How to join
Joining the therapeutic process in Hospice is done via the Medical Funds (The Hospice of the
Upper Galilee is connected to Clalit and Maccabi). The process commences in the patient’s
clinic. Once the family physician is convinced that there is a need for palliative care, he/she
make their recommendation to the Medical Fund which then examines the case and may
refer the patient to the Hospice. Once the Hospice of the Upper Galilee receives the referral,
they contact the patient and begin the in-take process.
Palliative Care
The care is given at the patient’s home. The first visit will be a doctor and a nurse; this visit
takes approximately two hours, during which all the information is gathered about the
condition, the family and its way of coping with the changes. Then, a plan is provided, as well
as a letter to the family doctor. During the second visit, the hospice team will arrive with a
social worker. Based on the patient’s condition and the stage of the illness, other
therapeutic aspects will be included, such as: psychology, art therapy, music therapy and
more. The Hospice team will continue to visit weekly, but are always available by phone
24/7. In emergency cases, a medical team member will visit the patient at night or on
weekends.
During the years, the Hospice has been recognized and awarded for its activity, such awards
included: Yakir HaGalil award in 2012; Israel Cancer Association for excellence in special care
for cancer patients; Macmillan Prize in England for teamwork in Palliative care; Knesset Chairman award for the Hospice founder, Prof. Nancy aroline (RIP) who, after her passing,
was awarded the proffesor Medal of Honor, by the Israel Association of Medicine
and Law; same award was also given to the current Chief Medical Officer of the Hospice in
2015, the Hospice was honored by the Ometz Association for contribution to the
community.
The Dying Patient Law
In December 2005, the “Dying Patient Law” was enacted in the Knesset (Israeli Parliament), with the purpose ‘to regulate the medical treatment of the dying patient, while balancing the value of the sanctity of life with the value of the individual’s autonomy and the importance of quality of life’ (section 1A of the Law). The law includes the right to request medical treatment, avoid medical treatment and discontinue treatment if such has already begun. The Patient’s Rights Law determines that medical treatment should not be given unless the patient has given their consent.
The consent can be given only after the medical professional has given the patient all the information required to make a decision. With that, this law doesn’t include specific instruction regarding the validity of a refusal to a treatment, that might lead to a patient’s death, in cases where the patient cannot clearly express their opinion.
The Dying Patient Law expands on the right to refuse or accept a treatment, by allowing the patient express their preferences to treatment in advance, if and when it is determined that patient is dying. The doctors will rely on the instructions previously provided only if the patient can no longer decide, or express, their wishes. In other words, the law allows someone to provide instructions even when healthy; those would be used by the medical team in case the patient is unable to decide, or express, their own decisions regarding treatment.
By law, the dying patient has a right to refuse, or request medical treatment to prolong his her life, even if the doctor doesn’t see justification either way; the doctor is still under obligation to accept the dying patient’s wishes, within legal restrictions, and after the patient’s wishes have been proven beyond reasonable doubt. However, the law doesn’t permit all actions and treatment avoidance, rather it has reservations. The law states that deciding on such matters would only be acceptable by the patient’s wishes, and not by their families or other considerations. The desire of the patient can be proven in different ways, with the best one being written instructions left by the patient. Another way acceptable by the law, is Power of Attorney; in these cases, the doctors must accept the POA instructions as if they were the patient’s own.
You can read about the Dying Patient Law here.
What is Power of Attorney?
Medical Power of Attorney is a person’s best way to ensure their wishes regarding their treatment is heard even if they cannot express them themselves. According to the Dying Patient Law, every patient can assign a person that will be allowed to make all medical decisions for that patient. The agent (the one authorized to act on another’s behalf), acts as a sort of messenger, and is obligated to be loyal and truthful to the patient. The patient alone can decide who will receive Power of Attorney. The authorizing party must detail the circumstances and conditions in which the agent would be allowed to decide on treatment, examination, nursing or rehabilitation. It’s possible to authorize several people to be have POA.
Signing such an agreement must be done in front of professionals who are able to identify both sides, such as: doctor, psychologist, social worker, nurse, lawyer etc. It’s recommended to have at least 5-6 original copies (an original must be used in every medical procedure); the patient can determine an end date to the POA agreement. Regardless, the agreement is not permanent and, unless used, will be invalid within 10 years, unless stated otherwise.
Click here to download a Medical Power of Attorney form.
Other links:
Israel Cancer Association
National Insurance Institute of Israel
