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Article ; Online: The ethics of psychiatric management in times of disaster and war: experiences from Israel after the Oct 7 attack.

Strous, Rael D / Monovich, Yaakov

The lancet. Psychiatry

2024 Volume 11, Issue 4, Page(s) 242–244

MeSH term(s)	Humans ; Israel ; Disasters ; Disaster Planning
Language	English
Publishing date	2024-03-15
Publishing country	England
Document type	Journal Article
ISSN	2215-0374
ISSN (online)	2215-0374
DOI	10.1016/S2215-0366(24)00057-9
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Article ; Online: 'Witness in White' medical ethics learning tours on medicine during the Nazi era.

Fox, Matthew A / Strous, Rael D

Journal of medical ethics

2021 Volume 47, Issue 11, Page(s) 770–772

Abstract: During the Nazi era, physicians provided expertise and a veneer of legitimacy enabling crimes against humanity. In a creative educational initiative to address current ethical dilemmas in clinical medicine, we conduct ethics learning missions bringing ... ...

Abstract	During the Nazi era, physicians provided expertise and a veneer of legitimacy enabling crimes against humanity. In a creative educational initiative to address current ethical dilemmas in clinical medicine, we conduct ethics learning missions bringing senior physicians to relevant Nazi era sites in either Germany or Poland. The tours share a core curriculum contextualising history and medical ethics, with variations in emphasis. Tours to Germany provide an understanding of the theoretical origins of the ethical violations and crimes of Nazi physicians. Tours to Poland address the magnitude of the Nazi physician's atrocities as well as displays of heroism by Jewish and righteous among the nations' physicians. Exemplary as well as shameful physician behaviour is analysed from an ethical perspective. A combination of unique educational methodologies maximises learning and personal growth, enabling participants to examine ethically complex clinical situations with extrapolation to modern-day medical practice. Learning is designed with relevance to contemporary medical ethics dilemmas such as beginning and end-of-life issues, providing tenets from which participants can develop as more ethical and informed physicians. Participant feedback confirms efficacy and worth of these growth-promoting ethics learning tours which should be expanded to other international groups and settings (see online film
MeSH term(s)	Ethics ; Ethics, Medical ; Eugenics ; Germany ; Humans ; Jews ; National Socialism ; Physicians
Language	English
Publishing date	2021-03-19
Publishing country	England
Document type	Journal Article
ZDB-ID	194927-5
ISSN	1473-4257 ; 0306-6800
ISSN (online)	1473-4257
ISSN	0306-6800
DOI	10.1136/medethics-2020-107001
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Article ; Online: Psychiatry and COVID-19: putting our best foot forward.

Strous, Rael D / Gold, Azgad

The British journal of psychiatry : the journal of mental science

2020 Volume 217, Issue 2, Page(s) 410–412

Abstract: COVID-19 presents new challenges for psychiatry as clinical management, ethical dilemmas and administrative complications need to be addressed. The psychiatrist should protect the needs and rights of the mentally ill while maximising population health ... ...

Abstract	COVID-19 presents new challenges for psychiatry as clinical management, ethical dilemmas and administrative complications need to be addressed. The psychiatrist should protect the needs and rights of the mentally ill while maximising population health and ensuring solidarity, reciprocity and community well-being for all.
MeSH term(s)	COVID-19 ; Coronavirus Infections/prevention & control ; Humans ; Infection Control ; Mental Health Services/ethics ; Mental Health Services/standards ; Mentally Ill Persons ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Psychiatry/ethics ; Psychiatry/standards
Keywords	covid19
Language	English
Publishing date	2020-05-04
Publishing country	England
Document type	Editorial
ZDB-ID	218103-4
ISSN	1472-1465 ; 0007-1250
ISSN (online)	1472-1465
ISSN	0007-1250
DOI	10.1192/bjp.2020.90
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Article: ["WITNESS IN WHITE" SEMINAR TOURS ON MEDICINE AND PHYSICIANS IN THE HOLOCAUST].

Fox, Matthew A / Strous, Rael D

Harefuah

2020 Volume 159, Issue 4, Page(s) 287–291

Abstract: Introduction: The Holocaust represents a seminal event in the annals of medicine. For the first time in history, doctors played a prominent role in the extreme abuse of medical rights, violation of medical obligation to patients, infringement of patient ...

Abstract	Introduction: The Holocaust represents a seminal event in the annals of medicine. For the first time in history, doctors played a prominent role in the extreme abuse of medical rights, violation of medical obligation to patients, infringement of patient autonomy, forced and unnecessary invasive and damaging procedures for political purposes and the ultimate injustice of involuntary euthanasia. Physicians provided the legitimacy, know-how and momentum that allowed these processes to take place in a symbiotic relationship with the political establishment during the Nazi era. It is critical that modern day physicians be aware of what transpired during this period. For that purpose, we describe a multiyear program bringing Israeli physicians on a learning mission to relevant sites of medical involvement and complicity in Nazi era crimes. These guided educational tours, under the auspices of the Israel Medical Association, originally took place in Poland and more recently, alternately visit Germany and Poland. At all sites, background information on medical practice during the Nazi era is provided, as well as ethical discussions on the merits (positive) or demerits (negative) of physicians who played a role at those particular locations. In addition to site visits, background discussions and lectures are provided to achieve a more comprehensive, deeper and more profound understanding of the issues. Emphasis is placed on learning from examples with relevance to modern day medicine, thus providing the principles from which participants can grow to become more ethical, principled and sensitive physicians as well as individuals. The tour includes formal and emotional ceremonies when relevant at extermination sites where physicians were directly involved, as well as focus groups allowing and encouraging emotional expression and catharsis. The critical role of personal growth during the tour is emphasized with both pre-tour and post-tour meetings providing buffering on both ends. Participants and staff, as well as documented feedback over the years, attest to the utility and profound value of these learning and growth-oriented medical missions.
MeSH term(s)	Germany ; History, 20th Century ; Holocaust ; Humans ; Israel ; National Socialism ; Physicians
Language	Hebrew
Publishing date	2020-04-19
Publishing country	Israel
Document type	Historical Article ; Journal Article ; Review
ZDB-ID	953872-0
ISSN	0017-7768
ISSN	0017-7768
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Article ; Online: Role of Religion in Psychotic Illness in the Israeli Ultra-Orthodox Jewish Population: Patient Beliefs and Expectations.

Serfaty, David R / Strous, Rael D

The Journal of nervous and mental disease

2020 Volume 209, Issue 2, Page(s) 100–105

Abstract: Abstract: This study aims to describe the role that religion and belief may play in members of the Israeli ultra-Orthodox Jewish population hospitalized in the Mayanei Hayeshua Medical Center and diagnosed with a psychotic disorder. Religion was judged ... ...

Abstract	Abstract: This study aims to describe the role that religion and belief may play in members of the Israeli ultra-Orthodox Jewish population hospitalized in the Mayanei Hayeshua Medical Center and diagnosed with a psychotic disorder. Religion was judged essential by the patients in the management of their illness. Forty percent of the patients perceive their illness as their destiny, 26.7% as an "affliction of love," and 33.3% as resulting from their sins. Sixty percent of patients explained that faith is a source of hope in their life, with 76.7% indicating that collective religious practices help them face their illness. Ninety percent expressed no conflict between consulting a psychiatrist and their religious beliefs. Collective religious practices were correlated with higher treatment credibility. The use of religious coping methods was correlated with lower anxiety and tension among women. Higher conflict between religion and consulting a psychiatrist was correlated with lower treatment credibility among men.
MeSH term(s)	Adult ; Attitude to Health/ethnology ; Female ; Humans ; Interview, Psychological ; Israel ; Jews/psychology ; Male ; Middle Aged ; Physician-Patient Relations ; Psychotic Disorders/ethnology ; Psychotic Disorders/psychology ; Religion and Medicine ; Sex Factors ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2020-11-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	3020-x
ISSN	1539-736X ; 0022-3018
ISSN (online)	1539-736X
ISSN	0022-3018
DOI	10.1097/NMD.0000000000001264
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Article ; Online: Ethics of sharing medical knowledge with the community: is the physician responsible for medical outreach during a pandemic?

Strous, Rael D / Karni, Tami

Journal of medical ethics

2020 Volume 46, Issue 11, Page(s) 732–735

Abstract: A recent update to the Geneva Declaration's 'Physician Pledge' involves the ethical requirement of physicians to share medical knowledge for the benefit of patients and healthcare. With the spread of COVID-19, pockets exist in every country with ... ...

Abstract	A recent update to the Geneva Declaration's 'Physician Pledge' involves the ethical requirement of physicians to share medical knowledge for the benefit of patients and healthcare. With the spread of COVID-19, pockets exist in every country with different viral expressions. In the Chareidi ('ultra-orthodox') religious community, for example, rates of COVID-19 transmission and dissemination are above average compared with other communities within the same countries. While viral spread in densely populated communities is common during pandemics, several reasons have been suggested to explain the blatant flouting of public health regulations. It is easy to fault the Chareidi population for their proliferation of COVID-19, partly due to their avoidance of social media and internet aversion. However, the question remains: who is to blame for their community crisis? The ethical argument suggests that from a public health perspective, the physician needs to reach out and share medical knowledge with the community. The public's best interests are critical in a pandemic and should supersede any considerations of cultural differences. By all indications, therefore, the physician has an ethical obligation to promote population healthcare and share medical knowledge based on ethical concepts of beneficence, non-maleficence, utilitarian ethics as well as social, procedural and distributive justice. This includes the ethical duty to reduce health disparities and convey the message that individual responsibility for health has repercussions within the context of broader social accountability. Creative channels are clearly demanded for this ethical challenge, including measured medical paternalism with appropriate cultural sensitivity in physician community outreach.
MeSH term(s)	Access to Information ; Beneficence ; Betacoronavirus ; COVID-19 ; Codes of Ethics ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/virology ; Cultural Competency ; Culture ; Ethical Theory ; Health Education/ethics ; Health Equity ; Health Promotion/ethics ; Humans ; Internet ; Moral Obligations ; Pandemics/ethics ; Pandemics/prevention & control ; Paternalism ; Physicians/ethics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/virology ; Professional Role ; Public Health/ethics ; Religion ; SARS-CoV-2 ; Social Justice ; Social Responsibility
Keywords	covid19
Language	English
Publishing date	2020-09-21
Publishing country	England
Document type	Journal Article
ZDB-ID	194927-5
ISSN	1473-4257 ; 0306-6800
ISSN (online)	1473-4257
ISSN	0306-6800
DOI	10.1136/medethics-2020-106348
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Article ; Online: Anxiety Reactions and Coping Modalities with the COVID-19 Pandemic: A Cross-Sectional Study Comparing a Population of Religious Patients with Mental Illness and their Health Caregivers.

Serfaty, David R / Lugasi, Tamar / Strous, Rael D

Journal of religion and health

2021 Volume 60, Issue 3, Page(s) 1494–1506

Abstract: This study evaluates the nature and intensity of anxiety, interpretations of the COVID-19 pandemic and coping modalities of hospitalized patients with mental illness compared with their caregivers. One hundred and fifty-one subjects were evaluated with a ...

Abstract	This study evaluates the nature and intensity of anxiety, interpretations of the COVID-19 pandemic and coping modalities of hospitalized patients with mental illness compared with their caregivers. One hundred and fifty-one subjects were evaluated with a specially designed questionnaire. Psychiatric inpatients reported more anxiety and more negative feelings than staff members and healthy subjects, but inpatients felt protected by the hospital and Ministry of Health (MoH) measures. Despite this anxiety, inpatients reported a lower compliance with MoH instructions than staff and healthy subjects and gave more fatalistic interpretations to the pandemic. Haredi study participants reported less anxiety, more optimism and had a higher sense of control regarding the pandemic compared to non-religious participants.
MeSH term(s)	Adaptation, Psychological ; Anxiety/epidemiology ; COVID-19 ; Caregivers ; Cross-Sectional Studies ; Humans ; Mental Disorders/epidemiology ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2017250-3
ISSN	1573-6571 ; 0022-4197
ISSN (online)	1573-6571
ISSN	0022-4197
DOI	10.1007/s10943-021-01219-4
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Article ; Online: First-episode psychosis in the ultra-Orthodox Jewish population.

Serfaty, David R / Biran-Ovadia, Ateret / Strous, Rael D

Transcultural psychiatry

2021 , Page(s) 13634615211001706

Abstract: Few if any methodologically robust studies of first-episode psychosis have been carried out in the ultra-Orthodox Jewish population. The opening of an inpatient psychiatry department within an ultra-Orthodox neighborhood in Israel offered the unique ... ...

Abstract	Few if any methodologically robust studies of first-episode psychosis have been carried out in the ultra-Orthodox Jewish population. The opening of an inpatient psychiatry department within an ultra-Orthodox neighborhood in Israel offered the unique opportunity to study the specifics of first -episode psychosis in this subpopulation. Medical records of 60 ultra-Orthodox male Jewish patients with first-episode psychosis were examined over the first 18 months of the new department's operation. Data regarding the patients' demographical status, anamnestic information, clinical presentation, and psychiatric care were analyzed. Participants were 18-30 years old; 15 (25%) were already engaged or married. Most patients (37, 61.7%) had not been employed in any formal activity prior to their hospitalization, with 21 patients (35%) studying in a Talmudical school. Religion-related delusions were noted in 20 patients (33.3%), and community/rabbi-related delusions in 18 patients (30%). Only three patients (5%) reported suicidal attempts. Duration of untreated psychosis (DUP) ranged between 1-48 months (mean 10.4, SD 9.5). In contrast to other first-episode psychosis studies, this study highlights specific features of first-episode psychosis in the ultra-Orthodox Jewish population, which is characterized by a high marriage rate, short DUP, low rates of substance use and suicidal attempts, expression of religious- and community-related themes in delusion content, and limited cooperation with health care providers. A better understanding of the cultural specifics of first-episode psychosis in this subpopulation may enable earlier treatment, improve prognosis, and facilitate compliance with medications and rehabilitation programs.
Language	English
Publishing date	2021-04-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1378978-8
ISSN	1461-7471 ; 1363-4615
ISSN (online)	1461-7471
ISSN	1363-4615
DOI	10.1177/13634615211001706
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Article: Physician: make a boundary for thyself--keep out of partisan politics!

Strous, Rael D

The Israel Medical Association journal : IMAJ

2014 Volume 16, Issue 3, Page(s) 173–174

MeSH term(s)	Ethics, Professional ; Humans ; Israel ; Physician's Role ; Physicians/ethics ; Politics
Language	English
Publishing date	2014-03
Publishing country	Israel
Document type	Editorial
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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Article ; Online: Second call for second thoughts: a response to Ardagh and Wicclair.

Gold, Azgad / Strous, Rael D

Journal of medical ethics

2017 Volume 43, Issue 5, Page(s) 305–306

Language	English
Publishing date	2017-01-25
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	194927-5
ISSN	1473-4257 ; 0306-6800
ISSN (online)	1473-4257
ISSN	0306-6800
DOI	10.1136/medethics-2016-104085
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