CONSUMER
USE OF RIGHT-TO-DIE SAFEGUARDS
Even before new legislation is passed
to protect people who make wise life-ending decisions,
it is possible to apply safeguards that we choose
in order to make certain that we are making
the best possible
end-of-life choices.
The laws of any society are created
after most of the people have already accepted
some new standard of
behavior.
For example, it was standard medical practice
to withhold or withdraw life-sustaining medical care
in cases where there was no hope of recovery
long before laws were written to permit such medical choices.
Those who first apply new forms of medical ethics
might have a slight worry that they might run afoul of the law.
But if they have the backing of their colleagues in medicine,
it would be difficult to charge doctors with causing a premature death
if other doctors (and laypersons)
would have made the same
principle-based decision.
The use of brain-death
as a criterion for the death
of a patient
was debated in the medical community for some years
before some states started to change their laws
to permit what had by then become a standard medical practice.
A more controversial medical practice
will be
declaring patients to be dead
when they have been certified as permanently unconscious.
This would be a wise option when the permanently unconscious patient
had declared in advance (for instance in an Advance Directive)
that he or she wanted to donate organs
to save other lives.
And if the donor had declared
in addition that he or she approved
using the standard of the final
end of consciousness
as a valid definition of
death,
then the doctors would have even an even stronger case
for going ahead with organ-transplantation
even while most of the biological functions of the donor's body
continued.
In other words, permitting an earlier declaration of death
(using the criterion of permanent unconsciousness)
would allow transplant of organs while they are still functioning.
Allowing permanent unconsciousness to be an optional
definition of death
would also allow donors to be used as living cadavers.
SAFEGUARDS TO SEPARATE MERCY
KILLING FROM MERCIFUL DEATH
From time to time, the news media report that a
spouse or child
has been killed by a loving relative because the suffering became too
great.
Often these are acts of desperation,
taken after the loving relative has already tried
many other ways of dealing with the problem.
And sometimes charges are brought by the local prosecuting authority.
This is because in societies governed by the rule of law,
we cannot tolerate individuals ending the lives of others
without following careful safeguards to prevent premature death.
Such mercy killers usually have thought thru their
options in their own heads.
But usually they have not submitted the case to an ethics committee,
for example.
They fear that bringing any other people into the decision-making
process
will only hopelessly complicate the problems
and perhaps result in a decision they do not like.
But it might be possible for someone who wants to
facilitate a merciful death
(as distinct
from a mercy killing)
to apply at least the most relevant of the recommended safeguards
to create a decision-making process that might yield a wise result.
Here are the 26 recommended safeguards:
http://www.tc.umn.edu/~parkx032/SG-A-Z.html
Which of these would be more useful to a layperson
in attempting to make a wise life-ending decision for a relative?
Each of these recommended safeguards discusses how
applying it meaningfully
would discourage mercy killing, irrational suicide, & other forms
of premature death.
The process of gathering the information and professional opinions,
of discussing the options with others who are deeply concerned,
and writing out the fulfilled safeguards
is a step-by-step, orderly procedure that can be undertaken by almost
anyone.
And if the safeguards are fulfilled in good faith,
then some previous inclinations toward deciding for death
might be reversed:
Greater clarity and more options might show the way to a better choice.
The possible desperation of relatives thinking in isolation
might be replaced a community of caring persons
(both lay and professional) who offer alternatives other than death.
One safeguard that would have prevented almost every
mercy killing
is consulting
with a member of the clergy chosen by the patient and/or the
proxies.
No responsible minister, priest, or rabbi is going to approve a mercy
killing.
But when all of the medical facts and family opinions lead to the same
conclusion,
that it would be better for the patient to be granted a merciful death
now
rather than forcing him or her to suffer a prolonged and meaningless
dying process,
then even open-minded clergy-persons can agree with the life-ending
decision.
Religious leaders have seen the consequences to bad end-of-life
decisions.
And all religious leaders will have to face their own deaths.
Thus, it will be difficult—but
not impossible—to
fulfill the clergy safeguard.
After examining all the relevant medical facts and family perspectives,
an open-minded member of the clergy can approve a merciful death
or issue a statement disapproving
the proposed life-ending decision
because it would correctly be called a "mercy killing".
Another safeguards calls for an actual trial of
palliative care.
If the person who is tempted to commit a mercy killing
agrees to putting the suffering relative into professional palliative
care,
then the urge to kill as a means of relieving suffering might be
reversed.
And if such a palliative-care trial does not yield
the desired results
—if
it does not satisfactorily relieve the suffering—
then everyone will be more justified in a life-ending decision,
which might be called "merciful death".
Merciful death differs
from mercy killing in
the following four ways:
(1) Merciful death is a benefit
to the patient, not a harm.
(2) Merciful death is a well-reasoned
choice, not an irrational
urge.
(3) Merciful death is carefully
planned, not 'decided'
at a moment of crisis.
(4) Merciful death is admirable
and commendable, not regrettable
and tragic.
These four differences are worked out in greater detail here:
"Four Differences between Mercy Killing and Merciful Death":
http://www.tc.umn.edu/~parkx032/CY-MK-MD.html.
No matter what the state of the law,
a merciful death will be validated
by fulfilling the most relevant of the 26 safeguards.
And when the news media report any such deaths,
they should be encouraged to include the fact
that such-and-such safeguards for life-ending decisions were fulfilled
by the relatives before they went ahead with the life-ending decision.
And any jury-trial that follows a questionable
death
should include a complete presentation of the fulfilled safeguards.
Some judges will not allow such evidence,
saying that the medical condition of the 'victim'
and the views of the ethical consultants and doctors are not relevant
because this is a straight-forward case of murder.
But the laws can be changed so that judges
will not be permitted to exclude all such relevant information.
For example, here is draft legislation
that explicitly includes all 26 safeguards:
http://www.tc.umn.edu/~parkx032/PREM-DTH.html.
The prosecutor, the judge, & the jury
would be required to pay
attention to any evidence
that the family did in fact fulfill several safeguards
in the process of deciding for a merciful death.
And in cases of where the safeguards were most completely fulfilled,
doubts raised by anyone about the legitimacy of this chosen death
would be easily satisfied by a quick reading of the fulfilled
safeguards.
In short, the prosecutor would declare that there is no case,
since the fulfilling of the safeguards proves
that all due care was
exercised in making this life-ending decision.
Fulfilling the recommended safeguards will be an
operational method
for separating a harmful crime—mercy
killing—
from a helpful benefit to the patient—merciful
death.
SAFEGUARDS TO SEPARATE
IRRATIONAL SUICIDE FROM VOLUNTARY DEATH
Whenever we ourselves are tempted to commit suicide
for foolish 'reasons',
we can bring the suggested safeguards into play to help our own
thinking.
When we have suicidal urges, we are not thinking straight.
And applying the safeguards will draw others into the discussion
of our 'reasons' for wanting to end our lives now.
At the same time, fulfilling the safeguards will be
very strong proof
that we do indeed have valid, substantial reasons
for choosing death now
rather than death later.
Gathering the personal and professional opinions of perhaps 20 other
people
will go a long way toward making an air-tight case for voluntary death.
And very likely, drawing on the facts and opinions
provided by others
will help to save us from suicidal thinking
if we were on the verge of committing irrational suicide.
Here are the four basic differences between
irrational suicide and
voluntary death;
(1) Voluntary death is a benefit
to me, not a harm.
(2) Voluntary death is a reasonable
choice, not an irrational
urge.
(3) Voluntary death is well-planned,
not a capricious 'choice'.
(4) Voluntary death is admirable
and commendable, not regrettable
and tragic.
The following on-line essay explores these differences in detail:
"Four Differences between Irrational Suicide and Voluntary Death":
http://www.tc.umn.edu/~parkx032/CY-IS-VD.html.
If we seriously apply the most relevant of the 26 suggested
safeguards,
we will probably save
ourselves from irrational suicide.
Or if carefully fulfilling these safeguards leads to
a wise decision for death,
we will be able to say to all concerned
that our death was clearly a voluntary
death—not
an irrational
suicide.
All people who are open to the option of voluntary death
will be led by the same evidence to the same conclusion:
Death at this time is
better than death at some
later time.
And having fulfilled the safeguards to our own
satisfaction,
we can comfortably choose the best
means and the best
time for our own death.
Following these reasonable and workable procedures
is what it means for consumers
to use
the safeguards for life-ending decisions for themselves.
By carefully applying the most relevant of the safeguards,
we can achieve wise and compassionate end-of-life choices.
Created
March 1, 2008; Revised 3-3-2008; 3-12-2008; 4-4-2008
See the 26 recommended
safeguards
that can
be applied even by laypersons
to prevent
mercy killing, irrational suicide, & all other forms of premature
death.