title: "What the patient wants…": Lay attitudes towards end-of-life decisions in Germany and Israel.
abstract: National legislation, as well as arguments of experts, in Germany and Israel represent opposite regulatory approaches and positions in bioethical debates concerning end-of-life care. This study analyzes how these positions are mirrored in the attitudes of laypeople and influenced by the religious views and personal experiences of those affected. We qualitatively analyzed eight focus groups in Germany and Israel in which laypeople (religious, secular, affected, and non-affected) were asked to discuss similar scenarios involving the withholding or withdrawing of treatment, physician-assisted suicide, and euthanasia. In both countries, respect for patient autonomy and patients' wishes to die with dignity found broad consent. Laypeople argued in favor of accepting such wishes when they were put down in an advance directive. Laypeople in non-religious groups in both countries argued on the basis of a respect for autonomy for the possibility of euthanasia in severe cases but, at the same time, cautioned against its possible misuse. National contrast was apparent in the moral reasoning of lay respondents concerning the distinction between withholding and withdrawing treatment. The modern religious laypeople in Israel, especially, argued strongly, on the basis of the halakhic tradition, against allowing the withdrawal of treatment in accord with a patient's wish. We conclude by discussing the emergent notion of shared responsibility and views of professional responsibility, which we connect through relevant cultural themes such as religion and national culture.
authors.affiliation: Department of Medical Ethics and History of Medicine, University Medical Center Goettingen, Humboldtallee 36, 37073, Goettingen, Germany, julia.inthorn@medizin.uni-goettingen.de.
authors.forename: Julia
authors.initials: J
authors.lastname: Inthorn
authors.forename: Silke
authors.initials: S
authors.lastname: Schicktanz
authors.forename: Nitzan
authors.initials: N
authors.lastname: Rimon-Zarfaty
authors.forename: Aviad
authors.initials: A
authors.lastname: Raz
mesh_terms: D016223:Advance Directives / Q000941:ethics* / Q000331:legislation & jurisprudence; D001293:Attitude to Death / Q000208:ethnology; D002835:Christianity; D003431:Cross-Cultural Comparison; D003657:Decision Making / Q000941:ethics; D005065:Euthanasia / Q000941:ethics / Q000331:legislation & jurisprudence; D017144:Focus Groups; D005858:Germany; D006801:Humans; D007557:Israel; D007599:Judaism; D008020:Life Support Care / Q000941:ethics* / Q000331:legislation & jurisprudence; D028701:Patient Rights / Q000941:ethics* / Q000331:legislation & jurisprudence; D036301:Qualitative Research; D012068:Religion and Medicine; D017236:Suicide, Assisted / Q000941:ethics / Q000331:legislation & jurisprudence; D013727:Terminal Care / Q000941:ethics*; D028761:Withholding Treatment / Q000941:ethics / Q000331:legislation & jurisprudence