Israel - The Terminally Ill Patient Law [Новость добавлена - 14.12.2007]

The Terminally Ill Patient Law was passed – following the second and third hearing in the Knesset – on 6 December, 2005.

More than seven hundred professionals worked on this Law for six years. Rabbi Professor Abraham Steinberg, Chairman of the Committee, led lawyers, religion experts, physicians, philosophers, and many others toward forming an initial proposal. The proposal – The Steinberg Report – was published in 2002.

Following the initial proposal, the Law was written by the Joint Committee for the Committee of Labor, Welfare, and Health, together with the Legal Committee of Knesset, thus creating the final version of the law, one which is suitable to Israeli needs. The process was led by Knesset Member Shaul Yahalom.

The Terminally Ill Patient Law aims to set guidelines for paradoxical situations. There are situations where, on the one hand, medicine cannot cure the patients and save their lives. On the other hand, the medical profession tries to use invasive technology and procedures to prolong life, this regardless of the patients' wishes or the suffering of the patients and their families.

Several points should be made:

• The new law recognized Preliminary Guidelines. People whose illness is assessed to be incurable, and whose physicians estimate that they have no more than six months to live, may maintain their autonomy and decide on the form of treatment they will receive.

• The Law requires physicians to inform patients of their medical condition and the medical prognosis, and to fully clarify their wishes regarding artificial prolonging of life when the medical treatment is not helping, and the patients' condition deteriorates. In cases when the patient in incompetent, a guardian may act on the patient's behalf. The Law recognizes patients' full right to continue fighting for their lives until the very end.

• In situations where there is not active medical solution, the Law recognizes patients' right to receive palliative care – easing the symptoms and providing reasonable quality of life to the very end.

Hopefully, the Terminally Ill Patient Law will advance the position of Palliative Medicine. It is further hoped that recognition that patients' have the right to the best treatment possible will be followed by recognition, on the part of the Ministry of Health, of Palliative Medicine as a unique medical field based on specific academic and professional knowledge, and recognize professional specialization in this area.

The new Law attempts to resolve real conflicts that appear toward the end of life – conflicts between the sanctity of life and every person's right to make autonomous decisions regarding personal suffering. The situation is plain: The medical staff respects the patient's wishes and provides all necessary life-prolonging treatment, as long as the damage caused by the treatment is not greater than its benefits. Problems and difficulties arise when patients no longer want to prolong their lives, do not want to endure physical suffering, and do not wish to endure the suffering involved in innovative, advanced medical technology (resuscitation, dialysis, PEG, etc.).

Because suffering is individual, the Law determines that patient's wishes must be respected and all artificial life-saving procedures must be avoided. However, the Law acknowledges the right of the patient on deathbed to receive Palliative Care "Even at considerable risk to the life of the patient… in accordance with the wishes of the patient on deathbed, and in accordance with the Patient's Rights Act".

It must be made abundantly clear that the Law states unequivocally that it "forbids active termination of life," "forbids assisted suicide," and "prohibits cessation of ongoing medical treatment."

Michaela Berkovitch, MD
Research and Information Coordinator, Beit Friedman Oncological Hospice
Sheba Medical Center
The Sackler School of Medicine
Chair of the Israeli Palliative Medicine Society

Source of information http://www.eapcnet.org/latestnews/Israel.html