Israeli Dying Patient Act: physician knowledge and attitudes

Am J Clin Oncol. 2014 Dec;37(6):597-602. doi: 10.1097/COC.0b013e318295b022.

Abstract

Objectives: The recently enacted Israeli Dying Patient Act was designed to strike balance between enhancing patient autonomy in end-of-life decision making and cultural/religious norms that are in opposition to active euthanasia and physician-assisted suicide (PAS). The current study evaluated physician attitudes regarding active and passive euthanasia, and their knowledge of specific aspects of the law.

Methods: A survey was administered to a convenience sample of hospital-based physicians treating terminal patients. Physicians were queried about their attitudes regarding euthanasia and PAS. Physicians were also queried about specific aspects of the law and whether they had sufficient resources to uphold the law.

Results: Surveys were distributed to 270 physicians and 100 were returned and evaluated (37%). Nearly all physicians supported passive euthanasia (withholding treatment), whereas over 40% maintained that active forms of euthanasia should be allowed for terminal patients in severe physical pain. Multivariate analysis showed a negative relationship between support for more active forms of euthanasia and physicians' self-reported religiosity. Physicians cited lack of time as a reason for not complying with the new law. Physicians had a familiarity with the general aspects of the new legislation, but a large proportion was not aware of the specifics of the law.

Conclusions: Compared with previous surveys, a larger number of physicians support passive euthanasia. A sizable percentage of physicians would be willing to participate in active euthanasia and even PAS. Attitudes toward euthanasia are influenced by religious factors.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Clinical Competence*
  • Euthanasia, Active / legislation & jurisprudence
  • Euthanasia, Active / psychology
  • Euthanasia, Passive / legislation & jurisprudence
  • Euthanasia, Passive / psychology
  • Female
  • General Surgery
  • Humans
  • Internal Medicine
  • Israel
  • Male
  • Medical Oncology
  • Middle Aged
  • Multivariate Analysis
  • Patient Rights / legislation & jurisprudence*
  • Pediatrics
  • Personal Autonomy*
  • Principal Component Analysis
  • Religion and Medicine*
  • Suicide, Assisted / legislation & jurisprudence
  • Suicide, Assisted / psychology
  • Surveys and Questionnaires
  • Terminal Care / legislation & jurisprudence*
  • Terminal Care / psychology
  • Withholding Treatment