SAFEGUARD
FOR LIFE-ENDING DECISIONS
PHYSICIAN AGREES TO PROVIDE
LIFE-ENDING CHEMICALS
After the primary care physician has reviewed all
the medical facts and opinions,
he or she shall decide whether a voluntary death or a merciful death is
a wise course of action
given everything that has been collected in the death-planning process.
This safeguard will normally be one of the last to
be
fulfilled,
after the opinions of the patient, family, proxies, ethics committee,
etc.
have all been properly gathered and distributed
to everyone legitimately involved in the death-planning process.
This approval by the primary care physician
has not
always been recognized as a safeguards,
because it was assumed to be so central to the process
as defined in laws permitting the giving of life-ending chemicals.
But it is important for at least
one
central professional to approve the
life-ending decision.
If this safeguard is not used, the others become more important.
Exactly which chemicals should be used to achieve a
peaceful and painless death
can be decided by the professionals most centrally involved in the
life-ending decision.
But the purpose of the life-ending chemicals should be plainly stated
for all
to
understand.
Therefore, in order to avoid even subtle or subliminal misunderstanding,
the chemicals to be used to cause death
should never
be described as "medication".
Especially if there might be translation problems
for patients and families for whom English is not the first language,
the chemicals should be described as a "life-ending".
Every language has ways of discussing the end of human life.
The purpose of the life-ending chemicals must be
fully
explained
to the patient, family members, and/or the proxies.
Everyone involved in planning this death
should be made aware that the life-ending chemicals
will first render the patient
unconscious
and then cause death within
a few hours at the most.
The intent of providing and taking the life-ending chemicals
is to cause the patient to die a peaceful and painless death.
It is the responsibility of the physician who provides the life-ending
chemicals
to make sure that everyone else involved in the death-planning process
fully understands just how death will be caused by the life-ending
chemicals.
It might be helpful to give those who will observe the chosen death
some details about exactly how this death will occur.
Which bodily systems will be shut down by the life-ending chemicals?
Exactly how the life-ending chemicals will be
administered
to the patient
and who will be present for this final scene
will be decided according to what seems wisest in each case.
The physician who provides the life-ending chemicals
might be present for the
death or not.
HOW A DOCTOR PROVIDING LIFE-ENDING CHEMICALS
DISCOURAGES IRRATIONAL SUICIDE
AND OTHER FORMS OF PREMATURE DEATH
As said before in connection with other safeguards,
suicidal people are not likely to pursue the elaborate processes
required for a voluntary death or a merciful death.
These many safeguards were created
specifically to prevent
people from killing themselves irrationally.
But great care must be taken after the lethal
chemicals
has been obtained
that they not taken by some
other member of the household
for the purpose of committing irrational suicide.
Having a bottle of life-ending chemicals in the household
is more dangerous than having a loaded gun available.
Some suicidal people will be deterred
by the violence involved in a suicide by handgun.
But the same reluctance would not apply to taking life-ending chemicals.
Whenever a physician provides life-ending chemicals
for
a patient,
this physician is acting as a gate-keeper.
The physician names
the patient when providing the lethal chemicals.
If and when the life-ending chemicals are used,
the resulting death will not
be premature
in the professional opinion of the physician
who provides the life-ending chemicals.
(When any death is caused by a means not under the control of the
physician,
then the physician is not as direct a participant in the death-process.)
When life-ending chemicals provided by a physician
for a
specific patient are used,
then all should know that the physician who provides the lethal
chemicals
is taking professional responsibility for causing the resulting death.
In the professional judgment of the physician,
this death is at the best
time for the named patient.
Given all of the gathered medical facts and opinions
and all the assembled personal facts and opinions,
a voluntary death or a merciful death at this time
is the best course of action.
So the terminal-care physician provides life-ending chemicals,
which will soon bring the patient's life to a peaceful and painless
end.
(A
note on language:
This safeguard has carefully and intentionally avoided the following
words:
"drugs", "medication", "prescription", & all related terms.
This is intended to avoid any confusion that might arise
because physicians are also authorized to prescribe drugs for curing
diseases, etc.
And the provided chemicals need not be obtained from a licensed
pharmacy.
Thus, the laws regarding prescriptions should not apply.
Some laws using this safeguard will continue to refer to the chemicals
as "drugs", "medication", or "prescription",
but to allow the future functioning of such laws to be more open,
such terms from the practice of medicine and pharmacy should be
avoided.)
(An alternatives to this safeguard,
which licenses only some
doctors to provide life-ending chemicals, will be found here:
SPECIFICALLY-LICENSED
TERMINAL-CARE PHYSICIAN
AGREES TO PROVIDE LIFE-ENDING CHEMICALS.)
Created March 18,
2007; revised 3-20-2007; 3-22-2007; 9-26-2007; 10-3-2007;