Values underlying end-of-life decisions: a qualitative approach.

The purpose of the study discussed in this article was to reveal the values that would receive priority attention when considering end-of-life decisions. Nineteen elderly Israelis and their 28 family members participated in individual interviews that were analyzed using a hermeneutic phenomenological method. Analysis of the transcripts indicated that participants considered a unique set of value priorities that raised different considerations in each off our domains of life: physical-biological, social-psychological, familial, and societal. Three transcendent values crossed all four life domains: dignity, quality of life, and quality of death. These value considerations are useful information for social workers who consult patients and family members at times of end-of-life decisions.

The good death: reaching an inductive understanding.

The study examines descriptions by twenty-six elderly Israelis of a good death. The transcripts of personal interviews were analyzed using phenomenological methods to determine general and essential essences of the good death phenomenon. The good death was perceived as a multidimensional phenomenon based on eighteen general essences that were condensed into five essential essences that included the physiological, personal, interpersonal, social and cultural domains of life. The good death description further involved a critical component toward the ways in which death and dying are currently occurring in Israel. The research results call for Israeli policy-makers to more forcefully acknowledge and accommodate the different secular perspectives of the good death into law and to allow individuals more freedom and control over the dying processes and rituals following one's death.

Meanings and attitudes toward end-of-life preferences in Israel.

Thirty-six elderly people in Israel were interviewed concerning their meanings and attitudes toward end-of-life preferences. The phenomenological analysis method resulted in the identification of six meaning themes and a continuum of favorable to unfavorable attitude positions for each meaning theme. The combination of meaning themes and attitude positions produced 4 patterns of perspectives toward euthanasia, as well as a more holistic and integrative cultural dimension that was labeled Israel ego integrity. The 6 meaning themes were (a) moral perspectives, (b) religious beliefs, (c) mental and physical suffering, (d) family and community implications, (e) gaining control by willingness to trust others, and (f) previous experiences with death. The 4 patterns of perspectives toward euthanasia emphasized consequences for others, religious perspectives, concerns for personal suffering, and concerns for moral choice. The extensive diversity in the meaning-attitude perspectives from a small sample of elderly people suggested challenges for Israeli policy in regard to legalizing the living will to respect patients' rights to make end-of-life decisions.

Holocaust survivors' perspectives on the euthanasia debate.

The paper reports on a qualitative analysis of 15 personal interviews with holocaust survivors in Israel concerning their perceptions of similarities and differences between socially-assisted dying and the holocaust policies. The design of the study was exploratory/descriptive and asked the following questions: "Some discussions have expressed similarities between Nazi Germany and euthanasia. Do you believe the comparison is justified? In what ways are euthanasia and the holocaust similar? In what ways are they different?" Participants concluded that profound differences existed between Nazi Germany and socially assisted dying. These differences were established from four different perspectives in 10 different themes, and demonstrated by 24 different examples of the themes. Informants further cautioned philosophers about comparisons between the holocaust and other human behaviors. The survivors perceived that such a comparison has negative consequences for their own well-being, the dignity of their family members, the next generation and the Israeli society.