Abstract

The new Israeli Dying Patient Act is based on principles and processes that have achieved a wide consensus despite the fact that it is a very complex and emotionally loaded issue. It provides clear balancing approaches between opposing values as well as explicit mechanisms for issues that were previously not provided for in Israel or were unclear. These include mechanisms for providing autonomous patient decision making when incompetent in “real time”, with legally binding advance medical directives. These include methods of verifying the real and informed wishes of the patient or the appointment of a surrogate decision maker, a national registry of advance medical directives to optimize the validity of these wishes, legally binding palliative care as a citizen’s right, clear guidelines for physicians to know what is permitted and what is not in treating terminally ill patients, the appointment of a senior physician with clear directives of his or her responsibilities toward the dying patient, and dispute resolution including the innovative establishment of a National Ethics Committee composed of experts in all relevant fields.