Autonomy, altruism and authority in medical ethics: Essays in honor of Professor Shimon Glick

In this volume, written in honor of the eightieth birthday of Professor Shimon Glick, world renowned experts in the field of medical ethics struggle with the question of how to weigh the respective values of autonomy, altruism and authority in dealing with real life bioethical dilemmas. Professor A. Mark Clarfield addresses the issue of non-maleficence as it applies to the elderly, frail patient using the examples of screening for prostate cancer and Alzheimer's disease. Professor Cohen-Almagor chronicles his difficulties in researching and publishing his work on euthanasia in the Netherlands and the lessons he learned from these experiences. Professor Raanan Gillon respectfully argues against the contention that there is a moral difference between withdrawing and withholding therapy. Professor Michael Gross skillfully reviews the arguments for and against force feeding political hunger strikers ultimately concluding that, "force feeding should be rare and only come when attempts at reasonable accommodation fail." Professor Jonathan Halevy addresses the frequently overlooked ethical dilemmas facing a hospital director which have become more frequent in this era of resource driven medicine. He focuses on questions of risk management, triage, physician impairment, allocation of scarce resources and patient autonomy. Professors Kopelman and Appelbaum discuss the important issue of the impact of social media on the contemporary practice of medicine and the potential ethical challenges that this often brings. Issues such as confidentially and appropriate boundaries and their impact on the doctor-patient relationship are addressed in the context of social media. In telling the story of the death of his father and mother in law, Professor John Lantos demonstrates the complexity of each individual case and the difficulty of relying simply on ethical principles to resolve moral dilemmas in the hospital. In responding to Professor Lantos, Professor Alan Jotkowitz points out those Jewish ethical deciders who also realize the difficulties of a principle based approach and therefore use an insightful reading of Talmudic narratives to develop an authentic Jewish ethic. Professor Shifra Shvarts,Dr. Ofra Golan and Dr. Giora Kaplan trace the fascinating roots of the concepts of justice and equality in the Israeli healthcare system. They tell the intriguing story of how these concepts have evolved through the use of case histories from Jerusalem hospitals in the nineteenth century and the development of the early Sick Funds at the beginning of the twentieth century in Israel. Professor Avraham Steinberg addresses the question of how Jewish law defines basic concepts such as motherhood, fatherhood and a human being in light of modern science. Professor Alfred Tauber convincingly argues that opposition to physician strikes is rooted in the concept of what it means to be a physician. In Tauber's words "to enjoy the doctor status required not only an enormous fund of knowledge and professional commitment, one also accepted a deep personal responsibility for the care of the patient". Professor Paul Root Wolpe points out that the conceptual category of autonomy has become the dominant principle of Western bioethics, a development which he has labeled "the triumph of autonomy". The above notwithstanding, it is becoming increasingly apparent that placing autonomy at the top of one's hierarchy of values alone cannot solve all modern bioethical dilemmas.