Thursday, August 29, 2002

Follow up on Terminal Patient bill.
Professor Mordechai Ravid, director of the internal medicine ward at Meir Hospital, Kfar Sava, claims, in today’s Haaretz, that the Steinberg committee, appointed by former health minister Shlomo Benizri to legislate guidelines on the medical approach to a dying patient, determined principles that do not add to existing laws, but just complicated matters. To base this claim he complains that the Steinberg committee was made up of dozens of members who were split into four sub-committees. He contrasts this with the committee that dealt with reforms in the health services and headed by Judge Shoshana Netanyahu that consisted of just four members. I’m glad he mentioned this, because now I know why the health services reform was such a mess! The reform was, and remains, extremely unpopular. While the new health system substantially improves the situation of the very poor and the very sick, it seems to me that the great majority of the population pay a great deal more for their health services and receive a great deal less. For instance, I had my first child before the new system was initiated and my second child after. The result was that many of the routine pregnancy checkups that I was entitled to during my first pregnancy through my sick fund, I had to pay for privately, during my second. I was fortunate enough to be able to afford this (just about), but this is surely not the case for most women. Does this not raise the likelihood of babies being born with avoidable deficiencies? What does this mean for the future health of our population?

But the article is not about that. Professor Ravid makes some interesting remarks about the difference, morally, (if any) between active euthanasia or assisted suicide and refraining from giving life support treatment, in accordance with a patient’s wishes. He maintains that the innovative idea of a timing machine that will periodically stop a respirator and allow a doctor to refrain from turning it on again (you may remember my writing about this, a few days ago) is an absurd attempt at forcing religious values on secular patients. This is all very well, but we’re not living in a perfect world and I view this idea as a realistic solution to a political difficulty.

“The main issue the committee should have dealt with” he goes on to say, ”is living wills. It is necessary to establish rules regulating on what terms such a will is valid and how it should be phrased, what restrictions must be taken into consideration in implementing it and most important, for how long it is valid. A healthy person writing a will like this is not equipped to know how he will feel when ill. If an agreed document of principles could be put together on this issue, that would suffice”.