Researchers: Orna Tal ¹, Tami Karni¹

Background: All physicians are expected to base their clinical decisions on evidence-based- medicine alongside the principles of ethics. Only a few limited studies have been published in Israel examining the ethical environment of physicians.

Objectives: To outline the map of ethical perceptions of Israeli physicians, to identify consensus issues versus those that are controversial, and to compare the Israeli ethical concepts with those of other countries.

Method: 1. An online survey among all registered members of the Israel Medical Association aimed at evaluating ethical perceptions among physicians. 2,926 physicians completed the survey.
2. Two focus groups with 16 physicians were created in order to deepen the discussion on complex ethical topics raised in the survey.

Findings: Three patterns of ethical perceptions were identified in the survey: issues of high agreement; issues on which opinions were divided and issues characterized by a relatively high proportion of indecision. Physicians in both focus groups discussed values relevant to their daily medical practice (commitment, autonomy, beneficence and professional duty). Nevertheless, these same values directed physicians to a variety of pathways according to truth-telling to patients. As for the dilemma of assisting death, the participants agreed it encompasses compassion. However, its legitimacy is still struggling with barriers.

Conclusions: The ways in which physicians address ethical dilemmas seems to be dynamic. In the past, solutions were more structured and common, in accordance with principles of traditional ethics, but today one can identify controversies.

Recommendations: The understanding that certain questions are a challenge in practice leads to the need to expand the discussion on ethical issues in Israel, in particular - the patient's ability and willingness to be involved in a "patient-centered" concept.

Research end date: 04/2019