Introduction: Bioethics in Israel

Consider the following scenes: Early morning at an IVF clinic at a public hospital in a city in northern Israel: two women sit silently next to each other, both waiting for an ultrasound and a hormone adjustment protocol. Their weary eyes disclose that both have already had their share of ups and downs with these tiresome fertility treatments. The emotional roller coaster is clearly taking its toll; exhausted from the ongoing dance of hope and despair, the two are lying back on their chairs, motionless, staring at the clock in front of them. Who are these women? What are their stories? Is there any significance to the fact that both are Israelis? Grueling fertility treatments burden women everywhere who turn to them to fulfill their common wish to bring a child into the world. However, learning that one woman is undergoing her tenth cycle of treatments, subsidized by the Ministry of Health, and that the other is to be impregnated with the sperm of a dead man she had not known while alive, one could certainly attest to Israel’s unique reproduction policy as a major factor in this scene. Spring 2006: the global outbreak of avian influenza (H5N1) has become a clear public health menace. The Israeli army joins private contractors to cull infected poultry flocks, but collaboration on a regional scale is needed. Without cross-border partnerships with the Palestinians and the Jordanians, the Israeli efforts to combat the outbreak are not sufficient. Facing infectious diseases obliges preparedness at the international level. Indeed, rephrasing the “diseases know no borders” maxim, the head of foreign affairs at the Israeli Ministry of Health declared that “birds know no borders.” But how can this necessary collaboration be attained in a region as conflict-ridden as the Middle East? Can public health be separated from politics? In a prolonged state of conflict threatened with the potential of unconventional warfare and terrorism, is preparedness against emerging infectious diseases different from biosecurity? July 2015: the Israeli parliament, the Knesset, has enacted a law allowing a judge to sanction the force-feeding of hunger-striking prison inmates if there is a threat to an inmate’s life, even if the prisoner refuses. In response, the chairperson of the Israeli Medical Association declared the law unethical.