CONTROLLING
FREE-LANCE
'ANGELS OF DEATH'
Dr. Jack Kevorkian was the first famous 'angel of death'.
Before
he was stopped by being put into prison,
he helped about 120
people to die.
He did not serve his full term in prison and died a
natural death in 2011.
The major criticism
of his methods was the lack
of proper safeguards
to
make sure that the life-ending decisions were wisely made.
But in
Dr. Kevorkian's defense, we can say that he was operating
under
an extremely hostile legal environment.
He knew that he was
stretching the law.
But he was willing to help people to
die
because he wanted to shorten their terminal suffering.
Jack Kevorkian's own informal safeguards
caused him to reject
more requests for death than he accepted.
The major safeguard that Dr. Kevorkian did use
was getting
informed
consent from the patients whom he helped to die.
Without becoming entangled in any of the specific cases
where Dr.
Kevorkian provided aid-in-dying,
we can worry about future
such self-appointed 'angels of death'.
There is already a considerable
underground right-to-die movement.
Doctors, nurses, relatives,
& friends are helping patients to end their lives
using few
(if any) articulated safeguards.
One
informal safeguard often employed
is to make sure that the
patient really wants to die.
Is the patient giving wise
informed consent to death?
Has the patient seriously
considered the alternatives
to death?
But making sure that the
patient really
wants to die
is not sufficient,
because it does not take into account the urge
toward irrational
suicide.
Everyone who commits irrational suicide 'wants to
die' in some sense.
But other persons can sometimes bring new
perspectives
that will result in the suicidal person changing
his or her mind.
When open,
public safeguards are employed,
secretive 'angels of death'
should make their safeguards known.
Some of their informal
safeguards
will closely correspond with the safeguards linked
below.
But other guidelines or criteria might be too personal and
quirky.
For example, it is not sufficient for a nurse
to
decide that a certain patient has 'suffered enough'.
When wise safeguards for life-ending decisions are discussed
and
when some of them are enacted into laws,
then people who have been
'angels of death' in the past
might
be able to work within the new system of public safeguards.
And
some people from the underground right-to-die movement
will suggest meaningful safeguards that everyone can affirm.
In the meantime, societies all around the world
should continue to
identify and prosecute underground 'angels of death'.
Without
proper safeguards, how often do they cause premature death?
SAFEGUARDS
TO DISCOURAGE 'ANGELS OF DEATH'
The following 13 safeguards call upon the considered opinions
of a
wide variety of neutral persons who can help
to separate wise
life-ending choices
from foolish
decisions.
And even before such safeguards are
embodied in new laws,
free-lance individuals and organizations
that help people to die
can decide which
of these suggested safeguards
they want to include in their own
decision-making process.
If they have fulfilled several of these safeguards,
it will do them no
harm to
put everything into writing
—just
in case a prosecutor decides to charge someone with a crime.
The
written
death-planning record
should convince the jury
that the life-ending decisions were wise
and careful.
And even before a jury hears
the evidence,
the prosecutor should review the documents
to decide whether a real
crime was
committed or not.
The whole society is slowly moving in the
direction
of allowing patients to make wise
life-ending decisions.
And
even prosecutors are human beings,
who might at some later time
wish to claim their right-to-die.
If the case before them shows
all the signs
of being a wisely-decided end-of-life medical choice,
then
they will decide that no
prosecution is warranted.
With regard to the right-to-die,
public attitudes are usually
ahead of changes in the law
—and
changes in the practices of public prosecutors.
But
forward-looking prosecutors can still decide
not to prosecute
when
the facts suggest that good safeguards were employed.
Applying wise and meaningful safeguards like the following 13
can
change what might have been a rushed, premature death
into a later death
that took place at the best
time and
by the best
means.
These safeguards to control free-lance 'angels of death'
are
arranged beginning with the most powerful and effective.
The blue
title
links to a complete explanation of that safeguard.
The red
comments
explain how that safeguard
will control free-lance 'angels of
death'.
REVIEW
BY THE
PROSECUTOR (OR OTHER LAWYER)
BEFORE
THE DEATH
TAKES PLACE
Jack Kevorkian never reported his plans for death
until after the
death had already taken place.
If the plans for death are shared
with the prosecutor,
that public official responsible for
bringing any criminal charges
will make sure that any life-ending
decisions were wisely chosen.
For example, the prosecutor could
approve in advance
the withdrawal of all life-support measures
even tho this will result in the immediate death of the patient.
The public prosecutor could issue a written statement
guaranteeing that no
one will be prosecuted
if the plans for death are carried forward
as explained in
the written documents.
CIVIL
AND CRIMINAL PENALTIES FOR CAUSING PREMATURE DEATH
When clear penalties are known in advance by 'angels of death',
they
will think more carefully about doing harm.
They will create
detailed written records
showing how they followed careful procedures.
Using meaningful safeguards will be their 'stay out of
jail' cards.
PSYCHOLOGICAL
CONSULTANT EVALUATES
THE
PATIENT'S
ABILITY TO MAKE MEDICAL DECISIONS
If a psychological consultant has confirmed
that
the patient is able to make medical decisions,
including
any decisions that will result in death,
and if the patient is
freely and wisely choosing
to
die now
rather than to
die later,
then
the persons who are planning to help
the patient to die
will
know that their plan is valid.
A professional psychological
consultant approves
the plans for death.
AN
INSTITUTIONAL ETHICS COMMITTEE
REVIEWS
THE PLANS FOR DEATH
'Angels of death' are no longer acting alone
when they make sure
that the institutional ethics committee
has also approved the
chosen course of action
that will result in the patient's
death.
The ethics committee can be more objective and
dispassionate
about the best
time
and the best
means
for this patient's life to end.
WAITING
PERIODS FOR REFLECTION
Free-lance
'angels of death' often act without giving enough time
to review
and revise any life-ending decisions.
Waiting periods should be
used by everyone involved
as an opportunity to re-think all decisions
about death.
Taking
time to reconsider
can prevent premature death.
Does death still seem the best
option one week later?
STATEMENTS
FROM FAMILY MEMBERS
AFFIRMING
OR
QUESTIONING CHOOSING DEATH
When the
family is involved, the 'angel of death' is not acting alone.
When
family-members endorse the chosen death,
some of them might decide
to be present
for the last moments of life
---affirming by their cooperation that
this will be a timely
death.
Signed supportive statements from family members
should
convince the prosecutor that no
crime was committed.
STATEMENTS
FROM ADVOCATES FOR DISADVANTAGED GROUPS
IF
INVITED BY THE PATIENT AND/OR THE PROXIES
'Angels
of death' who are accustomed to operating in secret
will seldom
ask for a written opinion from anyone else.
So if they obtain
written approval from a consultant
who was specifically chosen to
protect the interests of the patient,
then everyone else should be
assured
that this was a wise
death,
not a mercy-killing.
PHYSICIAN'S
STATEMENT OF CONDITION AND PROGNOSIS
Careful
'angels of death' will make sure that they are acting
on the
basis of well-established medical facts about the patient.
It is
not sufficient to get the patient and family to agree.
Are there
objective
reasons
for choosing death?
The written statement of the physician
responsible for terminal care
---explaining
in detail the patient's condition and prognosis---
forms
the background for all end-of-life decisions.
INDEPENDENT
PHYSICIAN
REVIEWS
THE CONDITION AND PROGNOSIS
The
written statement from the second doctor
will be further evidence
for or against the choice of death.
The 'angel of death' is not
acting alone
but with
the cooperation of at least two licensed physicians.
HOSPITAL
OR HOSPICE ENROLLMENT
If the patient is receiving care in a hospital or hospice
program,
then the 'angel of death' should seek their approval and
cooperation.
And the hospital or hospice program will
not cooperate
if
they believe that the proposed death would be premature.
Health-care
organizations put the best interests of the patient first.
And
sometimes everyone agrees that 'pulling the plug' is the best
choice.
INFORMED
CONSENT FROM THE PATIENT
Patients
usually do not want to be put to death prematurely.
If they
approve of their own deaths in unambiguous terms,
then the 'angels
of death' are doing
them a service,
not
committing
any sort of crime
or harming
them.
When the patient has requested
the aid-in-dying,
this is strong evidence that this death was
wisely chosen.
COMPLETE
RECORDING AND SHARING
OF
ALL MATERIAL
FACTS AND OPINIONS
When
the death-planning record is complete,
these several documents
should convince any suspicious persons
that this death was
chosen at the best
time
and by the best
means.
The
specific documents will not
be shared with strangers.
But those who aid the patient in dying
might disclose
the fact that
a written death-planning record was created.
THE
DEATH-PLANNING COORDINATOR ORGANIZES THE SAFEGUARDS
And
the fact that a death-planning coordinator
has gathered all of
the fulfilled safeguards into one place
should convince most
detractors that this death was not premature.
The compiled
documents prove this was a good death.
If
these 13 safeguards are not sufficient to control 'angels of
death',
there are two dozen more listed in the complete catalog of
safeguards:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-CAT.html.
Each
of these descriptions contains a few paragraphs
explaining how
that safeguard will discourage
all forms of premature death.
When public safeguards are affirmed and applied,
those who help
patients to die
will not be acting alone as free-lance 'angels of
death'.
Using the most appropriate safeguards for life-ending
decisions
will probably involve the opinions of a dozen other
people.
Created
March 22, 2007; revised 7-16-2008; 7-31-2008; 11-2-2008; 1-29-2009;
1-17-2010; 5-21-2010; 2-25-2011; 12-23-2011;
1-27-2012;
2-21-2012; 3-28-2012; 9-12-2012; 4-24-2013; 6-21-2013;
7-17-2014;
10-10-2014; 7-4-2015; 10-27-2016; 12-22-2017; 8-30-2018;
5-27-2020;
This
discussion of getting free-lance 'angels of death'
to embrace
meaningful and relevant safeguards
is now Chapter 11 of How
to Die: Safeguards for Life-Ending Decisions:
"Controlling
Free-Lance 'Angels of Death' ".
Go
to other dangers,
mistakes, & abuses of the right-to-die.
A closely-related
worry is called:
Preventing
Mercy-Killing.
Go to
the beginning of this website
James
Leonard Park—Free
Library