Abstract

This dissertation is an ethnographic study of how end-of-life decisions are made in Jerusalem, Israel. The primary focus of my study is what factors have the greatest influence on how these decisions are made. What cultural beliefs and values are involved, and how did they come to be internalized? What are the religious and social influences that affect the decision-making process? What happens when there are overlapping, and even contradictory, spheres of influence? What role does the influence of history, or people's perceptions of history, play in making end-of-life decisions? These are the main issues that are addressed in this study. ;The principal method of investigation was an intensive case study approach. The aim was to conduct long-term, in-depth studies of a small number of cases involving individuals who were in the process of making end-of-life decisions. This dissertation is organized around six of these cases that best exemplify the types of issues that arose during the course of this research. ;The presentation and analysis of the cases are followed by a consideration of several patterns that emerge which help to explain how Israelis view end-of-life decisions and how these decisions are made: a general agreement that religion should be allowed to play some role in the decision-making process but much confusion and ambivalence over exactly what role it should be allowed to play; a tension between making decisions based purely on the medical evidence and allowing one's emotions to enter into the decision-making process, giving great leeway to allowing feelings and emotional attachments to a patient to dominate the process; a commonly held belief that one should never give up hope, regardless of the hopelessness of the situation; and a general reluctance to establish or follow rules or routines. This is followed by an analysis of how and why these patterns developed and what implications we can derive from them