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Advance Directives-The Israeli Experience.

Pesach Shvartzman1, Yonatan Reuven2, Mordechai Halperin3

  • 1Department of Family Medicine and Palliative Care Unit, Clalit Health Services, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Palliative Clalit Health Services - Southern District Care Unit, Beer-Sheva, Israel.

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Summary
This summary is machine-generated.

The Israeli Dying Patient Law enables advance medical directives (AD), with most signatories being healthy individuals over 65. Increased awareness and physician involvement are recommended for broader AD adoption.

Keywords:
Advance directivesPatient Self-Determination Actdying patientend-of-life caresuffering

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Area of Science:

  • Medical Law and Ethics
  • Public Health Policy
  • Geriatric Medicine

Background:

  • Israel's "Dying Patient Law" (2005) established advance medical directives (AD) for competent individuals to outline future medical wishes.
  • The law permits individuals, even if healthy, to document preferences for end-of-life care should they become terminally ill and incompetent.

Purpose of the Study:

  • To profile the demographic characteristics of individuals completing advance medical directives (AD).
  • To analyze the content and trends within recorded ADs in Israel.
  • To understand the utilization patterns of ADs post-legislation.

Main Methods:

  • A cross-sectional study analyzed all computerized advance medical directives (AD) in Israel from 2007 to September 2010.
  • Data were sourced from the Ministry of Health's database.
  • Descriptive analysis focused on signatory trends, characteristics, and authorized procedures.

Main Results:

  • The number of signed ADs increased during the study period, with 1167 signatories.
  • Approximately 90% of AD signatories were aged 65 or older, and 95% were healthy when completing their directives.
  • The mean number of declined procedures differed significantly between end-stage (16.6 ± 4.7) and non-end-stage (12.7 ± 3.7) conditions.

Conclusions:

  • There is a critical need to enhance public awareness regarding the availability and benefits of advance medical directives (AD).
  • Greater engagement from family physicians, oncologists, and geriatricians is essential to facilitate the AD process.
  • Proactive physician involvement can improve the uptake and effectiveness of end-of-life care planning through ADs.