BRITTANY MAYNARD:
SAFEGUARDS FOR LIFE-ENDING DECISIONS

    This essay does not present any new information about Brittany Maynard.
It is based only on the public information well known to anyone
by means of the mass media.

    And the specific details of her medical condition
do not matter for the purpose of this discussion.
Anyone facing similar medical problems might employ
the same safeguards to reach a reasonable life-ending decision.

    Brittany Maynard decided to end her own life using gentle poison
rather than wait for her brain-tumor to grow and kill her.
She chose November 1, 2014 as her date of death.
Other patients have different conditions threatening death,
but similar safeguards can be used for all such situations. 

    These safeguards are listed in the order of their relevance
to life-ending decisions when the likely cause of death is known.

    Each safeguard links to a more complete explanation on the Internet.
And they retain their letters from the complete list
of recommended safeguards for life-ending decisions:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-A-Z.html

BRITTANY MAYNARD:
SAFEGUARDS FOR LIFE-ENDING DECISIONS
by James Leonard Park

SAFEGUARD D  Physician's Statement of Condition and Prognosis

    The decision to end her life was based on well-established medical facts.
Deep investigation and repeated tests and scans proved
that the patient definitely had a brain-tumor that was going to cause death.

SAFEGUARD E  Independent Physician Reviews and Condition and Prognosis

    Because this condition was so serious,
the medical facts were probably checked and re-checked
by other medical professionals specializing in this kind of disease.
If there was any doubt or differences of professional opinion,
these were resolved before the doctors recommended planning for death.

SAFEGUARD F  Certification of Terminal Illness or Incurable Condition

    If needed or requested by anyone involved,
the doctors who were caring for the patient
might have issued a separate statement affirming that death was inevitable,
perhaps giving a time-frame within which death should be expected
under each possible option for treatment or non-treatment.

SAFEGUARD B  Requests for Death from the Patient

    Because this patient was fully able to understand her situation,
she had an unquestionable right to request death for herself.
And in this case, she did make all the necessary arrangements
to move to Oregon and obtain the necessary lethal chemicals.
There was no doubt that the request for death came from the patient.

SAFEGUARD A  Advance Directive for Medical Care

    In this specific case, it is not known whether the patient
had written any 'living will' before being diagnosed with the brain-tumor.
But if there was an Advance directive,
then it could be consulted to see if the patient affirmed her right-to-die
if and when her situation became intolerable.
If she expressed such a determination before her disease was discovered,
this showed that her choice for death was a long-standing decision
---made independent of the life-threatening disease that later became known.

SAFEGUARD C  Psychological Consultant
            Evaluates the Patient's Ability to Make Medical Decisions

    Also, it is not known whether this patient and/or family
had any reason to consult a psychological professional,
who could have examined all of the reasons for choosing death
and any other dynamics relevant for this life-ending decision.
In other cases, the decision to choose death
might emerge after the patient began to lose some mental capacities.
Then a psychological consultation would have been quite relevant.

SAFEGUARD J  Informed Consent from the Patient

    Just to make certain that the death-planning record is complete,
it might have been useful for the patient to issue a signed statement
explaining and affirming the specific plan for death
under the circumstances causing her to choose death
rather than allow the brain-tumor to claim her life. 
The psychological consultant might have affirmed
that the patient had all the necessary mental powers
to make this life-ending decision.

SAFEGUARD K  Requests for Death from the Proxies

    And if someone might question the capacity of the patient
to make a life-ending decision under the given circumstances,
then the duly-authorized proxies have all necessary power
to carry forward the plans for death formulated earlier by the patient.

SAFEGUARD N  Statements from Family Members
            Affirming or Questioning Choosing Death

    In this case, all of the relevant family members seem to have agreed
that the chosen method and timing of the patient's death was appropriate.
Perhaps they did not create specific written statements to that effect,
but if they were asked to put their support into writing,
they would have been willing.
The closest family members were supportive from the start.

SAFEGUARD U  Waiting Periods for Reflection

    In this case, there was no need for additional waiting periods
to make certain that death was the wisest choice. 
Several months had already been used in the planning process.
And the required waiting periods under Oregon law were observed. 

SAFEGUARD Y  The Patient Must Be Conscious and Able to Achieve Death

    In this case, the patient decided to take the gentle poison herself,
which was dramatic proof to all observers
that this life-ending decision was her own free choice,
not something forced on her by others.



    These 11 safeguards were the most likely to be used in this case.
Several other people participated in the planning for this death.
And they showed by their full cooperation that they supported the decision.
It was doubtless a difficult choice to accept death in this way,
but the alternative was worse in their considered opinions.
Medical professionals also examined all of the medical facts and options
and came to the same conclusion that death at this time by this method
was best of this patient and this family.

    Other people who are facing death from other causes
might apply similar safeguards in order to make certain
that they are making the wisest possible decisions under the circumstances. 
If it is uncertain in other cases just how to proceed,
additional safeguard-procedures might be employed
to reach the best possible end-of-life decisions for the patient.
For example, if the patient is being cared for in a hospital or nursing home,
there might be an institutional ethics committee that could be asked
to review the decisions of the patient and/or the proxies. 

    Here is the complete list of
26 recommended safeguards for life-ending decisions.
Each patient and/or family can decide
which of these are most relevant and helpful:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-A-Z.html


AUTHOR:

James Leonard Park is an advocate of the right-to-die with careful safeguards.
He is the author of How to Die: Safeguards for Life-Ending Decisions.


Created October 17, 2014; Revised 4-26-2017; 1-10-2019; 1-14-2020;

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