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 SleepGuaranteed

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