title: Patient Autonomy in Talmudic Context: The Patient's "I Must Eat" on Yom Kippur in the Light of Contemporary Bioethics.
abstract: In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which treatment choices are sensitive to preferences. Here, we analyze a discussion in the Mishna, a foundational text of rabbinic Judaism, regarding patient autonomy in the setting of religiously mandated fasting, and commentaries in the Babylonian and Palestinian Talmuds, finding both a more expansive notion of such autonomy and a potential metaphysical grounding for it in the importance of patient self-knowledge.
authors.affiliation: Johns Hopkins Division of General Internal Medicine, Baltimore, MD, USA. zberger1@jhmi.edu.|Department of Health, Behavior, and Society, Johns Hopkins School of Public Health, Baltimore, MD, USA. zberger1@jhmi.edu.|Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA. zberger1@jhmi.edu.
authors.forename: Zackary
authors.identifier: http://orcid.org/0000-0002-5871-0342
authors.initials: Z
authors.lastname: Berger
authors.affiliation: Solomon Schechter School of Westchester, Hartsdale, NY, USA.
authors.forename: Rabbi Joshua
authors.initials: RJ
authors.lastname: Cahan
mesh_terms: D001675:Bioethics; D005215:Fasting; D006801:Humans; D007599:Judaism; D010358:Patient Participation / Q000379:methods*; D057240:Patient Preference; D026684:Personal Autonomy; D012068:Religion and Medicine
keywords: Autonomy; Jewish bioethics; Religion; Shared decision making; Talmud