SAFEGUARDS
AS SAND ON THE SLIPPERY SLOPE
When the idea of voluntary
death is
first presented,
suicide
is the first idea that appears in the minds of most people.
Several
minutes of explanations or several paragraphs of writing
are
required to convince the listener or the reader
that it might be
possible to permit
voluntary death
while
at the same time discouraging
irrational suicide.
Here are the four basic differences:
1. Irrational suicide
harms
the victim.
Voluntary death benefits
the patient.
2. Irrational suicide is not
based on reason.
Voluntary
death is wise
and reasonable.
3.
Irrational suicide is often
capricious.
Voluntary
death is well-planned.
4.
Irrational suicide is regrettable
and lamentable.
Voluntary
death is admirable
and laudable.
If you would like
to
explore these four differences more completely, read:
Will this Death be
an "Irrational Suicide" or a "Voluntary
Death"?
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/CY-IS-VD.html
The safeguards
linked below constitute the operational
methods
by
which several
other persons can evaluate the plans for death
to see whether
this chosen death
would be an irrational
suicide
or a voluntary
death.
Likewise, whenever the words "merciful
death"
appear,
the first idea that comes to mind is mercy-killing.
Much
explanation is required to convince the listener or the reader
that
it might be possible to permit
merciful death
while
at the same time continuing
to outlaw mercy-killing.
Here are the same four
basic differences:
1. Mercy-killing harms
the victim.
Merciful death benefits
the patient.
2. Mercy-killing is
not based
on reason.
Merciful
death is wise
and reasonable.
3.
Mercy-killing is
often capricious.
Merciful
death is
well-planned.
4.
Mercy-killing is
regrettable
and lamentable.
Merciful
death is
admirable
and laudable.
If you would like
to
explore these four differences more completely, read:
Will this Death by a
"Mercy-Killing" or a "Merciful
Death"?
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/CY-MK-MD.html
The safeguards linked
below constitute the operational
methods
by
which several
other persons can participate
in examining the proposed death
to see whether
it would be a mercy-killing
(harmful criminal behavior)
or a merciful
death
(helpful compassionate behavior).
This set
of worries about the right-to-die
is traditionally called the
"slippery-slope argument".
If we permit some
forms of life-ending decisions,
then
we will begin slipping down a hill to disaster
without the
possibility of stopping ourselves.
A
chain of terrible consequences will follow
if we take even the first step down the slippery slope.
If this were true,
that we could not
prevent harmful deaths
if we permit
good deaths,
then
(so the argument goes),
we should never take the first step onto
the slippery slope:
We should not permit even obviously good
deaths
because someone will distort the principles allowing
beneficial deaths
so
that harmful
deaths
will be inevitable.
The safeguards are the
sand
that can be put on the icy
sidewalk
so
that it will be safe to walk down the hill.
As long as the
safeguards prevent us from slipping out of control,
the trip down
the icy sidewalk will be safe.
Wise safeguards carefully applied
can
permit
wise deaths
and prevent
foolish deaths.
Changing the metaphor,
wise safeguards are the guard-rails on the
mountain road
preventing cars from crashing off the road and down
the cliff.
The slippery-slope argument would simply close
the road
so
that no car would be able to reach the desired destination.
Opponents
of the right-to-die use the slippery-slope argument
to construct
roadblocks
rather than guard-rails.
SAFEGUARDS
TO DISCOURAGE
IRRATIONAL
SUICIDE AND MERCY-KILLING
The following 18 safeguards call upon the considered opinions
of a
wide
variety of neutral persons
who can help
to separate those deaths that would be harmful
irrational suicides
from wise life-ending decisions that would create helpful
voluntary deaths
and
to separate those deaths that would be harmful
mercy-killings
from
wise life-ending decisions that would create helpful
merciful deaths.
These safeguards are arranged beginning with the most powerful and
effective.
The blue
title
links to a complete explanation of that safeguard.
The red
comments
explain how that safeguard deals with the specific worry
that
permitting wise
life-ending decisions
for some patients
might lead to foolish
deaths
for other people.
STATEMENTS
FROM FAMILY MEMBERS
AFFIRMING OR
QUESTIONING THE CHOSEN DEATH
Family
members can usually be assumed
to be choosing in
the best interests of the patient.
(If
some relative has mixed
motives, such as greed,
the other safeguards become more
important.)
But when most family members agree
that death
now
would be better than death
later,
this
is reason to believe that the life-ending decisions
are being
carefully and wisely made.
In their written statements,
family
members show that they have considered the alternatives
and
decided that a chosen death is the best option.
STATEMENTS
FROM ADVOCATES FOR DISADVANTAGED GROUPS
IF
INVITED BY THE PATIENT AND/OR THE PROXIES
When special advocates for disadvantaged groups have been
appointed,
more distant doubters (who do not know the details of
the terminal care)
will be more likely to accept the choices
made
by the persons who are making what might be life-ending
decisions.
Each death-planning process differs from other
situations of terminal care.
When an advocate for a disadvantaged
group approves one merciful death,
it does not mean that the next
proposed death will also be a wise choice.
This special advocate
is asked for a written opinion
explicitly
for the purpose of preventing discrimination
on the basis of group identity.
There must be no slippery
slope leading from one wise merciful death
for a member of a
minority group to approving
other deaths automatically.
PHYSICIAN'S
STATEMENT OF CONDITION AND PROGNOSIS
A mercy-killer almost never asks for a written statement from a
doctor.
When
the terminal-care physician explains in writing
the
medical condition and prognosis of the patient,
this
is the factual basis for wise end-of-life decisions.
The
very process of obtaining such a professional medical opinion
will
prevent some premature deaths correctly called "mercy-killings".
INDEPENDENT
PHYSICIAN REVIEWS THE CONDITION AND PROGNOSIS
When
an independent physician reaches the same conclusions,
this
is further evidence supporting the decision for death.
This
second professional opinion is another check
to
make sure that no mistakes occur
because
the physical condition of the patient was misunderstood.
HOSPITAL
OR HOSPICE ENROLLMENT
When a terminal patient is being cared for in a hospital or
hospice,
several
professionals and volunteers will be observing whatever
happens.
Careful
medical records will be kept of all decisions and procedures.
And
the fact of approving one death in the hospital
should not suggest
that every proposed death will be approved.
Both hospitals and
hospice-programs are committed
to life.
Only
when meaningful
life is no longer possible
will
these helpers approve a chosen death.
PSYCHOLOGICAL
CONSULTANT EVALUATES
THE PATIENT'S
ABILITY TO MAKE MEDICAL DECISIONS
When there is some reasonable doubt
about the patient's
decision-making capacity,
a
psychological professional might be called upon to evaluate that
patient.
This
psychologist or psychiatrist should be capable of
separating
the
irrational urge to commit suicide
from
any wise
end-of-life medical decisions.
And
this professional's written statement
(the
specific content of which will not
become public information)
should
go some way toward convincing distant critics
that
this life-ending decision was wisely made.
ADVANCE
DIRECTIVE FOR MEDICAL CARE
An Advance
Directive was probably created some years before death.
And it
explains the patient's
settled values
concerning life and death.
The proxies appointed in the Advance
Directive
are
carrying forward the plans established by the patient.
Even
if the patient has questionable decision-making capacities
toward
the end of his or her life,
the personal medical ethics contained
in the Advance Directive
can be re-affirmed by everyone who reads
that 'living will'.
REQUESTS
FOR DEATH FROM THE PATIENT
And if the
patient is fully capable of making medical decisions,
the
patient's explicit, detailed request for death
will prevent any
cascade of terrible consequences.
Only
this patient will be helped to die.
There is no general principle of putting all seriously-ill
patients to death.
This
death was explicitly requested in writing by this patient.
INFORMED
CONSENT FROM THE PATIENT
When a
specific plan for death is set forth,
the patient should be asked
to approve or disapprove this plan.
Some modification might be
required
before the patient will give informed consent.
But if
and when the patient has given written,
informed consent,
no
stranger should claim that the
patient was railroaded into death.
UNBEARABLE
SUFFERING
The patient who is suffering
near the end of life
should explain his or her specific forms of
suffering
so that all decision-makers will understand the need for
relief.
PALLIATIVE
CARE TRIAL
And several
methods of relieving suffering should be tried
before
the final decision is made
that voluntary death or merciful death
is the best remaining option.
ETHICS
COMMITTEE REVIEWS THE LIFE-ENDING DECISION
Institutional ethics committees are created
for the purpose of
giving
impartial reviews to all medical decisions,
including those decisions that will lead to the patient's
death.
The members of any ethics committee
should not be
involved in the personal life of the patient.
But they should
consult with the patient whenever possible
to make sure that the
patient and/or the proxies
are making wise decisions.
The fact
of an ethics-committee review
can be made public.
But the details of their deliberations should
be kept private.
A
MEMBER OF THE CLERGY
APPROVES OR
QUESTIONS THE CHOICE FOR DEATH
Likewise, any member of the clergy
who is asked to review a
life-ending decision
need not share the details of his or her
thinking with the general public.
But it will be reassuring to
distant critics to know
that a member of the clergy was consulted
and did agree with the terminal-care plan.
RELIGIOUS
OR OTHER MORAL PRINCIPLES
APPLIED
TO THIS LIFE-ENDING DECISION
And even
more explicitly, religious experts might apply their principles
to
the end-of-life situation at hand.
These religious authorities
might create a written document,
showing how the religious or
moral principles
led to the decision they endorse.
(And in
order to avoid public debate of private religious matters,
the
specific
contents
of any such documents should be kept private.)
But religious and
moral experts are welcome
to present and explain their general
end-of-life moral principles
as
fully and completely as they please.
REVIEW BY THE
PROSECUTOR (OR OTHER LAWYER)
BEFORE THE DEATH
TAKES PLACE
When the terminal-care plans are reaching their conclusion,
the
complete death-planning record (or a summary of it)
might be
provided to the prosecuting authority.
If the prosecutor finds
nothing that needs further explanation
and nothing that would lead
to a criminal prosecution,
he or she can issue a statement
declaring that there will be no
prosecution.
And
everyone can proceed with the plan for a wisely-chosen death.
Since
the prosecutor knows the applicable laws,
this will be the most
decisive way to separate harmful
criminal acts
from
acts
of mercy that clearly benefit the patient.
If
the prosecutor approves of the plans for death in advance,
how
could any critic claim that a harm
was committed?
CIVIL
AND CRIMINAL PENALTIES FOR CAUSING PREMATURE DEATH
But if the report to the prosecutor was incomplete or misleading,
the
law still provides for penalties
if it can be shown that the
death in question was premature.
And
all people who might be tempted to commit a mercy-killing
should
be reminded as frequently and clearly as possible
that
mercy-killing
is a criminal offense.
And
even when the standards for a criminal
conviction
are not met,
it might still be possible for a civil court to
conclude
that a wrongful
death
did occur.
COMPLETE
RECORDING AND SHARING
OF ALL MATERIAL
FACTS AND OPINIONS
A careful death-planning process will be open
and honest.
All
people who have a legitimate right to be involved in the process
will
receive all of the documents created to fulfill the safeguards.
When
a life-ending decision emerges from due
consideration
of
all of the alternatives to a chosen death,
there will be no
taint of an underground mercy-killing.
THE
DEATH-PLANNING COORDINATOR ORGANIZES THE SAFEGUARDS
When a death-planning coordinator is employed,
this individual
will organize and preserve all of the records
showing which
safeguards were fulfilled and by whom.
These
records do not become public information.
But
the fact that a certain number of safeguards were fulfilled
might
be disclosed to satisfy distant doubters
that this death was
wisely and compassionately chosen.
If
these 18 safeguards do not seem sufficient
to discourage
irrational suicides and mercy-killings,
there are several more
listed in the complete catalog of
safeguards:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-CAT.html
Each
of these descriptions contains a few paragraphs
explaining how
that safeguard will discourage
irrational suicide and other forms
of premature death.
Created
February 25, 2007; revised 2-21-2008; 11-13-2008; 1-24-2009;
2-4-2010; 11-21-2010;
2-26-2011; 9-20-2011; 12-22-2011;
1-27-2012; 2-21-2012; 3-27-2012; 5-29-2012; 9-11-2012;
3-17-2013;
6-20-2013; 7-17-2014; 10-10-2014; 5-6-2015; 7-3-2015; 10-20-2017;
This
discussion of the 18 different kinds of sand to put on the slippery
slope
has become Chapter 7 of How
to Die: Safeguards for Life-Ending Decisions:
"Safeguards
as Sand on the Slippery Slope".
If you are an advocate of
the right-to-die,
you might consider joining a world-wide
Facebook Seminar
that will discuss over 30 proposed safeguards.
See the complete description for this book-club:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/ED-HTD.html
Join
our Facebook Group called:
Safeguards for Life-Ending
Decisions:
http://www.facebook.com/home.php#!/groups/107513822718270/
Go
to other dangers,
mistakes, & abuses of the right-to-die.
Go to
the beginning of this website
James
Leonard Park—Free
Library