PHYSICIANS
REVIEW
THE COMPLETE DEATH-PLANNING RECORDS
Once most of the other safeguards have been fulfilled,
there will be a collection of written documents
that should be reviewed and responded to by all the physicians
who are involved in the terminal care of the patient.
In addition, there might be other written statements
that would be relevant for the physicians to review.
These include, but are not limited to the following:
A statement
from the psychological consultant
that the patient is mentally able to make all medical decisions
—including life-ending decisions.
A statement
from the institutional ethics committee
that they also have reviewed the death-planning record
and found that death at this time is the wisest course of action. Statements
from hospital or hospice staff
recording their observations and views concerning the plans for death.
The physician who is supervising the process of
planning for death
will specify exactly which documents he or she has reviewed,
including the date of each document, who signed it, etc.
And this physician should write a brief response to each
document.
Then this doctor will add his or her final analysis
of the process,
ending with a recommendation either
for further treatment and
exploration of medical options
or for a peaceful and painless death for the patient.
If more than one doctor is deeply involved in
planning for this death,
any additional doctors should also write their final recommendations.
HOW THE DOCTORS' WRITTEN RESPONSES
TO THE DEATH-PLANNING RECORDS
WILL DISCOURAGE IRRATIONAL SUICIDE
AND OTHER FORMS OF PREMATURE DEATH
When the doctors involved in terminal care
review the fulfilled safeguards for life-ending decisions,
they will be in the final stages of the patient's life.
If there was any reason to worry about irrational suicide,
it would have been mentioned in the documents created by others.
And everyone concerned will take appropriate actions
to prevent the patient from harming
himself or herself.
Likewise, these terminal-care doctors
will be aware
of the distortions
and abuses
that sometimes come into planning for death.
And they will take whatever actions they find appropriate
to prevent any possible premature death.
Once the dangers of irrational suicide
and other forms of premature death have been ruled out,
and if the patient and/or the proxies agree
that death at this time
is better than death at some
later time,
then the most appropriate life-ending decisions can be made.
Everywhere in the developed world,
the following four methods of managing dying are permitted:
1. increasing pain-medication with the knowledge
that this will probably shorten the process of dying.
2. terminal coma---keeping the patient unconscious until natural
death.
3. withdrawing all medical treatments and life-supports.
4. giving up water and other fluids.
These four methods are explained more fully here:
"Four Medical Methods of Managing Dying": https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/CY-L-END.html Depending on the
most desirable methods of managing dying chosen by the patient, the proxies,
& the terminal-care doctor, an approximate date of death can be
projected. Everyone who has taken part in
planning for this death should be notified of the planned time
and place of death.
An orderly and
peaceful death will be achieved by the chosen means. The family and friends can decide to
be present for this death
and/or for the funeral or memorial service that might follow.
And after the
chosen death has been achieved according to plan, the death-planning records can be
permanently stored, just in case there might be some
future need to review exactly how this death was planned and
managed.
Created January 24,
2007; revised later, including 5-19-2010; 5-27-2011; 12-16-2011;
2-1-2012; 2-23-2012; 3-24-2012; 8-3-2012; 8-23-2012; 3-5-2013;
6-28-2013; 5-8-2015;
1-9-2016;1-6-2018; 11-9-2018; 12-23-2019;