J Med Ethics 30:353-357 doi:10.1136/jme.2002.000885
  • End of life

Is the clock ticking for terminally ill patients in Israel? Preliminary comment on a proposal for a bill of rights for the terminally ill

  1. Y M Barilan
  1. Correspondence to:
 Y Michael Barilan MD, MA
 Dept. Medicine B, Meir Hospital, Kfar Saba, Israel;
  • Received 28 October 2002
  • Accepted 24 January 2003
  • Revised 6 November 2002


This paper presents and discusses a recent Israeli proposal to legislate on the rights of the dying patient. A gap exists between elitist biases of the committee proposing the law, and popular values and sentiments. The proposed law divides the dying patients into two groups: “those who wish to go on living” and “those who wish to die”. The former will have a right to life prolonging extraordinary care. It is not clear who would foot the bill for this care. Also it is hard to see how this munificence could fail to discriminate against all other patients. Both the secular ethicists and the rabbis involved in drawing up the proposal accepted the assumption that it is good for some terminal patients to die. The rabbis objected, however, to direct and active interventions that shorten life. The solution arrived at was to install timers in the ventilators so as to allow them to expire automatically unless the patient wishes for their resetting.


  • The Steinberg report fails to credit Dr Meir and Rabbi Sternbuch for the idea. I do not know why the clock ventilators never materialised. Contemporary legislation had better take lessons from the past. As a matter of fact, according to Waldenberg’s responsum there is no duty to implement artificial life support, and it is also allowed to disconnect them. He actually suggests that there might be a religious duty (mitzvah) to disconnect artificial life support when the patient is suffering. Many discussants of Jewish bioethics who elaborate on other responsa by Waldenberg, ignore this responsum. See—for example: Zohar, Rosner, Sherwin, Dorff, Pellegrino and A I Faden, and Resnicoff.11–16