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עמוד בית
Thu, 21.11.24

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February 2024
Shani Ben Shetrit LLB LLM MA, Jamal Daghash MD, Daniel Sperling SJD BA (Philosophy)

In recent years, we have been experiencing a technological revolution, which signifies an ethical and societal transformation. Artificial intelligence (AI) based technologies have gradually permeated all aspects of life and solidified their position. Within this context, the emergence of these technologies offers new opportunities in the medical field, including palliative care, which is aimed at alleviating suffering and improving the quality of life for terminally ill patients and their families. In Israel, the Dying Patient Act of 2005 (the law), which promotes values such as the sanctity of life and individual autonomy, allows terminally ill patients to determine their preferred treatment, and withhold life-saving treatment under certain circumstances. The law represents a significant step toward improving care for terminally ill patients, reducing pain and suffering, and respecting the patient's wishes and worldviews in their final days. However, the practical implementation of the law has encountered numerous challenges, ranging from lack of familiarity among doctors and healthcare professionals and the requirement to determining life expectancy to fulfilling the law's purpose. These challenges are associated with ethical, cultural, and religious perspectives. In this article, we describe how AI-based technologies hold immense potential in applying the law and providing palliative care based on their predictive capabilities, prognostic accuracy, and optimization of treatment as well as communication between patients and healthcare providers. However, as an innovative, developing, and complex technology, it is crucial not to overlook the ethical, societal, and legal challenges inherent in implementing and using AI-based technologies in the context of palliative care.

March 2007
M. Gordon
Cardiopulmonary resuscitation is an emotion-ridden issue that often leads to conflicts when crucial decisions have to be made. The purported benefits of this 40 year old procedure in the frail elderly have been scrutinized, establishing its lack of efficacy. A review of the medical, ethics and halakhic* literature on the potential merits of CPR[1] in the frail elderly revealed that in secular medical practice, CPR is often routinely provided to elderly frail individuals for whom its clinical benefit is questionable. For patients suffering from dementia, surrogates are usually responsible for decision making, which complicates the process. With such poor clinical outcomes, the halakhic interpretation of what steps should be taken, and currently are, may not be valid and CPR may be applied too frequently. When clinical ambiguity is combined with strong cultural and religious influences, an acceptable CPR/DNR (Do Not Resuscitate) approach to cardiac arrest can be daunting. A clinically responsible, ethically sound and religiously sensitive approach to CPR requires a deep understanding of the factors involved in decision making. It seems timely for the halakhic interpretation of the duty to provide CPR in the frail elderly to be reevaluated. Perhaps a more humane and halakhically sound approach might be reached by stringently limiting CPR to clinically unusual circumstances rather than the common practice of providing frail Jewish elders with CPR in the absence of a DNR order.





* Pertaining to Halakha, the corpus of Jewish law


[1] CPR = cardiopulmonary resuscitation


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