NINE
CHARACTERISTICS
OF
GOOD SAFEGUARDS
FOR LIFE-ENDING DECISIONS
1. The safeguard must be simple,
clear, & straight-forward.
The best safeguards will be easy to understand even
from
their names.
There will be no hidden or technical procedures concealed in details.
Laypersons must be able to understand and apply the safeguard.
2. The safeguard must be
possible
to fulfill
with a few
hours of work.
When laypersons consider a safeguard for drawing
life to a close,
they must not first experience an urge to avoid that safeguard
because it would take too much time.
For example, a safeguard calling for a second
professional
opinion
should allow reasonable time for the second doctor
to examine the patient and to review the medical records.
A series of committees reviewing lengthy
documents
would not be a
reasonable safeguard.
Opponents of the right-to-die will propose 'safeguards'
that are intended to delay death for as long as
possible.
3. The safeguard must be open
to
reasonable exceptions.
Sometimes a particular safeguard will not be
applicable
because of special circumstances.
For example, how can we get a statement from a patient in a coma?
The record for planning this death will simply state
that it was not possible
to get any statement from the patient
because the patient has been in a coma or in a persistent vegetative
state
for a specific length of time and is not expected to awaken enough
to make a valid statement of medical preferences.
When a particular procedure cannot be used,
it is sufficient to explain briefly why it cannot be fulfilled.
The other safeguard-procedures become more important
when some safeguards do not apply for stated reasons.
4. The safeguard does not
require
excessive paperwork.
One page of documentation should be enough to prove
that a particular safeguard has been fulfilled.
Multiplying pages of documents
would probably not improve the
death-planning process.
And when too much paperwork is required,
people tend to take short-cuts to avoid
the extra (and they believe
unnecessary) work.
For example, each of us has many pages of medical
records.
But instead of just making copies of everything,
the doctors should summarize
the medical facts and recommendations
in one or two pages of common-sense explanation.
Only if there are doubts or questions about medical
matters
would more documentation be relevant.
5. The safeguard must seem
reasonable and workable
on first
exposure.
When laypersons read a safeguard, they should say:
"Yes, I can fulfill that safeguard."
"Yes, this is a reasonable way to prevent mistakes and abuses."
Unreasonable
safeguards will immediately arouse
opposition:
"How can we get around this safeguard?"
"This safeguard does not apply to us because we are good people."
Unworkable
safeguards will arouse the following
responses:
"This requirement would take more time than we have right now."
"This 'safeguard' prevents us from claiming the
right-to-die."
"We would have to hire a lawyer to fulfill this safeguard."
6. The safeguard has real
potential to prevent premature death.
Some unwise decisions that would result in premature
death
will be prevented when
a specific safeguard is applied.
Whenever a 'right-to-die' exists, mistakes and abuses can take
place
under any system of
certifying reasonable life-ending decisions.
For example, a second professional opinion
should contain the real
possibility that the second doctor
will discover some medical facts or offer some recommendations
that will modify the
original decision to choose death.
Perhaps those who originally proposed an early death
were acting primarily from their own greed
or wanting to be relieved
of the
burden of caring for the dying
person.
Then one or two of the safeguards should have the potential
of discovering such an abuse of the right-to-die.
If the 'right-to-die' has become the 'duty-to-die',
will this safeguard uncover that distortion?
For example, when a clergy-person
speaks privately
with the patient,
that patient might say that he or she does not really want to die
but is feeling pressure
from the family to die quickly.
If the patient is not entirely free in making the life-ending decision,
then some safeguards should be designed
to discover such coercion
and
manipulation.
7. Safeguards should take
into
account
the reasonable
fears of special
groups of people,
such as racial or ethnic
minorities
and people
with
disabilities.
At least one safeguard should
address the fears
of special groups.
For example, disabled persons should be able to request that their cases
be reviewed and approved by some individual or group
that is well aware of the special concerns of patients with
disabilities.
It would be unreasonable to propose a safeguard
to prevent all
disabled persons from making life-ending decisions.
Likewise, it would be unreasonable to propose a
safeguard
that prevented any person of
color from asserting the right-to-die.
Careful safeguards can prevent bias against
any group
while still permitting individuals of all sorts
wisely to choose their best pathways towards death.
8. Each safeguard should make
serious
efforts
to prevent
irrational suicide.
Advocates of the right-to-die do not generally favor
irrational
suicide.
Therefore, safeguards should be proposed that genuinely and easily
separate those people who
are planning an irrational suicide
from those who have good
reasons for choosing death.
Some suicidal people will use right-to-die language
as a way of disguising their irrational wish to die.
In fact, irrational suicide
is more common than voluntary
death.
For example, what safeguards would discourage
teen-agers
from killing themselves for foolish 'reasons'?
To separate irrational suicide from voluntary death,
see:
Will
this
Death be an "Irrational Suicide" or a "Voluntary Death"?
9. Some safeguards could be
offered as optional
rather than mandatory.
When laws require certain safeguards to be
fulfilled
before a chosen death will be permitted,
the same laws could also suggest some additional safeguards
that might be fulfilled if the people who are planning the death
decide that they want to create even more complete proof
showing that death now
is better than death later.
For example, a family preparing for a
voluntary death
might take it upon themselves to create a recording
of the patient explaining in his or her own words
just why he or she is choosing death at this time.
This could be either an audio-recording or a video-recording.
And the whole family might be included,
since that will show more convincingly than anything else
that everyone involved fully understands what is being proposed
and that they agree with the plan for a timely death
—not too soon and not too late.
Another example might be having a
member of the clergy
review the requests for death and the recommendations of others.
If the patient and/or the family have no religious connections,
this safeguard could be omitted.
Bringing in religious views not relevant for this patient
would unnecessarily complicate the
process of planning for death.
In all secular countries of the world,
the views of religious authorities are optional.
Let the patient and/or the proxies decide what safeguards to use.
drafted
9-29-2006 by James Park,
revised
9-30-2006, posted on the Internet 10-2006;
revised
10-11-2006, 11-24-2006, 1-3-2007; 2-24-2007; 5-3-2007;
8-22-2007;
3-4-2009;
2-12-2010; 5-19-2010;
1-12-2012:
2-22-2012; 3-22-2012;
7-29-2012; 8-18-2012; 10-18-2012;
5-16-2013;
6-26-2013; 7-22-2014; 11-30-2014; 5-2-2015; 10-9-2015;
1-4-2018;
10-12-2018; 12-3-2019; 8-21-2020;