SAFEGUARD
FOR LIFE-ENDING DECISIONS
KEEPING
GOVERNMENT OFFICIALS, THE MEDIA,
&
OTHER STRANGERS OUT OF THE LOOP
Death-planning is a private process
conducted by the patient and his or her close relatives,
doctors, & other advisors chosen by the patient and/or the proxies.
All safeguards found appropriate for each patient
define exactly which persons will be involved in the death-planning
process.
All other persons, organizations, agencies of
government, etc.
are explicitly excluded
from the process.
The only exception to this rule of exclusion is the prosecuting
authority.
If some crime might have been committed
under the color of a legal death-planning process,
then the prosecutor has the authority to investigate fully
—without
any limitation concerning who may be questioned
or what documents may be examined.
In other words, each and every individual who has
access
to the facts and documents of the death-planning process
has an explicit reason to be
involved.
When clergy-persons and ethical consultants are invited to participate,
they have to be explicitly
authorized by the patient and/or the proxies.
No self-appointed guardians of the dying
have any right to interfere with the death-planning process.
The formulation of how the various safeguards are to
be fulfilled
is a matter of public record.
This is the meaning of "public
safeguards".
Exactly how the safeguards were fulfilled in any particular case is
private information,
available only to those who have a legitimate right to know.
The same laws that apply to medical records
apply to death-planning records.
All such records are not
open to public examination.
They are not available to
the news media.
They are not available to
any public official,
with the exception of the prosecutor, as noted above.
The reasons for keeping all strangers out of the
loop are self-evident.
But it will do no harm to make these reasons explicit here.
Self-appointed individuals
who see themselves as guardians of the dying
have their own ethical agendas,
which may or may not be the same as the ethical principles of the
patient.
If the death-planning records were public information,
then such strangers would be involved full-time
in examining records and attempting to intervene
in the deaths they believe would be inappropriate.
The news
media should not have access to the
death-planning process
because that would only inflame passions on all sides.
It would encourage people who know only what is reported in the media
to draw their own conclusions about what should be done in the cases
reported.
This would enormously complicate
what should be a private process of making medical decisions.
Government
officials should be excluded from the
death-planning process
because they also come with preconceived principles of what is right
and wrong.
And they might try to use the various powers that come with their
offices
to influence the decisions that are being made by the duly-authorized
persons.
A major fear based on the Nazi example
is that government power will be misused to put certain persons to death
without regard to what is best for the patient
and without regard to what the proxies decide.
Government bureaucrats must never become involved
in deciding who lives and who dies.
The 2005 example of Terri Schiavo in the Florida
shows what can happen when government officials interfere in medical
decisions.
The governor of Florida, the Florida legislature,
and then the US Congress and the US President
all took various actions in attempting to decide what should happen to
Terri Schiavo,
whose autopsy proved was in a persistent vegetative state.
Barring all government officials from attempting to
make medical decisions,
including life-ending decisions, will prevent repeats of such
controversies.
If additional laws are needed to protect patient privacy,
let them be enacted at all appropriate levels of government.
Government officials should not only be prohibited
from asking for private medical records,
but they should be punished
for any actions they take in their official
capacities
that are intended to influence private medical decisions.
HOW EXCLUDING STRANGERS FROM THE DEATH-PLANNING PROCESS
DISCOURAGES UNREASONABLY-PROLONGED DYING
AND PREVENTS GOVERNMENT-ORDERED DEATH.
Keeping strangers out of any process for making
medical decisions
will simplify every such effort to reach a reasonable decision.
The persons legitimately
involved in the decision-making process
will not have to fear that their choices will be reviewed by strangers,
who will usually have some ethical or political agenda
at odds with the basic purpose of making medical decisions.
In totalitarian countries where there might be a
legitimate fear
that the dictator will order some 'useless eaters' put to death,
keeping all medical records out of government hands
will prevent bureaucrats from choosing who will die.
In the United States prohibiting and punishing the
efforts of government officials
to interfere in the private medical decisions of any family
will prevent a repeat of the Terri Schiavo conflict.
In the United States the only officials who might be asked to review
any case
are the prosecutors and the courts
—members
of the judicial branches of each level of government.
And these prosecutors and judges can only become involved
if any medical decision (including life-ending decisions)
might violate any law then on the books.
Created March 9,
2007; revised 2-14-2008