Behavior, attitudes, and expectations regarding the use of life-sustaining treatments among physicians in Israel: An exploratory study

The use of life-sustaining treatments (LST) for prolonging lives of terminally ill patients without being able to improve the quality of life is a source of ethical, medical, economic and legal dilemmas for physicians. Although physicians in all Western countries face these dilemmas, they are unique in each society due to the special combination of its dominant religion, and its priorities regarding social values and legislation. This paper presents opinions, attitudes, expectations and behavior regarding the use of LST among 25 physicians attached to one teaching hospital in Israel. The data, which was collected by in-depth, semi-structured interviews, indicate that all of the physicians agree that life does not always have to be artificially prolonged. The general message that the physicians conveyed was that they deal quite effectively with these issues. They are not at all bothered by economic considerations and found ways to deal with the legal, ethical and medical dilemmas. It is suggested that in Israel the core issue is not the current law, but lack of communication among physicians and between physicians and patients/families. The relevance of the dominant model of the doctor-patient relationship and applications for medical education and practice are discussed. A list of hypotheses derived from this exploratory study for future intra-societal and inter-societal research is presented.