SAFEGUARD D FOR LIFE-ENDING DECISIONS

PHYSICIAN'S STATEMENT OF CONDITION AND PROGNOSIS


    The physician who is primarily responsible
for supervising the care of the patient
issues a written statement explaining all relevant aspects
of the patient's physical condition,
with special attention to the facts that are likely to lead to death.

    The physician includes a good-faith estimate
of the likely course of the patient's current condition
if the patient continues to receive
all presently-provided supportive care and medical treatments.
The physician will also include a good-faith estimate
of the likely course of the patient's condition
if the life-supports and medical treatments are discontinued.
And if additional forms of life-support and treatment might be relevant,
the physician should include the likely impact of such medical choices.

    If the patient is probably dying,
the primary-care physician could include this fact
in the statement of condition and prognosis.
Or a separate certificate of terminal illness could be created.

    Copies of this physician's statement of condition and prognosis
shall be provided to all persons who have a legitimate interest
in the medical care of the patient.
But copies shall not be made available
to the general public or to the news media.

    When and if the patient's condition changes significantly,
the physician then having primary responsibility for the care of the patient
shall issue a new written statement of the patient's condition and prognosis.
This new statement might take the form of additional facts and projections
added to the original statement of condition and prognosis.

    The doctor's explanation of the medical situation
should be in language that can easily be understood by laypersons.
All medical terms and expressions should be translated into plain language.
The terminal-care doctor should meet with the patient and/or the proxies
to answer all of their questions about the patient's medical condition
and all remaining options for further treatment and supportive care.
Those who will be making the end-of-life decisions for this patient
need a complete understanding of all the relevant medical facts
and the professional medical recommendations.



HOW THE DOCTOR'S WRITTEN STATEMENT
OF CONDITION AND PROGNOSIS
DISCOURAGES IRRATIONAL SUICIDE
AND OTHER FORMS OF PREMATURE DEATH

    Sometimes patients and/or their families panic
when they receive a bleak diagnosis.
They might begin to believe that death is imminent
when there are still several months or even years
remaining in the possible life-span of the patient.
Sometimes patients and their families do not fully understand
what they have heard only verbally.
When the patient and the family have a written statement
of the patient's condition and prognosis,
they can more calmly consider the facts and the possibilities.
And they can ask for further elaboration and explanation
if they do not understand some parts of the physician's statement.
Complete information is essential for making wise medical decisions.

    Most suicidal persons will not request a written statement from a doctor.
Thus, this safeguard will not be an effective method of suicide prevention.
But it might prevent some suicidal persons from using the medical system
as a cover for their irrational acts of self-destruction.
And if some suicidal people ask for a physician's statement
of their condition and prognosis, some of them will discover
that they do not have as serious a medical condition
as they might have believed in their darkest moments.

    When patients and/or their proxies make medical decisions
based on an imperfect grasp of the medical facts and prognosis,
they might choose what would turn out to be a premature death.
A clear statement of the patient's condition and prognosis
will be the foundation of any and all future medical decisions.

    If proxies want the patient dead for their own selfish reasons,
the physician's written statement of condition and prognosis
might be evidence against their harmful decision for death.
The proxies will not be able to claim
a different view of the condition and prognosis of the patient.
Anyone who is guilty of causing a premature death
will not be able falsely to claim
that their action was supported by the physician.
Thus, the physician's statement of the patient's medical condition
will prevent at least some decisions
that would have resulted in a premature death.

    And if the primary-care physician is required to write
a prescription for a gentle poison, the physician will not cooperate
unless he or she is convinced that a chosen death
is the best option for this patient, given all the medical facts.


Created January 14, 2007; revised 3-18-2007; 3-5-2008; 2-5-2010; 5-9-2010; 9-9-2010;
5-27-2011; 12-15-2011; 1-29-2012; 2-22-2012; 3-22-2012; 8-1-2012; 8-19-2012; 11-6-2012;
5-22-2013; 6-26-2013; 7-24-2014; 5-19-2015; 10-10-2015; 1-6-2018; 10-24-2018; 6-5-2020; 


This explanation of the importance of getting a written professional medical analysis
of the condition of the patient is Safeguard D
in How to Die: Safeguards for Life-Ending Decisions:
 "Physician's Statement of Condition and Prognosis".

Go to the Catalog of Safeguards for Life-Ending Decisions

Go to the list of 26 recommended safeguards.

Go to the index page for the Safeguards Website.

Go to the Right-to-Die Portal.


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