Document Detail


Reclaiming the patient's voice and spirit in dying: an insight from Israel.
MedLine Citation:
PMID:  20136822     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the latter half of the 20th century, Western medicine moved death from the home to the hospital. As a result, the process of dying seems to have lost its spiritual dimension, and become a matter of prolonging material life by means of medical technology. The novel quandaries that arose led in turn to medico-legal regulation. This paper describes the recent regulation of dying in Israel under its Dying Patient Law, 2005. The Law recognizes advance directives in principle, but limits their effect and form through complex medico-legal artifices. It reflects a culture that places high value on both scientific medicine and the sanctity of life as such, and illustrates a medical culture that pitches battle against death. At the same time, the Law constructs the will of the individual in a medico-legal language that is alien to the lay person. The paper suggests an alternative approach to advance care planning that is patient-centred and addresses the psycho-social needs of the individual in terms of her relational autonomy. From this perspective, advance care planning becomes an opportunity to extract the patient from the medical context and allow her to speak about her approaching death with close ones in her own terms of reference. To this end, there is a need for facilitation of an intimate encounter where patients can speak about their concerns with their loved ones. The paper also presents a methodological approach of attentive listening, which can be applied across diverse cultures and circumstances.
Authors:
Carmel Shalev
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bioethics     Volume:  24     ISSN:  1467-8519     ISO Abbreviation:  Bioethics     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-08     Completed Date:  2010-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704792     Medline TA:  Bioethics     Country:  England    
Other Details:
Languages:  eng     Pagination:  134-44     Citation Subset:  E; IM    
Affiliation:
Department of Reproduction and Society at the International Center for Health, Law and Ethics, Haifa University, Tel Aviv, Israel. cshalev@012.net.il
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MeSH Terms
Descriptor/Qualifier:
Advance Directives* / legislation & jurisprudence
Cultural Characteristics
Euthanasia, Passive
Female
Humans
Infant
Israel
Jews*
Patient-Centered Care*
Personal Autonomy
Professional-Patient Relations*
Right to Die
Tay-Sachs Disease
Terminal Care* / legislation & jurisprudence

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