PROTECTING PATIENTS FROM
FINANCIAL MOTIVES FOR CHOOSING AN EARLIER DEATH
might sometimes become the duty-to-die
when the dying patient has a significant estate
that will pass into the hands of relatives at death.
Usually these heirs are family members.
And usually they know in advance what they will receive
in terms of wills, trusts, life-insurance,
and/or the normal operation of inheritance law.
In some cases, the medical care of the patient
is being paid for (at least in part) from the assets of the patient
remainder of which will pass to the relatives upon death.
Putting this another way, the potential estate
is being used for the terminal care of the patient.
The relatives worry that these assets will be wasted in useless
They have in mind better uses for the cash, farm, business, stocks, or
If the patient is married, the financial cost to the other spouse
is even more obvious and direct:
Sometimes medical bills are being paid from their joint assets.
Pure greed is seldom the sole motive for wanting an
But every person who will benefit financially from the death of
has thought at least briefly about the money.
When the beneficiary is a family member,
that heir might have dismissed the monetary motive immediately.
But the amount to be inherited did appear in the thought of the
even if the primary feeling of the relative is love and compassion
for the person who is dying.
Few heirs are completely unaware
of what they stand to gain by the death of a relative.
Only rarely does a 'rich uncle' leave some money
that the heir did not know
Thus, financial gain is at least one part of the
mixture of motives
that happen when deciding the best
time for the patient to
AGAINST GREEDY RELATIVES
Careful safeguards can discourage premature
deaths motivated by money.
The safeguards that would counter-balance the financial incentives
call for the considered judgments of neutral persons with nothing to
Here are nine safeguards to counterbalance greed,
listed in order of effectiveness, beginning with the most powerful.
blue title leads to a
complete explanation of that safeguard.
The red comments explain
how that safeguard
deals with the specific problem of greedy relatives.
PROSECUTOR (OR OTHER LAWYER)
The office that is responsible for prosecuting any
is well aware of this danger inherent in any life-ending decision.
If the death-planning record is reviewed by the
the lawyers in that office will look for possible premature death
motivated by the desire to
inherit money sooner
and possibly to avoid
dissipating the estate in terminal care.
CRIMINAL PENALTIES FOR CAUSING PREMATURE DEATH
When everyone knows about the
criminal and civil
for anyone who cooperates in causing a premature death,
the relatives and other heirs will be more cautious
about their participation in life-ending decisions.
MEMBER OF THE CLERGY
QUESTIONS THE CHOICE FOR DEATH
When a clergy-person is asked for an opinion,
this is another opportunity for someone who knows the family situation
to urge going slow if there is any danger of financial motives
causing a premature decision for death.
Such a neutral person will put the best interests of the
DEATH FROM THE PATIENT
When properly applied, this safeguard makes sure
that it is the patient
who is requesting death,
not the relatives who might be motivated by greed.
CONSENT FROM THE PATIENT
Likewise, when the
patient himself or herself
gives informed consent to the plan for death,
there would be less worry about inappropriate financial
suffering considered in this safeguard
is the suffering of the patient,
not the financial problems that family members might be
Those called upon to read and evaluate the death-planning record
should watch for financial motives disguised as something else.
STATEMENT OF CONDITION AND PROGNOSIS
When a physician
issues a statement of the condition of the patient,
this covers the objective health status and future of the patient.
And the physicians' statements might counter-balance
exaggerated claims of imminent death by greedy relatives.
COMMITTEE REVIEWS THE LIFE-ENDING DECISION
The ethics committee of any medical institution
will make sure that only
medical facts and opinions
are being used to make any life-ending decision.
Because the members of the ethics committee
have nothing to gain financially from the death of the patient,
they can evaluate the situation more objectively.
THE PATIENT AND/OR THE PROXIES
And advocates chosen
to protect patients
from discrimination on the basis of group-identity
might also be aware of the danger from greedy relatives.
All such neutral observers should 'blow the whistle'
if they believe the patient is being rushed into death.
If these 9
safeguards do not seem sufficient,
there are two
safeguards that might be used
to make sure that the relatives'
are not distorting decisions
about terminal care.
created February 23, 2007; revised
3-22-2007; 8-30-2008; 11-5-2008; 12-3-2008;
2-18-2012; 3-25-2012; 5-29-2012; 9-11-2012:
10-8-2014; 7-3-2015; 8-10-2018;
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