One of the central problems of modern bioethics concerns the relative merits of medical expertise, legal authority and patient autonomy. This article examines the pre-modern conflict between these principles, revealing how the early tradition of Jewish law sustained different models of expertise, authority and personal autonomy. Rabbinic sources preserve opposed and contradictory voices regarding who is authorized to define a patient’s needs as dire enough to supersede important legal prohibitions. Early rabbinic law enshrined the authority of experts, while later rabbis emphasized that life is the preserve of the individual and maintained that only the patient can make critical decisions about prolonging life, based on his or her physical and psychological needs and desires. This transition is related to notions of consciousness and the self emergent among Christian contemporaries of the rabbis. The rise of a more sophisticated inner world and the significance accorded to individual choice influenced the interpretation and construal of law. By the late rabbinic period individuals were regarded as capable of recognizing their own needs and making informed choices regarding their bodies and selves. This ancient conversation offers a window into the history of the ethical questions that arise specifically in the field of medicine and more broadly in the legal realm.

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“心自知苦”：早期犹太法律中的权威、自我和耐心自治的起源

现代生物伦理学的核心问题之一涉及医学专业知识、法律权威和患者自主权的相对优点。本文考察了这些原则之间的前现代冲突，揭示了犹太法律的早期传统如何维持不同的专业知识、权威和个人自治模式。关于谁有权定义患者的需求足以取代重要的法律禁令，拉比来源保留了反对和矛盾的声音。早期的拉比法律尊崇专家的权威，而后来的拉比强调生命是个人的财产，并坚持只有病人才能根据他或她的生理和心理需求和愿望做出延长生命的关键决定。这种转变与意识的概念和在拉比的基督教同时代人中出现的自我有关。更复杂的内心世界的兴起和个人选择的重要性影响了法律的解释和解释。到了拉比晚期，人们被认为能够认识到自己的需求，并对自己的身体和自我做出明智的选择。这段古老的对话为了解在医学领域和更广泛的法律领域中出现的伦理问题的历史提供了一个窗口。到了拉比晚期，人们被认为能够认识到自己的需求，并对自己的身体和自我做出明智的选择。这段古老的对话为了解在医学领域和更广泛的法律领域中出现的伦理问题的历史提供了一个窗口。到了拉比晚期，人们被认为能够认识到自己的需求，并对自己的身体和自我做出明智的选择。这段古老的对话为了解在医学领域和更广泛的法律领域中出现的伦理问题的历史提供了一个窗口。