(photo credit: Channel 2)
A law aimed at allowing the terminally ill who wish to die to do so in dignity without being forced to be kept alive by artificial means will take effect very soon, now that the Knesset Labor, Social Affairs and Health Committee has passed the relevant regulations.
The law - seven years in the making - was passed on its third and final reading by the Knesset plenum in a 22-to-three vote at the end of 2005. Implementation had to wait until regulations setting down exactly how it will work in the field were prepared by the Health Ministry and, on Wednesday, approved by the committee; the law will take effect as soon as the regulations are published in the government's Gazette (Reshumot).
The legislation has been described as one of the most complicated and important ever passed by the Knesset.
A delayed-response timer built into a patient's respirator will be the main solution to the problem of how to let the terminally ill have control over how they die.
The recommendations that formed the basis for the bill were prepared by a 58-member public committee of physicians, scientists, medical ethicists, social workers, philosophers, nurses, lawyers, judges and clergymen representing the main religions in Israel. The panel, which met for two years, was headed by Prof. Avraham Steinberg, an Orthodox rabbi, pediatric neurologist, medical ethicist and winner of the Israel Prize for his encyclopedic work on Jewish medical ethics.
The regulations include registration of living wills and giving a power of attorney to another person to decide for the patient when he is unable to himself. In addition, a national database for this information will be set up, along with means for doctors to determine whether the patient wanted his life to be extended artificially.
If requested in a living will, renewable every five years, or by a person chosen to decide on his behalf, a terminally ill patient who is over the age of 17 may ask that his life not be extended by artificial means.
The withholding of nutrition, and active euthanasia, would not be permitted because they violate Halacha, but the legislation will allow for ongoing support to be halted using the timer device. No longer will families have to turn to the courts for permission to halt artificial measures that keep terminal patients alive against their will.
The timer - based on the idea of the Shabbat clock used in religious Jewish homes to turn electrical devices on and off on Shabbat and festivals - would operate for 24 hours at a time and set off a red light or an alarm after 12 hours as a reminder to reset it. The patient or his representative could at any time request an extension, but if the dying person is determined not to have his life extended, the timer would turn off the respirator at the end of the cycle.
Hospital ethics committees will become statutory committees, rather than voluntary ones without legal status, and palliative care to reduce pain will be an integral part of the process. A national ethics panel will hear appeals in special cases, so lower courts would not have to intervene at all.