SAFEGUARD
E FOR LIFE-ENDING DECISIONS
INDEPENDENT PHYSICIAN
REVIEWS THE CONDITION AND PROGNOSIS
In order to base life-ending decisions on
complete information,
a second doctor should examine the patient and issue a written
statement
summarizing the patient's problems and possible outcomes.
This should be an independent
professional evaluation
from a doctor who specializes in the disease of the patient,
who actually examines the patient in person
as well as all of the relevant medical records.
The second doctor should also read all of the death-planning record
that has been created up to that day.
Sometimes doctors give professional second
opinions
based mainly on the reputation
of the first doctor.
If the second doctor merely endorses the opinion of the first,
the consultation adds nothing.
But if the second doctor makes an independent assessment,
he or she might be able to give more perspective
on the condition and prognosis of the patient,
which could cause the people who are deciding
(either the patient or the proxies) to explore other options
that might not have been suggested by the first doctor.
In some cases it will be wise to obtain
more than one additional
professional evaluation.
If the statements of all doctors point to the
same conclusion
—for instance, that the patient is likely to die soon
no matter what new treatments or life-supports are used—
then the deciders should feel more confident
about making a life-ending decision.
If a certificate
of terminal illness is required,
any additional physicians asked to consult
can either sign the same certificate or issue their own certificates.
In addition to writing their independent
analyses
of the patient's
medical situation and prospects under various treatment options,
these other physicians should also meet with the patient and/or proxies
in order to answer all questions and offer further explanations
of the likely course of events for this patient.
Having several doctors review and explain the
situation of the patient
reduces the chances of misunderstanding by the patient and/or proxies
and of doctors failing to consider some experimental medical options.