Abstract
BackgroundMedicine has undergone substantial changes in the way medical dilemmas are being dealt with. Here we explore the attitude of Israeli physicians to two debatable dilemmas: disclosing the full truth to patients about a poor medical prognosis, and assisting terminally ill patients in ending their lives.MethodsAttitudes towards medico-ethical dilemmas were examined through a nationwide online survey conducted among members of the Israeli Medical Association, yielding 2926 responses.ResultsClose to 60% of the respondents supported doctor-assisted death, while one third rejected it. Half of the respondents opposed disclosure of the full truth about a poor medical prognosis, and the others supported it. Support for truth-telling was higher among younger physicians, and support for doctor-assisted death was higher among females and among physicians practicing in hospitals. One quarter of respondents supported both truth-telling and assisted death, thereby exhibiting respect for patients’ autonomy. This approach characterizes younger doctors and is less frequent among general practitioners. Another quarter of the respondents rejected truth-telling, yet supported assisted death, thereby manifesting compassionate pragmatism. This was associated with medical education, being more frequent among doctors educated in Israel, than those educated abroad. All this suggests that both personal attributes and professional experience affect attitudes of physicians to ethical questions.ConclusionsExamination of attitudes to two debatable medical dilemmas allowed portrayal of the multi-faceted medico-ethical scene in Israel. Moreover, this study, demonstrates that one can probe the ethical atmosphere of a given medical community, at various time points by using a few carefully selected questions.
Highlights
Medicine has undergone substantial changes in the way medical dilemmas are being dealt with
In this study we have examined the attitude of Israeli physicians to the two fundamental dilemmas discussed above: Should doctors tell the full truth (TFT) to their patients when the final prognosis is poor, and should physicians take part in doctor-assisted death (DAD)
In this paper we examine two debatable medical dilemmas, that of telling a patient the full truth about a bad prognosis (TFT), and that of assisting a fatally ill patient in life termination (DAD)
Summary
Medicine has undergone substantial changes in the way medical dilemmas are being dealt with. Medicine has undergone substantial transformations in recent decades This is manifested by major technological advances allowing the provision of better healthcare, and by conceptual changes which have significantly altered the nature of medical practice. The emergences of new moral dilemmas that can no longer be found in the Hippocrates’ ethical model have led to a Another shift in medical practice relates to redefinitions of the interactions between physicians and patients. This has been affected by the substantial attention given to patient autonomy, and by the fact that patients are better informed [2]. The internet and social media have accelerated the patient’s ability and willingness to take part in medical decisions [3] and at
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