(Issur Tipul) are legally binding instructions prepared under Israel's Dying Patient Law (2005) in which a competent person specifies which medical interventions they accept or refuse in terminal or irreversible conditions. Directives filed with the Ministry of Health registry are binding on treating physicians and take precedence over decisions by an attorney-in-fact or family members. The Law Office of Adv. & CPA Shoshi Arbib prepares advance medical directives as part of comprehensive long-term care and estate planning for clients in Israel.
What Is an Advance Directive in Israel?
Advance directives (Hanchayot Mekadimat) are written instructions that specify a person's wishes regarding medical treatment in the event they can no longer communicate those wishes themselves. In Israel, they are governed by the Dying Patient Law (2005) and allow individuals to consent to or refuse specific medical interventions in advance.
What Can Be Addressed
- Consent to or refusal of specific life-sustaining interventions (ventilation, CPR, tube feeding).
- Conditions under which you wish treatment continued or withdrawn.
- Appointment of a healthcare proxy authorised to make decisions on your behalf.
- Pain management preferences and comfort care instructions.
Interaction with an LPA
An Israeli Lasting Power of Attorney can also include healthcare instructions and appoint an attorney-in-fact for medical decisions. The relationship between an LPA and a separate Advance Directive document must be clearly established — ideally both documents reference each other and are consistent. In case of conflict, the more specific instruction generally prevails.
Is an advance directive legally binding on doctors in Israel?
Yes — the Dying Patient Law (2005) gives advance directives legal binding effect on medical staff in Israel, within the law's scope. A physician cannot provide treatment explicitly refused in a valid advance directive. However, the law has specific procedural requirements: the directive must be in writing, signed, witnessed, and either registered with the Health Ministry or submitted to the treating hospital. Directives that do not meet these requirements may not be enforceable.
What is interaction with an lpa?
An Israeli Lasting Power of Attorney can also include healthcare instructions and appoint an attorney-in-fact for medical decisions. The relationship between an LPA and a separate Advance Directive document must be clearly established — ideally both documents reference each other and are consistent. In case of conflict, the more specific instruction generally prevails.
Official References: Israel Ministry of Justice — POA · Israel Ministry of Justice · National Insurance Institute of Israel · Israeli Courts Administration · Israel Land Authority
Steps to Drafting Advance Medical Directives
- Understand the difference between documents — Advance directives address end-of-life medical treatment; an expression-of-wishes document covers broader life preferences — both complement each other.
- Consult and draft — Define specific instructions on resuscitation, life-prolonging treatment, pain management, and appoint a healthcare proxy — with an elder-law attorney.
- Witnesses and signature — Sign in front of two independent witnesses who are not family members and not beneficiaries, as required under the Dying Patient Act.
- Distribute to relevant parties — Provide copies to the treating physician, hospital, chosen family member, and the Ministry of Health Central Registry.
Shoshi Arbib Law Office — Attorney | CPA | Mediator, Netanya, Israel.
