PRESERVING
GOOD DOCTOR-PATIENT RELATIONS:
WILL MY DOCTOR DECIDE TO KILL ME?
Physicians often oppose the right-to-die
because of they fear that allowing doctors to recommend death
will harm the trust between doctors and their patients.
Such fears are not well-grounded in reality,
since most doctors are committed to the well-being of their patients.
But some patients already have an irrational fear of doctors.
And permitting doctors to take any part in life-ending decisions
might seem to corrupt the mission of the healing professions.
Many patients are already reluctant to consult
doctors.
Thus, adding the additional worry that doctors might recommend death
if their cases becomes too difficult or troublesome
would not improve doctor-patient relations.
When we consult doctors, we want to know in advance
that our doctors will do everything reasonably-possible to save us from
death.
If we begin to see doctors as people who might provide death pills,
we might want to stay away from such 'executioners'.
We will probably know that the doctor will consult
with everyone involved
before agreeing to participate in a voluntary death or a merciful death,
but even thinking of this as part of the role of the doctor
can turn us away from the healing services of the physician.
If the right-to-die were completely dissociated from
the healing professions,
if, for example, someone other than physicians could provide the gentle
poison,
then the patients would not be confused about the role of the doctor.
They would know that the doctor is completely committed to curing.
And if the doctor decides that cure is no longer
possible,
her or she will refer the patient to another kind of professional,
who will help with the life-ending decisions.
This would keep the doctor always
associated with healing
and allow others to take over the care of the patient
when a reasonable process has concluded
that a voluntary death or a merciful death is the best option.
SAFEGUARDS TO PRESERVE GOOD DOCTOR-PATIENT RELATIONS
When we consider what safeguards to include in our
new right-to-die laws,
we should try to keep the doctor-patient relationship
as meaningful and positive as possible.
The following 20 specific safeguards
should go a long way toward making sure that wise life-ending decisions
are made.
The doctors will be in charge of all the medical information and
opinions.
But the patient and/or the proxies
will be responsible for making all end-of-life decisions.
These safeguards are arranged beginning with the
most powerful and effective:
SPECIFICALLY-LICENSED
TERMINAL-CARE PHYSICIAN
AGREES TO
PROVIDE GENTLE POISON
PHYSICIAN'S
STATEMENT OF CONDITION AND PROGNOSIS
INDEPENDENT
PHYSICIAN REVIEWS THE CONDITION AND PROGNOSIS
HOSPITAL OR
HOSPICE ENROLLMENT
INFORMATION ABOUT
PALLIATIVE CARE
AND OTHER
ALTERNATIVES TO DEATH
PALLIATIVE CARE
TRIAL
PSYCHOLOGICAL
CONSULTANT EVALUATES
THE PATIENT'S
ABILITY TO MAKE MEDICAL DECISIONS
ADVANCE
DIRECTIVE FOR MEDICAL CARE
REQUESTS FOR
DEATH FROM THE PATIENT
INFORMED
CONSENT FROM THE PATIENT
OPPORTUNITIES
FOR THE PATIENT TO RESCIND THE LIFE-ENDING DECISION
THE PATIENT
MUST BE CONSCIOUS AND ABLE TO ACHIEVE DEATH
ETHICS
COMMITTEE REVIEWS THE LIFE-ENDING DECISION
STATEMENTS
FROM FAMILY MEMBERS
AFFIRMING OR
QUESTIONING THE CHOSEN DEATH
A
MEMBER OF THE CLERGY APPROVES OR QUESTIONS THE CHOICE FOR DEATH
RELIGIOUS OR
OTHER MORAL PRINCIPLES
APPLIED TO THIS
LIFE-ENDING DECISION
REPORT TO THE
PROSECUTOR BEFORE THE DEATH TAKES PLACE
CIVIL AND
CRIMINAL PENALTIES FOR CAUSING PREMATURE DEATH
COMPLETE
RECORDING AND SHARING OF ALL MATERIAL FACTS AND OPINIONS
THE
DEATH-PLANNING COORDINATOR ORGANIZES THE SAFEGUARDS
If these 20
safeguards do not seem sufficient to encourage good doctor-patient
relations,
there are a dozen more listed in the complete catalog of safeguards:
http://www.tc.umn.edu/~parkx032/SG-CAT.html.
Each of these descriptions contains a few paragraphs
explaining how that safeguard will discourage
all forms of choosing a premature death.
Created March 22, 2007; revised
4-12-2007; 9-26-2007; 7-16-2008