SAFEGUARDS
EMBRACED BY
CRITICS
OF THE RIGHT-TO-DIE
SYNOPSIS:
Whenever new legislation is proposed to advance the
right-to-die,
critics complain that there are not enough safeguards
to prevent abuses
and mistakes.
This chapter presents a prioritized list of safeguards
that would be embraced by the people who raise doubts and worries
about any changes of law that might allow people to choose death.
These 12 safeguard-procedures have been selected
from the list of
26 recommended safeguards:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-A-Z.html
And they retain
the letters from that list.
Top positions are given to those safeguards
most likely to prevent the mistakes and abuses
imagined by initial opponents of the right-to-die.
What safeguards would be most likely
to overcome the worries of those who object to the right-to-die?
Which safeguards would be most powerful in preventing harms?
OUTLINE:
Each safeguard discussed is linked to a fuller
explanation on the Internet.
S. REVIEW
BY THE
PROSECUTOR (OR OTHER LAWYER)
BEFORE
THE DEATH
TAKES PLACE
F. CERTIFICATION
OF TERMINAL ILLNESS OR INCURABLE CONDITION
O.
A
MEMBER
OF THE
CLERGY
APPROVES OR QUESTIONS CHOOSING DEATH
P.
RELIGIOUS
OR OTHER MORAL PRINCIPLES
APPLIED
TO THIS
LIFE-ENDING DECISION
Q.
AN
INSTITUTIONAL
ETHICS COMMITTEE REVIEWS THE PLANS FOR DEATH
R.
STATEMENTS
FROM
ADVOCATES FOR
DISADVANTAGED GROUPS
IF
INVITED BY
THE PATIENT AND/OR THE PROXIES
D. PHYSICIAN'S
STATEMENT
OF CONDITION AND PROGNOSIS
E. INDEPENDENT
PHYSICIAN REVIEWS THE CONDITION AND PROGNOSIS
C. PSYCHOLOGICAL
CONSULTANT EVALUATES
THE
PATIENT'S
ABILITY TO MAKE MEDICAL DECISIONS
J.
INFORMED
CONSENT FROM THE PATIENT
U.
WAITING
PERIODS FOR REFLECTION
V.
OPPORTUNITIES
FOR THE PATIENT
TO
RESCIND OR
POSTPONE ANY LIFE-ENDING DECISIONS
SAFEGUARDS
EMBRACED BY
CRITICS OF THE RIGHT-TO-DIE
by
James Leonard Park
S. REVIEW
BY THE
PROSECUTOR (OR OTHER LAWYER)
BEFORE
THE DEATH
TAKES PLACE
If critics of the right-to-die had to select just
one safeguard,
they would probably propose a review by the public prosecutor.
Everywhere in the world that has any system of law-and-order,
there are public officials responsible for bringing criminal
charges
against any individuals and organizations that (might) have violated
laws.
If
this law-enforcement official agrees
that the patient will not be
harmed
if the plans for death
proceed as outlined,
then even distant critics of the right-to-die will probably be satisfied
that the particular case has been examined carefully
and a reasonable conclusion has been reached:
The chosen pathway towards
death will not violate any laws.
If the prosecutor finds any problems in the
death-planning record,
he or she will call a halt to the whole process
until all questions and objections have been resolved.
F. CERTIFICATION
OF TERMINAL ILLNESS OR INCURABLE CONDITION
Even people initially opposed to any
so-called 'right-to-die'
will endorse limiting any such right to patients
who have been officially certified to have terminal diseases.
If the patient is already
clearly dying,
then those who oppose a right-to-die for others
might accept this as a meaningful safeguard
that would prevent non-terminal patients from exiting prematurely.
O. A
MEMBER
OF THE
CLERGY
APPROVES
OR
QUESTIONS CHOOSING DEATH
Especially critics who are deeply religious
will be pleased for their priests or ministers to review life-ending
decisions.
If professional religious leaders who value
human life
are convinced by the dire circumstances of the patient
that a chosen death
is better than forced
suffering,
then even the strongest critics of the right-to-die
should rest assured that all factors have been taken into
account.
Even from this religious point-of-view,
death now is preferred
over death later.
P.
RELIGIOUS
OR OTHER MORAL PRINCIPLES
APPLIED
TO THIS
LIFE-ENDING DECISION
Modern
thinking asks about life-support systems:
When is it best to disconnect the 'tubes and machines'
that are keeping the patient alive?
Almost all religious principles concerning
life-supports
do acknowledge some tipping
point
at which more
harm will be done to
the patient
by keeping the tubes and machines attached
than by disconnecting the medical technology
and allowing the patient to die a natural death.
When people who lack the medical details of
any particular case
learn that this end-of-life situation has been examined
from a stated religious or moral point-of-view,
such potential critics will be more assured
that everything appropriate has been tried
and that even the best moral
principles protecting living
persons
now point towards death as
the best option using this moral system.
Q.
AN
INSTITUTIONAL
ETHICS COMMITTEE
REVIEWS
THE
PLANS FOR DEATH
Critics of the right-to-die will also be assured
if they know that an institutional ethics committee
associated with the patient's hospital or nursing home
has also reviewed the end-of-life options for this patient
and concluded that in their considered judgment
it is better now for this
patient to be allowed to die
rather than continuing more medical treatments and life-supports.
Such committees are composed of a wide range of
experts,
who apply their various perspectives to evaluate this particular
patient,
in his or her special end-of-life predicament.
Distant critics will probably not contradict the conclusions
of an ethics committee
that has examined all the facts and medical recommendations.
R.
STATEMENTS
FROM
ADVOCATES FOR
DISADVANTAGED GROUPS
IF
INVITED BY
THE PATIENT AND/OR THE PROXIES
If the patient is a woman, a disabled person,
or a
member of a minority group, critics sometimes worry
that she or he will not receive adequate
medical
care.
Is death being recommended as
a short-cut
rather than providing the most appropriate health-care?
But if a respected representative of that
sometimes-disadvantaged
group
has also reviewed the plans for death
—and
perhaps requested additional facts and professional opinions—
and
if this identity-group leader also
endorses the decision for
death,
then more-distant members of such groups
can rest assured that no
discrimination has taken place:
This particular patient has been given all appropriate medical care.
There was no lower level
or less-complete care
because this patient is not from the same group as the care-givers.
The written statement from this special advocate
should reassure people who often have legitimate reasons to wonder
whether members of their groups are receiving worse medical care
because of perceived group-identity.
D. PHYSICIAN'S
STATEMENT
OF CONDITION AND PROGNOSIS
Critics of the right-to-die want to prevent
premature death.
Having a written statement of the patient's physical problems
and the likely outcomes of various methods of medical treatment
will form the factual background for all end-of-life decisions.
If the primary-care physician cooperates by issuing a statement,
everyone who has reservations about the right-to-die
will know that a medical professional has explored all the options.
When doctors agree that death
now would be better than death later,
how can distant critics insist that the dying process be
prolonged?
E.
INDEPENDENT
PHYSICIAN REVIEWS THE CONDITION AND PROGNOSIS
Additionally, having another doctor examine
the patient
and issue another statement of condition and prognosis
should assure anyone who questions the process
that good professional safeguards are being applied.
Two medical gate-keepers have
personally examined the patient
and have decided to open the
gate to death.
Why should more distant critics try to keep that gate closed?
If any reasonable doubts remain,
additional professional medical advice can be sought.
C.
PSYCHOLOGICAL
CONSULTANT EVALUATES
THE
PATIENT'S
ABILITY TO MAKE MEDICAL DECISIONS
Critics of the right-to-die often worry
that the
patient has inadequate 'reasons' for wanting to die.
Requiring a consultation with a psychiatrist or psychologist
would prevent many people from foolishly choosing irrational suicide.
This consultation would examine the reasons for choosing death.
The psychological professional would evaluate
the patient's abilities to
make well-reasoned medical decisions
—including any
decisions that would bring his or her life to an end.
Also, is the patient under
any pressure from relatives to 'choose'
death?
Are there psychological or
emotional problems
that might be pushing toward irrational suicide?
The psychological consultant will resolve all such doubts
before approving any life-ending decisions.
J. INFORMED
CONSENT FROM THE PATIENT
Any set of safeguards should include
asking for the
informed consent of the patient.
Has this patient really considered all of the options?
Does this patient understand that he or she is asking for death?
Have all of the life-ending decisions been properly put into writing?
Are they signed, dated, & witnessed?
If the patient can no longer make wise medical
decisions,
have the proxies given their
informed consent?
U. WAITING
PERIODS FOR REFLECTION
When reasonable waiting periods have been observed,
the patient and/or the family might reconsider the choice for
death.
Waiting periods between requests for death
give time for everyone who has a legitimate right to speak
to be fully heard and responded to before the final act begins.
A certain percentage of people who thought they wanted to die
will change their minds
as the result of being forced to reconsider.
Reasonable waiting periods might result in postponing death.
Timely death means not too
soon and not too late.
V. OPPORTUNITIES
FOR THE PATIENT
TO
RESCIND OR
POSTPONE ANY LIFE-ENDING DECISIONS
And explicitly providing opportunities for changing
course
is very important for avoiding unwanted momentum towards death.
If the patient (or other decider) acknowledges
that it is always possible to cancel or postpone the plans for death,
and if the patient nevertheless continues the death-planning process,
all critics should be satisfied that the patient had several
opportunities
to rescind or postpone any life-ending decisions.
MIGHT OTHER SAFEGUARDS BE USEFUL?
Each individual or organization that helps patients
to choose the best pathway towards death
will have its own system of safeguards.
If the twelve safeguards discussed above
do not seem sufficient, there are several others that might be adapted.
Here is a list of 26 recommended safeguards:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-A-Z.html.
And here is an even more complete catalog of possible safeguards:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-CAT.html.
A different set of safeguards would be selected by advocates of the
right-to-die:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-COMM.html.
AUTHOR:
James Leonard Park supports the
right-to-die with careful safeguards.
He is the webmaster for the portal called "Safeguards for Life-Ending
Decisions":
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG.html.
Several related essays on the Internet are linked below.
Much more about him will be learned from his personal website:
James
Leonard Park—Free
Library.
The above selection
of safeguards favored by critics of the right-to-die is also
Chapter 26 of How
to Die:
Safeguards for Life-Ending Decisions:
"Safeguards Embraced by Critics of the Right-to-Die".
Further reading concerning
safeguards for life-ending decisions:
Fifteen
Safeguards
for Life-Ending Decisions
Pulling
the Plug:
A Paradigm for Life-Ending Decisions
A
New Way to
Secure the Right-to-Die:
Laws against Causing Premature Death
Choosing
Your
Date of Death:
How to Achieve a Timely Death
—Not
too Soon,
Not too Late
Will
this Death
be an "Irrational Suicide" or a "Voluntary Death"?
Will
this Death
be a "Mercy-Killing" or a "Merciful Death"?
Four
Medical
Methods of Managing Dying
VDD:
Why
Giving Up
Water is Better than other Means of Voluntary Death
Voluntary
Death by Dehydration:
Safeguards to Make Sure it is a Wise Choice
Induced
Terminal Coma: Dying in Your Sleep—Guaranteed
Do
I Lose the
Right-to-Die When I Lose Consciousness?
Created
May 13, 2010
; Revised 5-14-2010; 5-22-2010; 8-28-2010; 12-7-2010;
1-13-2012;
2-1-2012; 2-23-2012: 3-16-2012; 3-24-2012; 7-14-2012; 8-3-2012;
8-24-2012;
3-6-2013; 3-28-2013; 5-24-2013; 6-29-2013;
4-24-2014; 5-6-2015;
7-10-2015; 5-5-2016; 5-18-2017; 11-16-2018; 6-3-2019; 6-18-2020;
Go to
the beginning of this website
James
Leonard Park—Free
Library