Designing Medical law in a Multicultural Society: The case of Israeli end-of-life laws

Background: Designing public health policy is one of the challenges that have accompanied the State of Israel throughout its existence. Taking into account the democratic and Jewish aspects of the State of Israel and the nature of Israeli society–multi-ethnic, multicultural, and pluralistic–presents a great challenge in shaping public health policy. These challenges become even greater when within the Jewish internal discourse there are intense controversies regarding many medical issues. This paper aims to characterize the nature of this challenge, then to present two legislative models intended to cope with the multicultural challenge: the uniform law model and the legal pluralism model. Methodology: The paper examines these models based on two test cases of Israeli health legislation: The Israeli Dying Patient Act (2005) and the Israeli Brain Respiratory Death Act (2008). Both these acts were intended to regulate healthcare policy issues that have been highly contentious in Israeli society, with heated debate between religious-conservative and liberal factions. While both laws were intended to cope with the multi-cultural challenge which characterizes Israeli society, they attempt to do so in different ways, one by creating a uniform law that establishes a compromise between opposing positions, the other by a legal pluralism approach that recognizes the different positions within the legal framework. Discussion and conclusion: The paper will analyze the advantages and drawbacks of the two models, concluding with an argument in favor of the legal pluralism approach as an instrument for promoting a multi-cultural public policy.