The Health-Care Team and Culture in an Israeli Cancer Center, Israel

Health care decisions are significantly influenced by individual and cultural factors. There is no universal agreement on how to make health care decisions. This chapter describes the impact of Israeli culture and faith on decision making in a comprehensive cancer center. Israel’s demographics include several large cultural and religious groups. Topics of analysis include the process of making decisions; the value of life; definition of “dying”; rabbinical medical brokers; withdrawal of treatment; minimal medical care for the dying; cultural paternalism; and what in Israel constitutes the ethical unit. Clinical cases illustrate principles. The chapter also looks at practical ways of improving the decision-making process by documenting the culture of the health care team, minimizing bias, and determining the wishes of the individual patient in the context of their subculture.