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 CHOOSING 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 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 choosing 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 CHOOSING 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; 8-23-2018; 



    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:
https://www.facebook.com/groups/107513822718270/




Go to other dangers, mistakes, & abuses of the right-to-die.




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