Advantages of the Premature-Death Approach to the Right-to-Die
Requires
Less Paperwork
The paradigm for laws against causing premature death
is the well-established practice of withdrawing
life-support systems.
Under present law and medical practice
in all places in the world where life-support systems are used,
doctors, patients, & proxies for these patients
make life-ending decisions every day
by means of deciding to withdraw or withhold life-supports.
The medical records for each such patient
show what happened and when.
And all such accounts show that the patient died
as the result of the underlying disease, illness, or condition.
The withdrawal of the life-support machinery and drugs
might be noted as the last medical decision for this patient.
In most such cases, there is no ambivalence about
what to do.
The patient, proxies, & physicians explored
all of
the alternatives
before they decided to withdraw the life-supports,
knowing full well that death would follow soon after
the respirator and/or the feeding-tube were withdrawn.
Perhaps for 1 death in 1,000, there might be some question
of whether the life-supports were
withdrawn prematurely.
And such cases would be open to criminal investigation.
Some harm might have
been visited upon the patient,
which means that some crime
might have been committed.
Normally this would be some lower level of homicide,
the exact degree of murder to be charged
depending on the level of malice
among those who decided to disconnect the life-supports.
The normal medical records for this patient
would then become the primary evidence to be examined
in order to determine whether a crime was committed
or whether it was a medical mistake in judgment,
which might result in a civil suit for malpractice against the doctors.
Because withdrawing life-supports is so common,
no special records are kept of such medical decisions
apart from all of the normal record-keeping of the hospital.
In other words, there was no
application to any government agency
for permission to withdraw the life-support systems.
And in the vast majority of cases of withdrawing
life-supports,
there will never be any question of criminal prosecution.
Such life-ending decisions are taken without anyone even thinking
that someone might be charged with a crime.
Other life-ending decisions will not involve discontinuing
life-supports.
But the family and medical persons involved
would be wise to keep good records of their deliberations
leading to whatever end-of-life decisions they ultimately make.
The best-organized way to keep these records
would be in the form of fulfilling
the safeguards
named and described in the law against causing premature death.
These
death-planning records would not be available
to anyone beyond those legitimately involved in the end-of-life plans.
The only exception to this rule
of privacy
would arise when there is reason to suspect
that someone caused a premature death.
Then the prosecutor could examine all the medical
records.
And the potential defendants would be invited
to offer their planning records to show that no crime
was committed.
In most cases, little paperwork would be
required.
Most deaths are open-and-shut cases.
The deaths were correctly decided by the right people.
Their own records of the decisions can be kept private
unless there is good reason to open a criminal investigation.
A new law against causing premature death
would at least alert people that they should keep good records
of the end-of-life discussions in which they participate.
Most people will not fulfill very many safeguards,
since there will be no question that this death was wisely-decided.
And even if they did not put their
fulfilling of the
safeguards
into writing at the time,
if they are called upon to testify in a criminal case,
they will be able to remember
their conversations and decisions.
And a jury of their peers will acquit them
if it seems that their motives were mercy rather than malice.
When any family confronts medical decisions for a
loved one,
they will decide just how much paperwork would be appropriate
to make sure that their end-of-life choices are wisely decided.
Which of the 26
recommended safeguards would be most useful
in making certain that the proposed death is not premature,
that it will be a timely
death—not
too soon and not too late?
Created March 30,
2007; revised 3-31-2007; 2-1-2008; 2-28-2008; 8-25-2008; 3-5-2009;
6-10-2009;
3-27-2010; 2-15-2011;
1-17-2012; 1-25-2012; 2-28-2012; 3-30-2012;
7-20-2012; 9-7-2012;
4-6-2013; 6-15-2013; 6-20-2014; 3-18-2015; 7-15-2015; 8-7-2016;
2-28-2018; 12-2-2020;
In
contract to the apply-for-approval laws,
laws
against causing premature death involve less paperwork
because
most cases can easily be proven to be wise end-of-life medical choices.
This
argument appears in Section E of Chapter 60 of
How
to Die:
Safeguards for Life-Ending Decisions.