Assisted life termination and truth telling to terminally ill patients – a cross-sectional study of public opinions in Israel

• Published in: Israel journal of health policy research 2020-10, Vol.9 (1), p.1-57, Article 57
• Main Authors: Bodas, Moran, Velan, Baruch, Kaplan, Giora, Ziv, Arnona, Rubin, Carmit, Peleg, Kobi
• Format: Article
• Language: English
• Subjects: Assisted suicide; Attitudes; Autonomy; Care and treatment; Caregivers; Catalysts; Cross-sectional studies; Death; Decisions; Doctor-assisted-death; End of life; Ethical aspects; Ethical standards; Ethics; Euthanasia; Mortality; Original; Palliative care; Patients; Perceptions; Physician-patient relations; Physicians; Public opinion surveys; Social aspects; Sociodemographics; Surveys; Terminally ill persons; Truth-telling
• ISSN: 2045-4015; 2045-4015
• DOI: 10.1186/s13584-020-00419-9

Background End-of-life decisions are highly complex socio-normative and ethical phenomena. The goal of this study was to provide an assessment of public opinions in Israel concerning aspects of end-of-life decisions. Methods An online cross sectional study was performed in February 2020. The primary tool including items pertaining to death assistance and truth telling to patients. A sample of 515 participants representative of the adult Israeli population was obtained. Results The majority of participants (71%) supports telling the entire truth to patients even in harsh conditions. Support for truth telling decreases with affiliation to religion, with as little as 40% support among ultra-orthodox. People with vocational education are the least supportive of truth telling. Concerning doctor assisted death, almost half (49%) of the sample were supportive. Opposition is positively associated with religiosity, with 90% of ultra-orthodox and 58% of religious participants opposing doctor-assisted death, compared to only 18% among seculars. Non-Jews were 3.35 times (95%CI: 1.90, 5.91) more likely to oppose doctor assisted death than Jews (p < .0001). An Interrelationship analysis crossing between attitudes revealed that the largest group (39%) was comprised of participants who support both ("autonomists"). Conclusions Israelis are overwhelmingly supportive of truth telling to patients. In contrast, Israeli public opinions on doctor assisted death are divided. For both attitudes, religiousness plays a crucial role as a catalyst for conservatism and opposition to change. Almost a half of the public is also supportive of an autonomist approach that would allow patients to decide on ending their own lives. Keywords: End-of-life, Doctor-assisted-death, Truth-telling, Autonomy