Abstract
BackgroundEnd-of-life decisions are highly complex socio-normative and ethical phenomena. The goal of this study was to provide an assessment of public opinions in Israel concerning aspects of end-of-life decisions.MethodsAn online cross sectional study was performed in February 2020. The primary tool including items pertaining to death assistance and truth telling to patients. A sample of 515 participants representative of the adult Israeli population was obtained.ResultsThe majority of participants (71%) supports telling the entire truth to patients even in harsh conditions. Support for truth telling decreases with affiliation to religion, with as little as 40% support among ultra-orthodox. People with vocational education are the least supportive of truth telling. Concerning doctor assisted death, almost half (49%) of the sample were supportive. Opposition is positively associated with religiosity, with 90% of ultra-orthodox and 58% of religious participants opposing doctor-assisted death, compared to only 18% among seculars. Non-Jews were 3.35 times (95%CI: 1.90, 5.91) more likely to oppose doctor assisted death than Jews (p < .0001). An Interrelationship analysis crossing between attitudes revealed that the largest group (39%) was comprised of participants who support both (“autonomists”).ConclusionsIsraelis are overwhelmingly supportive of truth telling to patients. In contrast, Israeli public opinions on doctor assisted death are divided. For both attitudes, religiousness plays a crucial role as a catalyst for conservatism and opposition to change. Almost a half of the public is also supportive of an autonomist approach that would allow patients to decide on ending their own lives.
Highlights
End-of-life decisions and processes are becoming more complex in recent years due to shifts in socio-normative and ethical perceptions
The results of this study demonstrate a wide public support of truth telling to patients about their medical status, even in harsh conditions
While truth-telling to terminally-ill patients seems to enjoy a consensus among adult Israelis, this cannot be said for the other component of end-of-life decisions assessed in this study – assisted death
Summary
End-of-life decisions and processes are becoming more complex in recent years due to shifts in socio-normative and ethical perceptions. A national plan for palliative care was established in 2015 at the request of the Ministry of Health According to this plan, palliative care should be perceived as part of an overarching care system designed to improve terminally ill patients’ coping capacities and quality of life. The medical team is obliged to honor the patient’s will, unless in cases involving the prevention of treatment designed to relief pain and suffering or procedures aimed at assisting death This setting bring forward numerous questions, including whether the legal status in Israel reflects public opinions regarding the issue at hand. One may ponder whether the abovementioned legal and formal framework in Israel is compatible with the steadily increasing favorable views of end-of-life processes by the public in Israel and abroad Before these questions can be answered, a review of global status is required. The goal of this study was to provide an assessment of public opinions in Israel concerning aspects of end-of-life decisions
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