Posted on November 3, 2019 at 2:54 PM
The Israeli Medical Association recently issued a new position paper titled “Medical Ethics and the Treatment of Patients with Incurable Diseases and Useless Treatments.” (Note that this is my translation.)
The ethics committee decided on nine guiding principles:
- The physician and the patient in an incurable disease will discuss the patient’s aspirations and expectations from the treatment, against realistic medical capabilities and set the treatment goals.
- The physician will consider and decide on the most appropriate clarification and treatment for the patient, according to up-to-date guidelines in medical expertise, professional knowledge and experience as a physician. Will consider benefits against unwanted side effects. Continuing ineffective and futile treatment can harm the patient and even shorten his life.
- The physician will involve the patient and the significant lenders in the patient’s eyes with the medical data, as soon as possible, to enable understanding, adaptation to the situation and correct patient decision-making.
- The physician will avoid concealing or beautifying the condition and the absence of curative treatment in order to preserve the patient’s autonomy.
- The physician will be aware of his or her own personal values, and ascertain what the patient’s values are. Any action or failure to be aware of these considerations when making decisions about patients with ill-incurable diseases.
- The physician will identify in his work environment professional factors from various fields for regular consultations. Consultation is especially important when there is a discrepancy between professional considerations, patient requests and personal values of the physician.
- The physician will strive to make principled decisions about treating the incurable disease so that it will be accepted, in advance, by the patient and his / her caregivers, when there is still time for thought, before hospitalization.
- The childcare physician, his loyalty should be first and foremost for the benefit of the child. At the same time, the parents are the caregivers responsible for the child and it is important to treat their suffering with extreme sensitivity, (in exceptional situations where the doctor fears that the guardians are not serving the minor’s good, legal measures must be taken).
- The physician will refer to treatment that improves quality of life when the other treatment is futile, (palliative care required in various situation