Assisted life termination and truth telling to terminally ill patients – a cross-sectional study of public opinions in Israel

Bodas, Moran; Velan, Baruch; Kaplan, Giora; Ziv, Arnona; Rubin, Carmit; Peleg, Kobi

doi:10.1186/s13584-020-00419-9

Cited by 7 publications

(14 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is noteworthy that despite the overarching consensus on the importance of family caregivers’ involvement in EoL processes, the current legal situation in Israel does not provide a proper framework for such participation, as family caregivers are not automatic substitute decision-makers when the patient loses decision-making capacity. The Patient’s Right Law (1996) and the Dying Patient Law (2005) are not fully compatible with the findings of this and previous studies [ 12 ]. Despite the vacuum created in the absence of such a legal framework, it appears that traditions and habits have developed, allowing family caregivers to impact end-of-life care practices.…”

Section: Discussioncontrasting

confidence: 67%

“…The first one, published by Velan et al (2019) [ 11 ], addresses the attitude of Israeli physicians towards life termination and truth-telling to terminally ill patients. The second one addresses the attitude of the Israeli population toward the same issues [ 12 ]. The third one by Tawil et al (2023) examines qualitatively the role of family caregivers during the EoL process [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…The minimum sample size for a representative sample of this age group, with a 95% level of confidence, a maximal marginal error of 5%, and an expected frequency of one of the key EoL attitudes assessed (70% support of truth-telling [ 12 ]) was 323, according to OpenEpi Sample Size Calculator [ 14 ]. Participant recruiting and data collection were conducted using iPanel , an online polling service.…”

Section: Methodsmentioning

confidence: 99%

“…To date, there is no account for the typology of the utilization of end-of-life care practices in Israel. Previous studies primarily assessed the attitudes and opinions of Israeli physicians [ 11 ] and the general public [ 12 ]. More prominently, there is no account for the effect of caregivers’ socio-normative attitudes on the utilization of end-of-life care practices.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The association of medical, social, and normative factors with the implementation of end-of-life care practices

Ziv,

Shaulov,

Rubin

et al. 2024

Isr J Health Policy Res

Self Cite

View full text Add to dashboard Cite

Background End-of-life (EoL) care practices (EoLCP) are procedures carried out at the EoL and bear directly on this stage in the patient’s life. Public support of these practices in Israel is far from uniform. Previous studies show that while ∼30% of participants support artificial respiration or feeding of terminally ill patients, 66% support analgesic treatment, even at the risk of shortening life. This study aimed to create a typology of six end-of-life care practices in Israel and assess the association of medical, social, and normative factors with the implementation of those practices. These practices included mechanical ventilation, artificial feeding, deep sedation, providing information to the patient and family caregivers, including family caregivers in EoL decision-making, and opting for death at home. Methods This cross-sectional study was performed as an online survey of 605 adults aged 50 or more in Israel, of which ~ 50% (n = 297) reported supporting a dying terminally ill relative in the last 3 years. Participants were requested to provide their account of the EoL process of their relative dying from a terminal illness in several aspects, as well as the EoL care practices utilized by them. Results The accounts of the 297 interviewees who supported a dying relative reveal a varied EoL typology. The utilization of end-of-life care practices was associated with the socio-normative beliefs of family caregivers but not with their socioeconomic status. Strong correlations were found between family caregiver support for three key practices (mechanical ventilation, artificial feeding, and family involvement in EoL) and the actual utilization of these practices in the care of dying patients. Conclusions The findings portray an important image of equity in the utilization of EoLCP in Israel, as the use of these practices was not associated with socioeconomic status. At the same time, the study found substantial diversity in family caregivers’ preferences regarding EoL care practices use not related to socioeconomic status. We believe that differences in preferences that do not lead to problems with equity or other important societal values should be respected. Accordingly, policymakers and health system leaders should resist calls for legislation that would impose uniform EoL practices for all Israelis. Instead, they should take concrete steps to preserve and enhance the widespread current practice of practitioners to adapt EoL care to the varied needs and preferences of Israeli families and cultural, social, and religious subgroups. These steps should include providing frameworks and tools for family caregivers to support their loved ones close to their deaths, such as educational programs, seminars, supportive care before and during the end of life of their loved ones, etc.

show abstract

Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The association of medical, social, and normative factors with the implementation of end-of-life care practices

Ziv,

Shaulov,

Rubin

et al. 2024

Isr J Health Policy Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…A large proportion of published research was undertaken in the past 5 years accounting for its less citations. Out of the total 26 articles, 4 articles had <10 citations,[ 6 7 8 9 ] 11 articles[ 10 11 12 13 14 15 16 17 18 19 20 ] had citations between 10 and 50, 4 of the articles[ 21 22 23 24 ] had between 51 and 100, only 2 articles[ 25 26 27 ] had more than 100 citations and 5 of the included articles[ 28 29 30 ] had no citations.…”

Section: Review Of the Literaturementioning

confidence: 99%

The end-of-life care in the emergency department setting with respect to the Middle East countries and comparison with the Western countries

et al. 2022

View full text Add to dashboard Cite

Patients who are affected with severe chronic illness or in need for end-of-life care ((EOLC), they are mainly treated in the emergency departments (EDs) to provide the utmost amount of care for their condition. The major aspects which impact the accessibility of care in the ED include the clinical, social, and economic factors in different regions of countries. In recent years as the EOLC has been provided, it has been observed that patients experiencing EOL and dealing with a dying process do not always achieve the experience what resonates with a good death. The main cause of concern for these patients is the problem that in the ED they do not have access to palliative care options, mainly the ones who are suffering from noncancer ailments. These patients are provided palliative care at a very later stage in the ED when they could have been provided with palliative management at home in an earlier manner. EOLC plays a very critical role in ensuring that terminally ill patients are given a proper and adequate amount of care. The present article aims to highlight the EOLC in the ED in the Middle-Eastern regions. We aim to present a broader view that has impacted the current situation of EOLC in the Middle East regions and demonstrate a description of the EOLC in an ED setting between the Middle Eastern regions and western culture focusing on the following five important factors: Situation acceptance in the ED, cultural compatibility of bioethics, treatment perspective, skills among clinical providers and physician's attitude. In this literature review, we present the evidence associated with the EOLC in the ED setting with respect to the Middle East countries and bring out their differences in the religious, clinical, social, ethical, and economic aspects in comparison with the Western countries. We also tried to determine the differences between the two regions in terms of the principle of explaining the fatal diagnosis or poor prognosis, family relations, and do-not-resuscitate decision. This comparative analysis will help to bring out the gaps in the quality of care in the ED in the Middle East countries and promote the development of well-assessed policies and strategies to improve EOLC. The findings of this study and the future interventions that can be implemented to improve the structure and design of the EOLC that will act as a guiding force to execute evidence-based quality improvement program.

show abstract

Polarization in public attitudes toward end-of-life decisions in Israel – A cross-sectional study

et al. 2023

Self Cite

View full text Add to dashboard Cite

Objectives End-of-life (EoL) processes are a complex socio-normative and ethical phenomenon. This study aimed to generate a database of public opinion in Israel concerning EoL processes and decisions and to identify differences in attitudes across subgroups in the population, particularly based on experience as a family caregiver of a dying patient. Methods This cross-sectional study was performed in late March 2022. The study utilized an online sample of 605 adults over the age of 50 including those who accompanied a loved one to their death in the last 3 years. Participants were requested to provide their opinions and attitudes on several aspects of EoL decisions, including truth-telling, medically assisted dying, EoL procedures, pre-death actions, and family caregivers’ engagement. Results While only 27% and ∼30% of participants support artificial respiration or feeding (respectively) of terminally ill patients, 66% support analgesic treatment, even at the risk of shortening life. The data show an association between religiosity and agreement with life-extending procedures. For example, while 83% of seculars support medically assisted dying, only 59% and 26% of traditional and religious respondents support it. However, no statistically significant differences were observed in support of family involvement in EoL process in any sociodemographic variable. Significance of results The results of this study suggest that the Israeli public is relatively polarized on several issues about EoL processes, specifically patient autonomy and medically assisted dying. Yet, at the same time, there is a consensus among the Israeli public about certain EoL elements, particularly the importance of family caregivers in the EoL decision-making process.

show abstract

Assisted life termination and truth telling to terminally ill patients – a cross-sectional study of public opinions in Israel

Cited by 7 publications

References 36 publications

The association of medical, social, and normative factors with the implementation of end-of-life care practices

The association of medical, social, and normative factors with the implementation of end-of-life care practices

The end-of-life care in the emergency department setting with respect to the Middle East countries and comparison with the Western countries

Polarization in public attitudes toward end-of-life decisions in Israel – A cross-sectional study

Contact Info

Product

Resources

About