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 te rminally ill patients without being able to improve the quality of lif e is a source of ethical, medical, economic and legal dilemmas for phy sicians. Although physicians in all Western countries face these dilem mas, 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 an d behavior regarding the use of LST among 25 physicians attached to on e teaching hospital in Israel. The data, which was collected by in-dep th, semi-structured interviews, indicate that all of the physicians ag ree that life does not always have to be artificially prolonged. The g eneral message that the physicians conveyed was that they deal quite e ffectively with these issues. They are not at all bothered by economic considerations and found ways to deal with the legal, ethical and med ical dilemmas. It is suggested that in Israel the core issue is not th e 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 educat ion and practice are discussed. A list of hypotheses derived from this exploratory study for future intra-societal and inter-societal resear ch is presented. Copyright (C) 1996 Elsevier Science Ltd