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For the first time in half a century, real transformative innovations are coming to our world of passenger transportation.The convergence of new shared mobility services with automated and electric vehicles promises to significantly reshape our lives and communities for the better--or for the worse.

Exploring the experiences, perceptions and meanings of family members and close friends of Israeli individuals who sought aid-in-dying outside Israel. Using the phenomenological-interpretive approach, a qualitative research design was employed, based on ten in-depth semi-structured interviews with Israelis who had provided support for a relative who embarked on suicide tourism. The following five themes emerged from interviews: (1) facilitators for supporting an individual requesting suicide tourism; (2) choosing death and actively making the decision to die; (3) the meaning of traveling to die; (4) offering support throughout the process; and (5) facilitating procedures after death. The participants spoke of the active role that they played in their relative's suicide-tourism journey. They conveyed conflicting emotions and values regarding the decision at hand, the ability to say goodbye thanks to their pre-planned death, helping to reduce their suffering and burden, and dealing with the challenge of disclosing the deceased's plans, before and after the act, as well as their own involvement in the process. Relatives of suicide-tourism patients should receive professional support during and following this difficult process.

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Background The COVID-19 pandemic led to an intensified fear and threat of dying, combined with dying and grieving in isolation, in turn significantly impacting nursing in end-of-life situations. The study aims (1) to understand the lived experiences of nurses who provided care to end-of-life patients during COVID-19; and (2) to explore whether providing care under such circumstances altered the perspectives of these nurses regarding end-of-life care. Methods Applying the phenomenological-interpretive qualitative approach, 34 in-depth semi-structured interviews were conducted between March 2020-May 2021 with nurses from eight hospitals in Israel who were recruited through purposive and snowball sampling. Thematic analysis was applied to identify major themes from the interviews. Results Five main themes emerged from the analysis, including: (1) a different death; (2) difficulties in caring for the body after death; (3) the need for family at end-of-life; (4) weaker enforcement of advance care directives; and (5) prolonging the dying process. Discussion During the pandemic, nurses encountered numerous cases of death and dying, while facing ethical and professional issues regarding end-of-life care. They were required to administer more aggressive care than usual and even necessary, leading to their increased moral distress. The nurses’ ethical concerns were also triggered by the requirement to wrap the corpse in black garbage-like bags to prevent contagion, which they felt was abusing the dead. The findings also demonstrate how family presence at end-of-life is important for the nursing staff as well as the patient. Finally, end-of-life situations during the pandemic in Israel were managed in an individual and personal manner, rather than as a collective mission, as seen in other countries. Conclusions The study offers insights into the nurses’ attitudes towards death, dying, and end-of-life care. An emphasis should be placed on the key elements that emerged in this study, to assist nurses in overcoming these difficulties during and after medical crises, to enhance end-of-life care and professionalism and decrease burnout.

Following the increased presence of the Right-to-Die Movement, improved end-of-life options, and the political and legal status of aid-in-dying around the globe, suicide tourism has become a promising alternative for individuals who wish to end their lives. Yet, little is known about this from the perspective of those who engage in the phenomenon. This study applied the qualitative research approach, following the grounded theory tradition. It includes 11 in-depth semi-structured interviews with Israeli members of the Swiss non-profit Dignitas who contemplated traveling to Switzerland for aid-in-dying. Seven themes emerged from the data analysis, including health and functioning; feelings regarding survivorship and existence; interacting with the health sector; attitudes regarding death and dying; suicide; choosing death; and choosing suicide tourism. A significant portion of the participants had experienced suicidal thoughts and had even previously attempted suicide, some more than once. Most of them referred to chronic illnesses, functional disability, and social isolation. They understand suffering within the subjective dimension, namely only by the person who is actually subjected to the disease, ailments, and disability. Participants regarded aid-in-dying in Switzerland as positive thanks to its guaranteed outcome: \"beautiful death\", compared to \"disadvantaged dying\" which places a burden on the participants' loved ones throughout the prolonged dying. Most of them do not necessarily want to have their loved ones beside them when they die, and they see no significant meaning in dying in a foreign country to which they have no emotional or civil attachment. The desirable approval or tragic refusal by Dignitas to participants' requests for suicide tourism enhances the paradox between the perception of aid-in-dying as a mechanism for fulfilling controlled death and its bureaucratic and materialistic characteristics specifically reflected in a paid, formalized approach to aid-in-dying that cultivate dependency and collaboration.

Qualitative research is beneficial for researchers and society, and even for the participants themselves. Yet, end-of-life qualitative research also entails unique challenges given the sensitive topic and questions relayed to the participants, and the participants’ requests of the researchers. This paper was written following ethical issues that arose while conducting in-depth interviews with Israeli members of the Swiss Dignitas Organization in 2019. The interviews enabled participants to air their thoughts on assisted suicide and gather information about related plans that were not available to the public due to various issues. Yet, during these interviews, I also found myself dealing with significant ethical dilemmas that I had not previously encountered, such as participants asking me to lie for them, or accompany them to Switzerland to fulfil their wishes. While the interviews served as a safe environment in which the participants could air their thoughts on the topic, they led me to reexamine the ethical limitations of qualitative research and the researcher-participant relationship (within and outside the research context). By analyzing three of these interviews, I attempted to answer the following research question: What do the ethics of qualitative research entail with regards to researcher-participant boundaries, as established in sensitive situations and that involve vulnerable populations in end-of-life situations? The analysis was conducted in line with the ethical mindfulness framework and combined theoretical analysis of the literature. My analysis indicates that while qualitative research encourages the establishing of a researcher-participant relationship through trust and rapport – especially on sensitive topics that involve vulnerable populations – the researcher must also ensure both participant and researcher safety, by establishing and maintaining boundaries, even post-research. Introspective ethical inquiry, triggered by participants, requires the researcher to be vulnerable, potentially resulting in emotional discomfort. It also mandates re-engaging with the participants on ethical meanings that stem from this process.

Background Palliative care (PC) at the end of life (EOL) seeks to alleviate suffering and enhance dignity and quality of life, mostly for patients facing terminal illness. Yet within Israel’s Arab population, cultural, religious and linguistic dynamics deeply shape the experience of illness, care preferences and trust in the healthcare system. Care provision often fails to address these sociocultural complexities. This study aims to explore and understand the views and attitudes of terminal Israeli Arab patients regarding PC, their dying experiences and the meanings they attach to them as shaped by cultural, religious and socio-political factors. Methods A descriptive qualitative study was pursued based on an interpretive-phenomenological approach. Data were collected through 14 in-depth semi-structured interviews conducted in Arabic with 13 terminally ill Arab patients and one family proxy between July 2023 and July 2025. Participants were recruited via convenience and purposive sampling to reflect sample diversity. Interpretive Phenomenological Approach and thematic analysis organized by the Atlas.Ti. software was used to analyze the data. Results Four central themes were identified: 1.  God decides, but the System Fails – Religious acceptance of death coexists with mistrust in the healthcare system and perceived medical neglect; 2.  Faith, Control, and Family : Navigating the EOL journey Decision making at the EOL is shaped by spiritual frameworks, patient's reluctance to accept PC and to engage in EOL discussions, and strong familial involvement, at times overriding patient autonomy; 3.  Post-Mortem Concerns – Patients, especially parents, expressed intense anxiety regarding the fate of their dependents after death; 4.  The Spiritual Architecture of the EOL Journey – Faith served as a moral and existential framework, influencing perceptions of suffering, sedation and the dying process. Conclusions EOL experiences of terminal Arab patients are shaped by deeply rooted religious worldviews, family dynamics and perceptions of structural inequalities. Understanding these elements is vital to improving culturally sensitive PC that fosters trust, spiritual dignity and family-centered decision-making among minority populations.

Telehealth has become a transformative health care delivery approach post the COVID-19 pandemic. Although telehealth improves health care access and reduces disparities, mounting evidence suggests usage patterns may exacerbate pre-existing health care inequities. Understanding these patterns across diverse populations is crucial for equitable digital health implementation. This study aimed to examine telehealth usage patterns across sociodemographic groups in Israel's universal health system to identify equity issues. We investigated variations across intersecting demographic characteristics during pre-, mid-, and post-COVID-19 periods and assessed evolving after-hours usage patterns. We conducted a retrospective cohort analysis using health and administrative data from the electronic database of Clalit Health Services' Sharon-Shomron District in Israel. The study population comprised 499,607 adult members (≥25 years; mean age 50.6, SD 16.5 years) with continuous enrollment from March 2019 to February 2022. We analyzed telehealth usage across 3 periods that are pre-COVID-19 (March 2019-February 2020), COVID-19 (March 2020-February 2021), and post-COVID-19 (March 2021-February 2022). Telehealth services included telephone consultations, video consultations, and TYTO (Tytocare) remote diagnostic device usage. Primary outcomes were telehealth usage rates and after-hours usage patterns. We used descriptive statistics, temporal trend analysis, and multivariable logistic regression with bootstrapping. Telehealth usage among unique members more than doubled from 4.06% (20,264/499,607) pre-COVID-19 to 9.38% (46,868/499,607) post-COVID-19. Significant intersectional disparities emerged across multiple dimensions. In the post-COVID-19 period, young adults (25-35 years) used telehealth at 3.1 times the rate of older adults (≥70 years; 18,333/102,533, 17.9% vs 4129/72,280, 5.7%). Women consistently showed higher usage than men (26,702/258,471, 10.3% vs 20,166/241,136, 8.4% post-COVID-19). Profound socioeconomic disparities persisted, with high socioeconomic status members using telehealth at nearly 4 times the rate of low socioeconomic status members (19,064/172,011, 11.1% vs 1328/56,154, 2.4% post-COVID-19). Cultural differences were striking: religious Jewish sector members demonstrated nearly 10-fold higher usage than Arab and Bedouin members (904/7630, 11.8% vs 1125/76,895, 1.5% post-COVID-19). A U-shaped relationship with peripherality (geographic distance from major urban centers and service availability) persisted after adjusting for socioeconomic status. In geographic analyses, this pattern remained across locations. After-hours telehealth usage declined from 65% (324,744/499,607) of all telehealth visits pre-COVID-19 to 49% (244,807/499,607) post-COVID-19, indicating telehealth's evolution from an after-hours alternative to an integrated health care component. Multivariable analysis confirmed these disparities remained significant after adjusting for demographic and health factors. Telehealth expansion benefits remain unevenly distributed across populations in Israel's universal health care system. Significant disparities along age, socioeconomic, cultural, and geographic lines suggest that digital health innovations may widen existing health care inequities without interventions. Intersectional disparities require multidimensional approaches to overlapping barriers. Health care systems must intentionally address equity considerations to ensure digital health and telehealth integration reduces, not worsens, existing health care disparities in routine care delivery.