The Terminally Ill Patient Law requires large hospitals and other medical institutions to appoint an institutional committee.
- The purpose of this committee is to make a decision whenever there is a disagreement or doubt regarding implementation of The Terminally Ill Patient Law.
- The discussion of the committee eliminates the need for complex legal processes, and enables decisions to be made in an inter-disciplinary forum which is more suited to the matters at hand.
- Institutional committee decisions may be appealed to the National Committee for Decisions Regarding the Terminally Ill.
Composition of the Committee
- Every committee must have the following members:
- 4 medical specialists from the specific fields defined in the law
- 1 certified nurse
- 1 social worker or clinical psychologist
- 1 ethicist or philosopher (from academia)
- 1 jurist
- 1 clergyman - from the patient's faith, when at all possible
Cases for a Committee
- The institutional committee may be petitioned in cases such as the following:
- In order to appeal a decision the "presiding physician" has made relating to the law (for example if the patient is terminally ill, decisions regarding a terminally ill patient's competence to make medical decisions; who can be considered to have a close familial or emotional connection with a terminally ill patient; what a terminally ill patient's will is, etc.).
- When it cannot be clearly determined what a terminally ill patient's wishes as expressed in a living will are, or when instructions do not fit the current circumstances.
- When there is a lack of clarity regarding conflicting or different instructions a terminally ill patient has given.
- When there is concern that the proxy given power of attorney is not acting according to a terminally ill patient's wishes, or there is a conflict of interest. (In this case the committee can determine what the right treatment it is for the terminally ill patient or decide to nullify the power of attorney.)
- When there is a dispute regarding the treatment of a terminally ill minor or ward.
Who May Submit a Petition to a Committee?
- Any of the following people may petition an institutional committee:
- A terminally ill patient or authorized representative.
- A terminally ill patient's proxy who has been given power of attorney.
- Someone close to or the legal guardian of a terminally ill patient who is legally incompetent.
- Someone from the treating medical staff at the medical facility where a terminally ill patient is being treated
- The personal doctor of a terminally ill patient
- A social worker
Stages of the Process
Petitioning a Committee
- Institutional committees must be petitioned in writing and the following details must be included:
- Name of the institution in which the patient is hospitalized (if relevant), and the name of the care provider
- Name of the responsible physician according to the Terminally Ill Patient Law
- Name of the patient
- Name of the petitioner: Care providers must indicate their position; those who are not a care provider must provide name, national identification (teudat zehut) number, place of residence and address where a written response may be received
- Important facts related to the petition
- The petitioner's interest with regard to the committee decision
- The petitioner's relationship to the patient
- The patient's religion
- All facts should be explained to the greatest extent possible and relevant documentation should be attached to all petitions.
- All petitions must be sent to the director of the medical institution in which the committee operates.
Convening of a Committee
- An institutional committee will convene as soon as possible after receiving a petition, and in all cases quickly enough to guarantee that a decision is made in time to still be relevant.
- A committee must provide a decision within 10 days of receiving a petition.
- If the committee chair determines a petition to be urgent, the committee must decide on it within 48 hours.
- The committee's decision must be provided to the petitioner in writing, and it must be reasoned unless the committee has decided not to explain the decision for special reasons which must be recorded.
Reconsideration and Appeals
- Even after a committee decision has been issued, if there has been a change in the circumstances of the case, it is possible to petition the committee again to request that it reconsider the case.
- Institutional committee decisions may also be appealed to the National Committee for Decisions Regarding the Terminally Ill.