Harefuah
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The provision of care for the dying patient confronts the caring team with very complex ethical dilemmas that doctors have no "medical" means to manage. Such decisions should be made according to the patient's will and preferences reflecting the value of life and the quality of life. However, many patients are not competent at this stage to decide or to express their wishes. ⋯ One resolution is the requirement that an explanation of the relevant medical information be given by a doctor or a nurse to the person who wishes to prepare written advance directives. This article suggests that the required explanation should be given within the framework of a discussion that simulates a process of informed consent for an unknown scenario at the end-of-life. Such discussions should be conducted as a dialogue, in which the doctor, first and foremost, Listens to the patient in order to clarify his/her worries and wishes, according to which specific medical orders can then be formulated.
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In this article the authors review the history of ophthalmology in the Holy Land in the era spanning from 1948 till nowadays. Although there is material concerning ophthalmology in the Holy Land, it is not well organized. ⋯ In this review the authors strived to present a view of ophthalmology in the Holy Land in its first steps. Moreover, the authors presented the latest developments in eye health care in local eye departments.
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Accurate clinical reports of in vitro fertilization cycle rank (IVF-CR] are important because of their predictive value of treatment success--clinical pregnancy. This parameter, therefore, facilitates decision-making on both individual and population levels. The District of Haifa and Western GaLilee currently enrolls about 700,000 insured people, and provides hundreds of IVF cycles (pick-ups and frozen-thawed) at a cost of millions of shekels each year. Hence, accurate reports of IVF cycle rank is extremely important in order to ensure that public funds are actually directed to couples who may benefit from them. ⋯ CLinicaL reports of IVF-CR are currently accurate in less than a third of the cases. It is recommended that national regulatory bodies should issue compulsory guidelines in relation to recording and reporting of IVF-CR.
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Physicians are the backbone of every medical system. Physician function and behavior have a major impact on the function and outcomes of medical systems. Physician behavior is influenced by sets of incentives that are an inherent part of the medical system. ⋯ Physician behavior is influenced by a combination of all three types of incentives and not by a single incentive. The material incentive has more influence on recruitment while the social incentive has a stronger influence on retainment and attrition reduction. This article discusses the modern physician's environment in view of incentive sets and its impact on the medical system.