A new circular of the medical division of the Ministry of Health directs the hospitals treating cancer patients, including the private hospitals, to regularly, personally and multidisciplinary discuss almost every one of these patients. The discussion will be held in multidisciplinary meetings of experts from different fields, where all therapeutic alternatives will be considered and the appropriate treatment path will be chosen for each and every patient. This is what she reported yesterday (Sunday) Ronnie Linder In “The Marker”.
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According to the circular, at least an oncologist, a surgeon, a radiologist, a pathologist and other doctors in the relevant field, for example specialists in gastroenterology, pulmonary medicine, anesthesiologists, etc., must participate in each meeting. In addition, the circular recommends, but does not require, to include in the discussion a rehabilitation doctor and professionals in the health professions, as well as psychologists and social workers.
The directive to hold such a multi-participant discussion applies to all patients who have different therapeutic alternatives. That is, patients who have several treatment options from different areas of specialization. For example, different combinations of surgeries, chemical treatments or radiation treatments at different times, the choice of which and their correct timing may improve the treatment result.
Most cancer patients are included in this category, including pancreatic cancer, rectal cancer, stomach or esophagus cancer, HER2 positive or triple negative breast cancer patients and more. Regarding patients whose course of treatment for their disease is clear and unequivocal, the circular leaves the decision to hold the meeting to the discretion of the staff, but notes that “it is appropriate that every patient suffering from an oncological disease be presented at a multidisciplinary meeting.”
The circular states that all meetings will be documented, including noting the positions of the participants on the various alternatives and the summary of the discussion. The patient and his family will take into their own hands the decisions and the alternatives discussed. In case of disagreement between the meeting participants regarding the preferred therapeutic approach – the disagreement will be presented to the patient while explaining the reasons for it and presenting the alternatives that came up in the discussion.
According to Dr. Hagar Mizrahi, head of the medical division at the Ministry of Health, which signed the new circular, “It is true that there are accepted protocols for the treatment of cancer, but many times there are disputes and updates and new knowledge that accumulates. In addition, there is always a certain percentage of patients who need to be adjusted to a slightly different treatment from the standard protocol according to their personal medical condition, and this is the event where all the therapeutic aspects are heard.”
The new circular was not enacted in primary legislation or regulations, so it is not yet a legal obligation, but rather a directive from the Ministry of Health to the hospitals. However, the circular is detailed and reasoned and based on lengthy professional discussions, and actually determines what a reasonable action is, that is, how the “reasonable doctor” and the reasonable medical institution should act in the case of treating cancer patients who have several alternatives for treating them. Therefore, from the moment the circular is published, it will be possible to stage a violation of it, such as not having a multi-participant discussion, also in medical malpractice claims.