Aspects of Vulnerability

Article excerpt

THE EDUCATIONAL PHILOSOPHER ELIZABETH LEONIE

Simpson complained in the early 1970s about the escalating absence of clear boundaries between good and bad. [1] But Simpson also acknowledged that the positive side of this condition was that the boundaries for moral and ethical discussion had expanded. This simple description of our unstable moral condition--its form and its content--foreshadows the ethical reality in which we find ourselves 25 years later, and which the following essays reflect. On the one hand, we are now free to include concerns in our ethical discourse which heretofore had been ignored; but on the other hand, we are frustrated by the overwhelming number of perspectives and factors that influence our conclusions. Let us see if some of these freedoms and frustrations are related.

Medical ethics are generally discussed in terms of specific cases placed against a backdrop of actual precedents or of principles promoted by classic texts. A decision about what we should do in a situation involving conflicting values, or a situation which exposes other ambiguities most often involves deciding whether the language in the case at hand means the same thing as the language in the case from which the principle or precedent is drawn. David Ellenson has clarified this practice in his fundamental description of how we draw guidance from a tradition. [2] In his work as well as in the vital discussions and anthologies of Elliot Dorff, accommodation is made for new technology and even for new social arrangements which modify the terms of discourse and their relations. Elliot Dorff has--along with colleagues like Daniel Gordis and Louis Newman [3]--taken us beyond the halakhic strategy known as "changing times" (Shinu 'I 'Itim), although they continue to restrict the issues and problems to be consider ed to a kind of classic problem solving: "What shall we do in such and such a situation?"

The concerns raised move beyond the typical case-exception discourse of "halakhic formalism" to include more wide-ranging attention to values, daily practice, and epistemology. Laurie Zoloth-Dorfman especially challenges readers to overturn conventional ways of looking at bioethics. She insists that texts have been controlled by men in a "double-gendered" sense--men have been their authors and their readers. While she acknowledges that this condition has neither resulted in an epidemiological crisis, nor has it been intentionally hostile to women, it is certain that we miss an opportunity by not imagining a woman as reader of those texts, and even more of an opportunity by not looking for texts or (more likely) experiences authored by women.

Zoloth-Dorfman is not able to say precisely what changes would result from this re-gendering, but she tries to point the way beyond the simple aspiration of including more women in the canon so that the discussion will lead (inevitably) to new places. This "way beyond" is then broken out into several categories which involve spatial relations, narrative forms, point of view, residual thematics-indeed a variety of perspectives which sounds more like rhetorical and narrative theory than conventional ethics deliberations. [4] Her interest, however, is less to build a theoretical system than to generate practical results for the time being, to use her theoretical questions for very practical ends.

I support Zoloth-Dorfman's right not to predict the nature of specific results--especially at this fairly early stage in the development of Jewish bioethics. Indeed the combination of new epistemology with seemingly infinite technological capacity and frustrating economic realities have resulted in ambiguities that stretch the imagination. Zoloth-Dorfman is convinced, however, that there will be concrete results once woman moves from object of the gaze to its subject. I agree, but would suggest that the same shift from object to subject would apply if the subject were the "vulnerable patient" rather than "woman. …