Head of the Program for Advanced Studies in Bioethics (MA); Joint Program Law (LL.B) and Philosophy (MA)

Dr. Efrat Ram-Tiktin

טלפון
דוא"ל
efrat.ram-tiktin@biu.ac.il
תחומי עניין

Bioethics; Political philosophy (esp. 20th century); Moral philosophy, Applied Philosophy, Philosophy of Education, Philosophy of Law.

תחומי מחקר
    קורות חיים

    Dr. Efrat Ram Tiktin joined the faculty of the Department of Philosophy in 2009 and specializes in bioethics, applied ethics, political philosophy, philosophy of law and philosophy of education.

     

    Dr. Efrat Ram Tiktin completed her bachelor's, master's and doctoral degrees at Bar-Ilan University. BA in Social Sciences (Summs Cum Laude), MA in Philosophy in Bioethics (Magna Cum Laude) and PhD in Political Philosophy and Bioethics; "Distributive Justice in Healthcare" is the title of her doctoral thesis. 


    From 2009 to 2011, Dr. Ram Tiktin conducted a postdoctoral internship at Ono Academic College and served as associate editor of the journal of the Center for Medical Law and Bioethics. 
    In addition to teaching and research, Dr. Ram Tiktin is a member of
    Bar-Ilan’s IRB, and the Disciplinary Committee, and since 2015 she has been a member of the Ethics Committee of the Israeli Association for Reproductive Research and the Dying Patient Law Committee of Sheba Medical Center, Tel Hashomer regarding a terminally ill patients
    In March 2020, during the COVID-19 pandemic, Dr. Ram Tiktin was part of the team to prioritize the allocation of ventilators to patients.

     

    מחקר

    My main research interest is the interface between political philosophy—with an emphasis on the theories of distributive justice—and bioethics. The question that occupied me in my doctoral thesis was whether it is possible to formulate a unified theory of distributive justice in the domain of health that can provide guidance in achieving a just allocation of resources. In other words, my research goal was to develop a theory (which I called the “Sufficiency of Basic Human Functional Capabilities”) that would guide policy makers in prioritizing the inclusion of new medical technologies in the National Health Services Basket. The main innovation of the research lies in the attempt to create a unified theory of justice in the domain of health, that is to provide an account whose specific applications are derived from the fundamental values of a theory of justice and from the nature of the good being proposed for distribution. I claimed that such a theory would overcome the problems that I identified in the various solutions presented in the literature. Thus, on the one hand, there are general theories that are too vague to apply in the domain of health and on the other hand the theories that present practical guidelines for prioritization do not explain which values they are derived from. This research also suggested two possible contributions to the literature on distributive justice. The first is the extension of Frankfurt’s sufficiency principle in two directions: a) the delineation of the sufficiency threshold in a non-arbitrary manner, and b) the articulation of the two principles of number and benefit-size weighted sufficiency that determine the order of prioritization above and below the threshold. The second is the articulation of nine key systems of health-related basic human functional capabilities that replace Nussbaum’s list of ten basic human capabilities.

     

    During the years following my PhD, I developed additional aspects of the theory beyond those discussed in my thesis. These efforts took the theory in two main directions: The first is the advantage of the Sufficiency of Capabilities principle in healthcare relative to the dominant and competing ideals in the literature (such as Fair Equality of Opportunity in health as presented by Norman Daniels and Luck Egalitarianism in health as presented by Shlomi Segal and others). The second is the advantage of Amartya Sen and Martha Nussbaum’s capability approach, and my version of that approach, over other liberal positions, such as that of John Rawls, in dealing with the tension between respecting cultural diversity, including the respect of an individual’s freedom of conscience, and the implementation of universal principles of justice.

     

    My interest in the interface between political philosophy, bioethics and applied ethics has led me to investigate and write about three more specific topics. The first is whether the enhancement of an individual’s moral capacity through bio-medical interventions is desirable and what are the warning signs we should be aware of in this endeavor. In this context, I have made the claim that egalitarians are mistaken in claiming that this endeavor would lead to political inequality. Rather, our concern and efforts should be directed toward the possibility that moral bioenhancement would have negative effects on fair equality of opportunity. The second is the ethics of extreme circumstances. The research of this topic has sought to present and justify the principles of justice that should form the basis of an algorithm for prioritizing between patients (i.e. triage) in situations of a severe shortage of resources following natural disasters. The third attempts to identify the legitimate mechanisms of intervention that can be used by state institutions in the preservation and advancement of public health. In this context, I came out in opposition to the prevailing position of the leading health organizations on two matters. First, I claimed that our focus should be on population health rather than public health, since the latter relates to methods of intervention that promote population health and hence has instrumental value, while the former is good in itself (though it also has instrumental value in achieving other ends, such as the population’s prosperity). Second, and more importantly, public health is a public good (non-rival and non-excludable) while population health meets the criteria of a common good (rival and non-excludable) and therefore is at risk of depletion in the absence of state regulation. This more accurate perspective on population health and public health can be used to evaluate interventions by the state that affect the individual’s positive freedom. I presented a number of arguments which showed why interventions such as nudges (namely, a method used to encourage an individual to make choices that improve his situation) do not compromise the individual’s freedom but in fact advance it if we analyze the two aspects that give freedom its value (i.e. Sen’s opportunity and process aspects of freedom).

    In 2015, I completed a joint project together with Professor Gil Siegal which examined the uniqueness of Israeli bioethics as manifested in legislation, court rulings and the professional norms of healthcare workers as compared to the bioethics that has developed in other Western countries. The project’s findings and conclusions were presented in a book we edited, which was published by Mossad Bialik and the Ono Academic College.

     

    Three additional articles on applied ethics that deal with the issue of posthumous use of gametes for reproduction, an issue that has led to a stormy debate in recent years. In this research, which was carried out jointly with Dr. Roy Gilbar, I proposed a new perspective on the issue. While most writers on this subject have focused on individual rights in order to deal with the problems that arise from these medical procedures (and concluded that the parents of the deceased have no moral claim to use of their son’s sperm), we proposed a new theoretical framework to examine the issue which focuses on the value of social solidarity and an understanding of the individual’s autonomy as relational autonomy, rather than individualistic autonomy which is based on the approach of ontological individualism. In another article on this issue, which supports the position of parents who wish to make posthumous use of their son’s sperm, we proposed a critical examination of court rulings handed down in Israel and Australia.

     

    In 2018, I was awarded a research grant by the Israel Science Foundation to develop a unified theory of justice in education. Here again, I intend to propose a theory which, by examining the good to be distributed and the internal value of childhood, will be able to suggest principles for the just allocation of resources in formal and informal education. So far, two articles on the internal and instrumental value of childhood in the development of an authentic “self” and authoritative agency have been completed.

     

    קורסים

    Moral Philosophy:           Introduction to Moral Philosophy

                                              Questions of Justice and Morality in Emergencies

                                              Identity and Agency       

                        

    Political Philosophy:       Human Rights and Global Justice

                                               Social Justice and Health

                                               Amartya Sen and John Rawls on Injustice

                                               Egalitarianism and its Critiques

                                               Ideals of Distribution

                                               Reading, Thinking, Writing: On Freedom of Thought

     

    Bioethics:                          Applied Bioethics Seminar

                                               Central Arguments in Bioethics

                                               Moral Challenges in Medical Ethics

                                               Issues of Justice and Morality in Times of Crisis

                                               Human and Post-Human: Ethical implications of Human Enhancement

    פרסומים

    Edited Book

    Siegal, G., Ram-Tiktin, E. (2015). Israeli Bioethics. Jerusalem: Bialik Publishing and Ono Academic College. (Heb.)

    Refereed Articles

    Lipshitz N., Ram-tiktin E. 2021. “The Value of Being a Child: An Intuitive Case for a Development View”. The Journal of Value Inquiry (forthcoming).

    Ram-tiktin E. and Lipshitz N (2020). “Why Adults have to be Children First”. The Journal of Value Inquiry (forthcoming). https://rdcu.be/b7V1l

    Gilbar R, Ram-Tiktin E. (2019) It takes a village to raise a child: Solidarity in the courts - Judicial justification for posthumous use of sperm by bereaved parents (Medical Law Review, Forthcoming)

    Ram-Tiktin E, Gilbar R. (2019) Solidarity as a theoretical framework for posthumous assisted reproduction and the case of bereaved parents. Ethical Theory and Moral Practice, 22: 501-517. 

    Ram-Tiktin, E., Gilbar, R., Beck Fruchter, R., Ben- Ami, I., Friedler, S., Shalom-Paz, E. (2019). Expanding the use of posthumous Assisted Reproduction Technique: Should the deceased’s parents be allowed to use his sperm? Clinical Ethics, 14 (1):18-25. https://doi.org/10.1177/1477750918820648

    Ram-Tiktin, E. (2018). The Tragedy of the Commons and Population Health: The State’s Intervention in an Individual’s Actions and Choices from a Capability Perspective. Journal of Human Development and Capabilities 19(4): 438-455. https://doi.org/10.1080/19452829.2018.1471672

    Ram-Tiktin, E. (2018). Universal Principles of Justice and Respect for Cultural and Religious Diversity in the Capability Approach. Ethics, Medicine and Public Health, 5 (Apr.-Jun.): 35-46. https://doi.org/10.1016/j.jemep.2018.03.011

    Ram-Tiktin, E. (2017) “Ethical Consideration of Triage Following Natural Disaster: The IDF Experience in Haiti as a Case Study,” Bioethics, 31(6):467-475.

    Ram-Tiktin, E. What is Enough? Sufficiency, Justice and Health.  Carina Fourie and Annette Rid (eds.) “Basic Human Functional Capabilities as the Currency of Justice in Healthcare". 2017.  Oxford University Press. 144-163.

    Ram-Tiktin, E. “Equality of Opportunity versus Sufficiency of Capabilities in Healthcare”. 2016. World Journal of Social Science Research, 3(3): 418-437.

    Ram-Tiktin, E.  “The Possible Effects of Moral Bioenhancement on Political Privileges and Fair Equality of Opportunity”. 2014. American Journal of Bioethics, 14(4): 43-44.

     

    Ram-Tiktin, E. "The Right to Health Care as a Right to Basic Human Functional Capabilities". 2012. Ethical Theory and Moral Practice, 15(3): 337-351.

     

    Ram-Tiktin, E. "A Decent Minimum for Everyone as a Sufficiency of Basic Human Functional Capabilities". 2011. American Journal of Bioethics, 11(7): 24-25.

     

    Ram-Tiktin, E. "Setting Priorities among Patients Under Circumstances of Severe Scarcity –The IDF Humanitarian Mission to Haiti". 2011. Journal of Health Law and Bioethics, 4: 116-160. [in Hebrew]

     

    Under Review

    1. Inconsistency in the International Humanitarian Law and the use of moderate physical pressure. (International Theory: A Journal of International Politics, Law and Philosophy)

    In Progress

    1. Moral Fictions in the Dying Patient Act.

     

    Position papers (Ethics Committee of the Israeli Society for Reproductive Research):

    1.    Cross-border reproductive care (Dec. 2015)
    2.    Ethical limits on the use of new technologies (Apr. 2017)
    3.    Posthumous gamete retrieval and IVF (Mar. 2017)
    4.    Surrogacy for single men and gay couples (October, 2018) 
    5.    The limits of the physician’s duty to provide fertility treatment (February, 2022

    Last Updated Date : 22/11/2023