FAMILY USE OF SAFEGUARDS
FOR LIFE-ENDING DECISIONS

    Even before new legislation is passed
to protect people who make wise end-of-life decisions,
it helpful to use careful procedures
to make certain that we are making
the best possible end-of-life choices.

    The laws of any society are created after most of the people
have already accepted some new standard of behavior.
For example, it was standard medical practice
to withhold or withdraw life-sustaining medical care
in cases where there was no hope of recovery
long before laws were written to permit such medical choices.

    Those who first apply new forms of medical ethics
might have a slight worry that they could run afoul of the law.
But if they have the backing of their colleagues in medicine,
it would be foolish to charge doctors with causing a premature death
if other doctors (and laypersons)
would have made the same decision based on reasonable principles.

    The use of brain-death as a criterion for the death of a patient
was debated in the medical community for a few years
before some states changed their laws
to permit what had by then become a standard medical practice.

    A more controversial medical practice would be declaring patients dead
when they have been certified as permanently unconscious.
This would be a wise option when the patient in an induced coma
had affirmed beforehand (possibly in an Advance Directive)
that he or she wanted to donate organs to save other lives.
And if the donor had declared in addition that he or she approved
using the standard of permanent, terminal coma
as a valid definition of death,
then the doctors would have an even stronger case
for going ahead with organ-transplantation
even while most of the biological functions of the donor's body continued.
In other words, permitting an earlier declaration of death
(using the criterion of permanent, terminal coma)
would allow transplantation while the organs are still functioning.

    Allowing permanent coma or brain-death
to be optional definitions of death
would also allow donors' bodies to be used as living cadavers.

SAFEGUARDS TO SEPARATE
            MERCY-KILLING FROM MERCIFUL DEATH

    From time to time, the news media report that a parent, spouse, or child
has been killed by a loving relative because the suffering became too great.
Often these are acts of desperation,
taken after the loving relative has already tried other solutions.
The local prosecuting authority might charge some crime.
We cannot tolerate individuals ending the lives of others
without applying careful safeguards to prevent premature death.

    Such mercy-killers have considered their options in their own heads.
But usually they have not asked an ethics committee, for example.
They fear that bringing other people into the process of deciding
would only hopelessly complicate the problems
and perhaps result in a decision they do not like.

    But would it be possible for someone who wants to facilitate
a merciful death (as distinct from a mercy-killing)
to apply at least the most relevant of the recommended safeguards
to create a decision-making process that might yield a wise result?
Here are 26 recommended safeguards:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-A-Z.html
Which of these would be most useful to a layperson
in attempting to make wise life-ending decisions for an ailing relative?

    Each of these recommended safeguards
includes a discussion of how fulfilling that safeguard would discourage
mercy-killing, irrational suicide, & other forms of premature death.
The process of gathering the information and professional opinions,
of discussing the options with others who are deeply concerned,
and writing out the fulfilled safeguards
is a step-by-step, orderly procedure anyone can use.
And if the safeguards are fulfilled in good faith,
then some previous inclinations towards death might be reversed:
Greater clarity and more options might show the way to a better choice.
The possible desperation of relatives thinking in isolation
might be replaced by a community of caring persons
(both lay and professional) who offer alternatives other than death.

    One safeguard that would have prevented almost every mercy-killing
is consulting a clergy-person chosen by the patient and/or the proxies.
No responsible minister, priest, or rabbi is going to approve mercy-killing.
But when all of the medical facts and family opinions suggest
that it would be better for the patient to be granted a merciful death now
rather than imposing a prolonged and meaningless process of dying,
then some clergy-persons can agree with the life-ending decision.
Religious leaders have seen the consequences of bad end-of-life choices.
And all religious leaders will have to face their own deaths.
Thus, it will be difficult—but not impossible—to fulfill this clergy safeguard.
After examining all the relevant medical facts and family perspectives,
an open-minded member of the clergy can approve a merciful death.
Or if the gathered facts and opinions point the other way,
the clergy-person can issue a statement disapproving the proposed death
because it would more accurately be described as a "mercy-killing".

    Another safeguards calls for an actual trial of palliative care.
If the person who is tempted to commit a mercy-killing
agrees to professional palliative care for the suffering relative,
then the urge to kill as a means of relieving suffering might be reversed.

    And if such a palliative-care trial does not yield the desired results
—if it does not satisfactorily relieve the suffering—
then everyone will be more justified in making life-ending decisions,
which might result in a "merciful death".

     Merciful death differs from mercy-killing in the following four ways:
(1) Merciful death is a benefit to the patient, not a harm.
(2) Merciful death is a well-reasoned choice, not an irrational urge.
(3) Merciful death is carefully planned, not 'decided' at a moment of crisis.
(4) Merciful death is admirable and commendable, not regrettable and tragic.
These four differences are explored in greater detail here:
Will this Death be a "Mercy-Killing" or a "Merciful Death"?
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/CY-MK-MD.html

    In practice, merciful death will be validated by fulfilling safeguards.
And when the news media report any such deaths,
they should be encouraged to include the fact
that such-and-such safeguards for life-ending decisions were fulfilled
by the relatives before they went ahead with their plan for death.

    And any jury-trial that follows a questionable death
should include a complete presentation of the fulfilled safeguards.
Some judges will not allow such evidence,
saying that the medical condition of the 'victim'
and the views of the ethical consultants and doctors are not relevant
because this is a straight-forward case of murder.

    But the laws can be changed so that judges
will not be permitted to exclude all such relevant information.
For example, here is draft legislation
that explicitly includes all 26 recommended safeguards:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/PREM-DTH.html
The prosecutor, the judge, & the jury
would be required to pay attention to any evidence
that the family did fulfill several safeguards in choosing a merciful death.
And in cases where the safeguards were most completely fulfilled,
doubts raised by anyone about the legitimacy of this chosen death
would be easily satisfied by a quick reading of the fulfilled safeguards.
In short, the prosecutor would declare that there is no case,
since the fulfilling of the safeguards proves
that all due care was exercised in making this life-ending decision.

    Fulfilling the recommended safeguards will be an operational method
for separating a harmful crime—mercy-killing—
from a helpful benefit to the patient—merciful death.

SAFEGUARDS TO SEPARATE
            IRRATIONAL SUICIDE FROM VOLUNTARY DEATH

    Whenever we ourselves are tempted to commit suicide for foolish 'reasons',
we can bring the suggested safeguards into play to clarify our own thinking.
When we have suicidal urges, we are not thinking straight.
And applying the safeguards will draw others into the discussion
of our 'reasons' for wanting to end our lives.

    At the same time, fulfilling the safeguards will be very strong proof
that we do indeed have valid, substantial reasons
for choosing death now rather than letting death come later.
Gathering the personal and professional opinions of perhaps 20 other people
should help to create an air-tight case for voluntary death.

    And very likely, drawing on the facts and opinions provided by others
will help to save us from suicidal thinking
if we were on the verge of committing irrational suicide.

    Here are four differences between irrational suicide and voluntary death;
(1) Voluntary death is a benefit to me, not a harm.
(2) Voluntary death is a reasonable choice, not an irrational urge.
(3) Voluntary death is well-planned, not a capricious 'choice'.
(4) Voluntary death is admirable and commendable, not regrettable and tragic.
Here is a chapter exploring these differences in detail:
Will this Death be an "Irrational Suicide" or a "Voluntary Death"?
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/CY-IS-VD.html

    If we seriously apply the most relevant of the 26 suggested safeguards,
we will probably save ourselves from irrational suicide.

    Or if carefully fulfilling these safeguards leads to a wise decision for death,
we will be able to say to all concerned
that our death was clearly a voluntary death—not an irrational suicide.
All people who are open to the option of voluntary death
will be led by the same evidence to the same conclusion:
Death at this time is better than death at some later time.

    And having fulfilled the safeguards to our own satisfaction,
we can comfortably choose the best means and the best time for death.
See: "Choosing Your Date of Death:
How to Achieve a Timely Death—Not too Soon, Not too Late":
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/CY-DATE.html

    Following these reasonable and workable procedures
is what it means for ordinary people to use
the safeguards for life-ending decisions for themselves.
By carefully applying the most relevant of the safeguards,
we can achieve wise and compassionate end-of-life choices.


Created March 1, 2008; Revised 3-3-2008; 3-12-2008; 4-4-2008; 2-12-2010; 5-14-2010;
1-11-2012; 1-28-2012; 2-22-2012; 3-22-2012; 8-1-2012; 8-19-2012; 10-18-2012;
5-19-2013; 6-26-2013; 7-23-2014; 11-30-2014; 5-6-2015; 10-9-2015;
8-20-2016; 2-12-2018; 10-16-2018; 6-4-2020;

The above discussion of how ordinary people
can apply the recommended safeguards for life-ending decisions
has become Chapter 24 of How to Die: Safeguards for Life-Ending Decisions:
"Family Use of Safeguards for Life-Ending Decisions".


See the 26 recommended safeguards
that can be applied even by laypersons
to prevent mercy-killing, irrational suicide,
& all other forms of premature death.

Go to the Right-to-Die Portal.

Go to the beginning of this website
James Leonard Park—Free Library