CERTAIN
LIVES ARE WORTHLESS
Whenever the 'right-to-die' is discussed,
there are some people
who think first of the Nazi Holocaust.
Six million Jews and
others were murdered
by the Nazi regime
during the Second World
War.
The Nazi ideology held that Jews were sub-human
creatures.
Therefore the world would be better off
if as many
Jews as possible were exterminated.
Gypsies, homosexuals, Communists, and the inmates of asylums
were
also put to death because they were not wanted in the Nazi
paradise.
For part of this history of atrocities,
the word
"euthanasia" was used to describe killing people against
their will.
Thereafter any program that
allows chosen death
must work against the background of these Nazi
atrocities.
Even if there is no
similarity
between the Nazi gas chambers
and the modern hospital,
some
people will worry that new atrocities will be committed
in the
intensive care unit by disconnecting life-supports.
It is not sufficient to say that we are good people,
who would
never commit such crimes against humanity.
Actual
safeguards
must be kept in place to prevent
any human behavior even
remotely resembling Nazi atrocities.
The life of every human person has inherent worth.
And we should
resist devaluing the life of any person
just because someone else
finds that life less worthy.
Some opponents
of the right-to-die claim it is impossible
to separate good
deaths
from bad
deaths.
Therefore, the only safe course for any society
is to prohibit
all chosen deaths.
We
who advocate the right-to-die do not agree.
Careful safeguards can
separate
those deaths that harm
the victims
from
those deaths that genuinely benefit
the patients
who are suffering.
Good safeguards,
carefully fulfilled, will protect all vulnerable patients.
When
patients cannot speak for themselves,
then advocates who can speak
for them
become even more important.
Good record-keeping will prove that
vulnerable patients
were given extra protection—beyond the care needed by all
patients.
PROTECTING
PATIENTS
WHOSE LIVES
MIGHT BE DISMISSED AS WORTHLESS
The following 18 safeguards offer operational methods
for
protecting patients who might seem to be
in danger of being put
to death prematurely and/or unwisely.
These safeguards ask for the
opinions of many other persons.
Thus, if one
person dismisses a patient as having a worthless life,
other
neutral observers will probably not agree.
And
these other people asked to review any life-ending decisions
will
have several good opportunities to prevent premature deaths
among
patients who might otherwise have been allowed to die
because
someone found their lives to have low value.
These safeguards to protect patients whose lives might be
devalued
are arranged beginning with the most powerful and
significant methods
for preventing premature deaths of vulnerable
patients.
The blue
title
links to a complete explanation of that safeguard.
The red
comment
explains how that safeguard protects patients
whose lives might be
regarded by some people as worthless.
A
MEMBER OF THE CLERGY
APPROVES
OR
QUESTIONS CHOOSING DEATH
Persons professionally employed to lead religious organizations
are
well-placed to detect any devaluing of the lives of patients.
So,
if they publicly approve the plans for death,
this might persuade
others who have not closely examined the case
that the planned
death would not
harm
the patient.
RELIGIOUS
OR OTHER MORAL PRINCIPLES
APPLIED
TO THIS LIFE-ENDING DECISION
When
written ethical principles are applied to the death in question,
then
everyone can be more assured
that no patient was put to death
because his or her life was 'worthless'.
Everyone who reads any
such document
will see that the moral principles applied
were
intended to protect against devaluing any person's life.
REQUESTS
FOR DEATH FROM THE PROXIES
The persons
chosen by the patient to be proxies
already believe in the value
of the life of the patient.
And if they too request death,
then
we should be more assured that the patient
was not merely
dismissed by people who know nothing of the patient's life.
Strangers
applying abstract principles
might be more inclined to regard the
patient's life as worthless.
But the proxies were chosen (usually
selected by the patient)
precisely because they
value the life of the patient.
STATEMENTS
FROM FAMILY MEMBERS
AFFIRMING
OR
QUESTIONING CHOOSING DEATH
Family
members usually affirm the value of the patient's life.
If
relatives join in the death-planning process,
more distant
doubters will know that this death was not premature.
If some
family members might devalue the life of the patient,
then the
statements of other
family members become more meaningful.
STATEMENTS
FROM ADVOCATES FOR DISADVANTAGED GROUPS
IF
INVITED BY THE PATIENT AND/OR THE PROXIES
Advocates for less-favored groups will also be very sensitive
to
the possibility that some patients might receive lower levels of
care
because their lives are not as highly valued as other
groups.
So, if these advocates also
approve the life-ending decisions,
others who have not looked at
the case as closely can be assured
that the value of the life of
the
patient as an individual person
was
carefully taken into account.
PHYSICIAN'S
STATEMENT OF CONDITION AND PROGNOSIS
When a doctor takes the time to write a medical statement,
this
shows that the physician does not
regard this patient as worthless.
Careful attention has been paid
to all of the relevant facts
about this patient's medical
problems;
and a careful projection of the outcomes has been
presented.
INDEPENDENT
PHYSICIAN REVIEWS THE CONDITION AND PROGNOSIS
An independent physician can also protect against
any
tendency to devalue the patient.
If either doctor merely presents
a generic
statement,
a
pre-written set of words used for all patients in similar
circumstances,
this is itself a sign
of devaluing this patient.
Would
either doctor issue a generic
statement
for a close member of his or her family?
HOSPITAL
OR HOSPICE ENROLLMENT
When the patient is receiving care from a hospital or
hospice-program,
there
are already safeguards in place to protect patients
who
cannot fully protect themselves.
The fact that several
professionals are involved in the terminal care
will help to
compensate for any lower evaluations
by some
care-givers or family members.
STATEMENTS
WRITTEN BY HOSPITAL OR HOSPICE STAFF MEMBERS
Professional care-givers who have been deeply involved
in the
last days of the patient's life
will
also show by their daily behavior that they value the life of this
patient.
When
their statements also affirm any life-ending decisions,
we
know this is not
because they regard the patient's life as worthless.
PSYCHOLOGICAL
CONSULTANT
EVALUATES THE
PATIENT'S
ABILITY TO MAKE MEDICAL DECISIONS
A psychological professional who has evaluated the patient's
thinking
can
also see whether there is any possibility
that
this patient is being dismissed as worthless by others.
Is this
patient requesting death because he or she feels 'worthless'?
The
psychological consultant should also look
for signs of the urge
to commit irrational suicide.
REQUESTS
FOR DEATH FROM THE PATIENT
When the
patient himself or herself has clearly requested death,
this is a
decision from the person who has the deepest interest
in
preserving the value or worth of his or her own life.
The main exception to this would be patients with suicidal urges.
If
the patient plans a harmful, irrational, capricious, &
regrettable death,
then others must do their best to prevent any
harmful self-killing.
INFORMED
CONSENT FROM THE PATIENT
If the patient
believes his or her life is worthless,
then he or she cannot give
informed consent.
All the others involved in the end-of-life
planning
must protect the patient from debasing himself or
herself.
ETHICS
COMMITTEE REVIEWS THE LIFE-ENDING DECISION
When an ethics committee carefully reviews a planned death,
they
are necessarily indicating
that they do
value this patient's life as having worth.
If their review is
perfunctory,
this might be a warning sign
that the ethics committee is giving
less value to this life.
The ethics
committee will demonstrate that they value the patient
by paying a
personal visit to the bedside
to make sure that the plan for a
chosen death
is really the best option for this particular
patient.
WAITING
PERIODS FOR REFLECTION
If anyone
suffered a temporary phase
of thinking that the patient's life
was worthless,
then giving ample time to review the facts and
opinions
should allow everyone to recover from any such foolish beliefs.
THE
PATIENT MUST BE CONSCIOUS AND ABLE TO ACHIEVE DEATH
If the patient has valued and affirmed his or her life,
then the
conscious choice for death
and using his or her own hands to
achieve death
will be strong reasons to believe
that this
death did not occur because this life was worthless.
COMPLETE
RECORDING AND SHARING
OF
ALL MATERIAL
FACTS AND OPINIONS
When the death-planning documents are shared with everyone
who has
a legitimate right to participate in the end-of-life
discussions,
someone who believes that the patient should continue
to live
will have an opportunity to raise doubts
about the
wisdom of choosing death for this patient at this time.
REVIEW
BY THE
PROSECUTOR (OR OTHER LAWYER)
BEFORE
THE DEATH
TAKES PLACE
The prosecutor is aware of the danger of choosing death for others
because some people regard the patient's life as
worthless.
Reviewing the life-ending decisions from a legal
point-of-view
will assure everyone that the patient's life was not devalued.
CIVIL
AND CRIMINAL PENALTIES FOR CAUSING PREMATURE DEATH
And if death results from devaluing someone's life,
then the law
provides appropriate consequences
for anyone who has harmed
another person.
If
these 18 safeguards do not seem sufficient
to protect against
some patients being devalued as 'worthless',
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
all forms of choosing death too
soon.
created
March 1, 2007; revised 3-22-2007; 8-30-2008; 11-14-2008;
1-15-2009;
2-4-2010; 2-26-2011; 12-21-2011;
2-18-2012; 3-25-2012;
5-29-2012; 9-11-2012; 3-17-2013; 6-20-2013;
7-16-2014;
10-10-2014;
7-3-2015; 10-5-2017; 8-16-2018; 5-22-2020;
The
above discussion of the danger of some patients being regarded as
worthless
has become Chapter 5 in How
to Die: Safeguards for Life-Ending Decisions:
"Certain
Lives Are Worthless".
Go
to other dangers,
mistakes, & abuses of the right-to-die.
A closely-related
worry is explored in:
Protecting
Vulnerable Patients from Discrimination.
Go to
the beginning of this website
James
Leonard Park—Free
Library