." The future they so confidently foretold to anyone who cared to listen, and to many who did not, has found many of their prophetic visions to be poor predictions, but for Manuel they cannot be dismissed as utopian cranks or frustrated totalitarians. Many of the issues they raised and problems they sensed have yet to be adequately confronted, and it is this prescience, particularly with regard to the psychological conditions of social existence, that Manuel wishes to emphasize. This treatment, as its author admits, is a "frank attempt at rehabilitation, to right the balance of historical judgement and bestow new worth upon thinkers who have often been treated with superficiality" (pp. 1-10). Manuel's approach to the history of ideas lends itself quite effectively to this purpose. He admits to a "romantic view of history-writing" which entails an effort to establish an intimacy with his subjects through an immersion in their manuscripts, in the "scribbled brouillons, the casual notes, the personal letters," as well as in the identity presented through their published works. His writing of history is romantic not only in this regard but much more profoundly in his historicism, which attempts an immediate empathetic confrontation with the total organic complex of his subject's life, ideas, and environment. Manuel's evident sympathy occasionally tempts him into apologetics, but essentially he is not arguing a brief for the defense but trying to understand what it was that made these men see so far, and yet with such myopic arrogance, and what it was they saw. It seemed to me that his approach is most successful with Fourier, and least so with Turgot. Charles Fourier, the self-taught travelling salesman from Besan~on, is often summarily dismissed as a cosmic crank with easy reference to his fantastic aberrations --his seas of lemonade and the copulation of the planets. Manuel helps us to understand not only the aberrations but the prescient insights by establishing the relationship between Fourier's personality and his ideas, as well as by tracing the connections between apparently contradictory conceptions. He does not misuse this technique of intellectual biography by patronizing or justifying a system of thought with reference to its psychological antecedents, but rather helps to illuminate a philosophy by examining the reasons for its expression. This works particularly well with Fourier, an obsessed and deprived personality, whose great contribution, according to Manuel, was the assimilation into a social doctrine of the fundamental needs and drives of mankind--its "manifold wants, its secret desires, and its obstinate fixations" (p. 203). Both Fourier and the SaintSimonians believe that it was pointless to tinker with the social environment without regard for permanent psychological realities, but the latter hoped to sublimate human passions through a social organization that redefined them, while Fourier wanted a social system that would provide for their total gratification (p. 226). Occasionally Manuel rather triumphantly unearths striking parallels with our present BOOK REVIEWS 271 concerns that do not demonstrate the vision of his seers into the future so much as his discovery of analogues in the past. Fourier's case is not particularly strengthened by the observation that his vision of a climate so benign under the regime of phalansteries as to render tire very poles inhabitable is "no longer as... (shrink)

The Groningen protocol allows for the euthanasia of severely ill newborns with a hopeless prognosis and unbearable suffering. We understand the impetus for such a protocol but have moral and ethical concerns with it. Advocates for euthanasia in adults have relied on the concept of human autonomy, which is lacking in the case of infants. In addition, biases can potentially influence the decision making of both parents and physicians. It is also very difficult to weigh the element of quality of (...) life on the will to live. We feel an important line has been crossed if the international medical community consents to the active euthanasia of severely ill infants and are concerned about the extension of the policy to other at risk groups. (shrink)

Samuel Golubchuk was unwittingly at the center of a medical controversy with important ethical ramifications. Mr. Golubchuk, an 84-year-old patient whose precise neurological level of function was open to debate, was being artificially ventilated and fed by a gastrostomy tube prior to his death. According to all reports he was neither brain dead nor in a vegetative state. The physicians directly responsible for his care had requested that they be allowed to remove the patient from life support against the wishes (...) of the patient's family. Concurrently the Manitoba College of Physicians and Surgeons released a statement which states that the final decision to withdraw life support lies with the physician. In our opinion the statement is ethically problematic for a number of reasons. 1. It is an affront to the guiding principles of Western medical ethics: patient autonomy and human freedom. 2. The position of Samuel Golubchuk's physicians and the new statement lack cultural sensitivity towards other traditions. 3. In modern society there exists an erosion of a basic attitude towards the value of life. 4. The ability of physicians to predict life expectancy in terminally ill patients has been shown repeatedly to be quite limited. (shrink)

The physician charter on medical professionalism creates standards of ethical behaviour for physicians and has been endorsed by professional organisations worldwide. It is based on the cardinal principles of the primacy of patient welfare, patient autonomy, and social welfare. There has been little discussion in the bioethics community of the doctrine of the charter and none from a Jewish ethical perspective. In this essay the authors discuss the obligations of the charter from a Jewish ethical viewpoint and call on other (...) cultures to develop their own unique perspectives on this important document. (shrink)