Advance Directives-The Israeli Experience.

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.