CAUSING PREMATURE DEATH
DRAFT ADDITION TO THE HOMICIDE LAW
OF EACH STATE OR COUNTRY
REPLACING THE LAW AGAINST ASSISTING SUICIDE
modification of this proposed law should replace
all existing state and
national laws against
Or if the laws against assisting suicide
are still wanted to discourage assisting an irrational suicide,
a revised law against helping others to commit foolish self-killings
could replace the present ambiguous laws.
This model law against causing premature death
deals with patients who were believed to be dying.
It should be placed within the homicide law,
as the lowest degree of
perhaps after negligent vehicular homicide.
numbers in the left margin
are intended to facilitate
discussion and revisions.
Only the numbered lines are intended as text for the law.
Each state or national
legislature will create its own version
of this proposed legislation.
1. Section I.
2. "Premature death" shall mean
3. the ending of a human life before the best time for
that life to end.
4. Those who cause premature death
5. have acted to end
the life in question too soon.
6. The operational proof that a death was not premature
7. consists of fulfilling substantially all the
safeguards in Section V.
2. "Life-support systems" shall
3. all procedures, devices, and medications intended
to sustain life.
4. These include but are not limited to the
5. respirators, heart-lung machines, dialysis
6. blood transfusions and other intravenous fluids
7. feeding tubes to supply nutrition and hydration,
8. drugs to maintain blood pressure, and cardio-pulmonary
9. And it shall include new methods of supporting
10. that will be invented in the future.
11. But it will not include means of controlling
pain and providing comfort.
2. "Irrational suicide" shall
mean the premature ending of one's own life.
3. As a matter of public policy,
4. this state does not wish to encourage irrational
5. but neither irrational suicide
6. nor attempted
irrational suicide is prohibited by this law.
7. However, assisting an irrational suicide of a
8. or assisting an attempted irrational suicide
9. are both prohibited as forms of causing premature
10. or attempting to cause premature death.
2. "Voluntary death" shall mean
ending one's own life
3. at the right time according to one's own ethical
4. and by the methods of one's own choosing.
5. To be certified and recorded as a voluntary death
6. the choice must meet all four of the following
7. (1) It must be a benefit to the patient,
not a harm.
8. (2) It must be a rational decision
by the patient.
9. (3) It must be planned well in advance,
10. taking the
opinions of those who will be affected into account.
11. (4) It must be regarded as a commendable
and admirable choice
12. by others who
know all the facts.
13. Operationally, these four
criteria will be fulfilled
14. if the death-planning record shows that
15. of the safeguards in Section V have been
16. Neither voluntary death nor
assisting a voluntary death
17. is prohibited by this law.
2. "Mercy-killing" is the
premature ending of the life of another person,
3. whether requested by the decedent or not.
4. Mercy-killing is distinguished from other forms
5. in Section II of this law.
6. Mercy-killing remains a punishable crime under
2. "Merciful death" is the
practice of ending the life of another person
3. at the right time and by the most appropriate
4. according to the ethical principles of the
proxies duly authorized
5. to make life-ending decisions for the patient.
6. To be certified and recorded as
a merciful death
7. the choice
must meet all four of the following criteria:
8. (1) It was a benefit to the patient,
not a harm.
9. (2) It was chosen rationally
duly-authorized proxies for the decedent.
11. (3) It was planned and announced
sufficiently in advance
12. to allow
all concerned to express
options about the decision.
14. (4) It is regarded by those who know
15. as a wise
and compassionate choice.
16. Operationally, these four
criteria are satisfied
17. if substantially all of the safeguards
18. in Section V of this law are fulfilled.
19. Merciful death is not
prohibited by this law.
20. And persons who perform or cooperate in a
21. are protected from prosecution
22. by fulfilling substantially all of the safeguards
in Section V.
1. Section II. Causing Premature Death
Distinguished from other
2. Causing premature death shall
3. from other forms of homicide by the following
4. The act shall be classified as causing a premature
5. when all of the following factors are present:
6. (1) The perpetrator personally
knew the decedent.
7. (2) The perpetrator believed
with good reason
the time of the act that the decedent was dying.
9. (3) The perpetrator believed
with good reason
10. at the time
of the act that the decedent was suffering
11. and that
the causes of that suffering
12. could not
be cured or changed.
13. (4) The perpetrator's motive
was mercy rather than malice.
1. Section III. Three Classes of the Crime:
Causing Premature Death
2. The prosecutor shall decide
which of the following
3. three classes the alleged crime fits most closely:
4. (1) Premature ending of medical
5. (2) Assisting another person in
an irrational suicide.
6. (3) Acting to cause the
premature death of another person.
This crime is
commonly known as "mercy-killing".
1. Section IV. Punishment
2. If found guilty of any form of
causing premature death,
3. the court shall sentence the perpetrator
4. to imprisonment for a term of one year or less,
5. depending on the circumstances of the crime
6. and any prior convictions the perpetrator might
7. This term of imprisonment shall
be less than
8. the punishment for any other form of
9. The term of
imprisonment for the person found guilty
10. of causing a premature death
11. shall not be greater than the number of days lost
by the victim.
1. Section V. Safeguards for Life-Ending
which may be offered as Defense
Against the Charge of
Causing Premature Death
The thrust of these defending factors
is to show that the death was not premature,
that the patient's life ended at a reasonable time
and by a painless means.
If these conditions are met, no harm came to the patient.
And hence no crime
2. Any and all of the following
factors shall constitute a defense
3. against the charge of causing a premature death:
1. A. ADVANCE DIRECTIVE
FOR MEDICAL CARE
2. The patient issues an
advance directive for medical care.
3. This will normally be prepared years before the
advance directive sets forth the patient's medical ethics.
5. The patient explains how to separate
6. the conditions that
lead to the choice of continued life
7. from the conditions that lead to a life-ending decision.
Probably as an appendix to the patient's
9. the chosen proxies and perhaps others close to
10. can create their own statements
11. expressing their agreement with the advance directive
12. and (if they are proxies) their commitment
13. to carry forward the settled values of the patient.
1. B. REQUESTS FOR
DEATH FROM THE
2. The patient
repeatedly asked for death
3. over a period of several weeks.
4. If the patient put these requests into
5. as in a 'living will' or
advance directive for medical care,
6. this defense is strengthened.
7. If the patient was not capable of making any
requests for death
8. at the time of death, his or her prior requests
9. under similar circumstances are definitive.
10. And any written records of such requests
11. also strengthen the case for the defense.
12. If the patient was not capable of making
requests for death
13. but had authorized a proxy or proxies
14. to make medical decisions for him or her,
15. then any requests for death given by such proxy
16. shall have the same standing as requests from
1. C. THE PATIENT IS
MENTALLY CAPABLE OF MAKING A LIFE-ENDING DECISION
2. The patient was mentally
capable of deciding his or her death
3. at the time any requests were made.
4. This capacity may be established by the testimony
5. as well as by the professional
6. of licensed
psychologists or psychiatrists.
1. D. PHYSICIAN'S
OF CONDITION AND PROGNOSIS
2. A physician had
issued a professional opinion
3. that the patient was dying or had an incurable
4. or was in a debilitated or unconscious condition
5. from which he or she would probably never
6. Such conditions include, but are not limited to,
7. persistent vegetative state and permanent coma.
1. E. INDEPENDENT
PHYSICIAN REVIEWS THE CONDITION AND PROGNOSIS
2. An independent
physician confirmed and substantially agreed
3. with the
diagnosis and prognosis of the physician mentioned in D.
1. F. CERTIFICATION
OF TERMINAL ILLNESS OR INCURABLE CONDITION
2. The same physicians who have written
statements of the patient's condition and prognosis
4. can create a separate
document to certify
5. that the
patient has a terminal illness or condition
6. if they can say with confidence that the patient's
illness or condition
7. will lead to death within 6 months.
8. They should say whether this projection includes
life-supports or not.
1. G. UNBEARABLE
2. The patient requests death because of
3. that cannot be relived sufficiently by any known means.
4. This suffering is documented as well as possible
5. by the doctors who have been consulted.
1. H. UNBEARABLE
2. The patient suffers from psychological
3. that do not yield to any known methods of treatment.
4. Because being in a such psychological state
5. might render the patient unable to make wise medical
6. proxies for the patient have been appointed,
7. who then must make the final life-ending decision
8. if it seems better than all the other alternatives.
1. I. PALLIATIVE CARE
2. The patient actually received comfort care
3. from medical personnel well trained in the care of
4. This goes beyond explaining the
benefits of palliative care.
5. And it is more than a consultation with a palliative
6. The patient actually received physical and psychological
7. from providers who know how to care for the dying.
9. However, if the patient knew the benefits
of palliative care
10. and/or consulted with a palliative care specialist,
11. these facts support the claim that the death was
1. J. INFORMED
CONSENT FROM THE PATIENT
2. The patient must have full information
about his or her condition
3. and all the relevant medical treatments that are still
4. Only when the patient has received and understood
5. the doctor's statements concerning
condition and prognosis
6. is the patient able to make wise life-ending decisions.
1. K. REQUESTS FOR
FROM THE PROXIES
2. If the patient can no longer make medical
3. then the decision-making power shifts to the proxies,
4. who have been carefully chosen by the patient
5. when the patient was still fully able to make medical
6. The proxies shall carefully consider all
the facts and opinions
7. from other persons protecting the
best interests of the patient.
8. Then the proxies can
decide to request death
9. in the same ways the patient could request death while
1. L. ENROLLMENT IN A
HOSPITAL OR HOSPICE
2. The patient was
treated in a hospital or a hospice program,
3. which kept careful records of all
discussions and decisions
4. regarding the care of the patient,
including but not limited to
5. all discussions and decisions related to
1. M. STATEMENTS FROM
HOSPITAL OR HOSPICE STAFF MEMBERS
2. Beyond the medical records kept by
the hospital or hospice,
3. nurses, doctors, and volunteers
4. who have had
meaningful connections with the patient
5. can also create statements
about their discussions
6. with the
patient about life-ending decisions.
1. N. STATEMENTS
AFFIRMING OR QUESTIONING THE CHOSEN DEATH
2. Other persons who
knew the patient
3. for meaningful
periods of time agreed with the life-ending decision.
4. Even though these significant other persons
5. might not have been directly involved
6. in the process of making the life-ending decision
7. and were not responsible for carrying it out,
8. they knew of the
plans well in advance of the
9. and in their considered opinions, it was a wise
1. O. A MEMBER
APPROVES OR QUESTIONS THE CHOICE FOR DEATH
2. A member of the
clergy of any religious organization
3. or the professional leader of an ethical
4. known by the patient approved the life-ending
5. If the patient was not part of any such
6. another similar responsible member of the
7. may fill this role of neutral
1. P. RELIGIOUS
OR OTHER MORAL PRINCIPLES APPLIED TO THIS
2. If chosen by the patient and/or the
3. some authority on
the doctrine of the religion with which
3. the patient is
affiliated reviews how those moral principles
4. apply to the
5. being considered by the patient and/or the proxies for
6. If that
interpretation supports a life-ending
7. then a written statement to that effect
8. could be made
part of the death-planning record.
9. If the patient and/or the proxies so choose,
10. some non-religious moral principles
11. can be brought to bear on this life-ending decision.
12. Such moral reviews can show that the
death was not
1. Q. AN
ETHICS COMMITTEE APPROVES THE DEATH
2. An ethics
committee of the institution
3. where the patient is being cared for
4. reviews all of the documents created for the
5. and approves the life-ending decisions.
6. Whenever possible,
the ethics committee (or some member thereof)
7. should consult with the patient in person.
8. An independent ethical
consultant can also fill this role.
1. R. STATEMENTS FROM
IF INVITED BY
THE PATIENT AND/OR THE PROXIES
2. If the patient has any worries about
3. because of membership in a group sometimes
disfavored by society,
4. he or she can select an advocate from his or her
5. who will review the death-planning documents
6. to make sure that no discrimination has taken place
7. because of the group-identity of the patient.
8. Adding any such statements to the death-planning
9. will assure others who are not as close to the
10. that the life-ending
decisions were not tainted by discrimination
11. and that the patient's terminal care
PROSECUTOR BEFORE THE DEATH TAKES PLACE
2. If those who are making plans
3. have any doubts about the legality of their
proposed course of action,
4. they can opt to send a report of
the death-planning process
5. to the local
prosecuting authority for review.
6. They might explain which of the
following they are planning:
7. (a) withdrawal or withholding life-support
8. (b) assisting in a voluntary death, or
9. (c) granting a merciful death.
10. And the several documents of the death-planning
11. might be shared or summarized for the prosecutor
12. to show that the proposed course of action
violates no laws.
13. The prosecutor should be
allowed one week to respond.
14. The prosecutor can reply that the death should go
15. and that all who participate or cooperate in the
16. will not be subject to prosecution for any crime.
17. Or the prosecutor can ask for additional
18. to make certain that this death will not be
1. T. CIVIL AND
CRIMINAL PENALTIES FOR CAUSING PREMATURE DEATH
2. Civil and
criminal penalties will remain in place.
3. Anyone tempted to encourage or cause a premature death
4. will know that there are criminal and civil
5. that will be applied if someone does any harm to another
6. under the guise of making life-ending decisions.
7. Fulfilling the other safeguards for
8. will show that this death was a wise, end-of-life
1. U. WAITING PERIODS
waiting periods are allowed to elapse
3. between the time when the life-ending decision is
4. and when the act is performed:
5. (a) one week for the
withdrawal of life-support systems,
6. (b) one year for a voluntary
7. (c) six months for a merciful
8. These waiting periods may be adjusted
9. when adequately explained by
10. the special circumstances of this life-ending
11. Spreading the life-ending decision over significant
periods of time
12. allows all concerned to re-think their previous
1. V. OPPORTUNITIES
FOR THE PATIENT TO RESCIND OR POSTPONE ANY LIFE-ENDING DECISIONS
2. If the patient has already
begun the death-planning process,
opportunities shall be provided
4. for the patient
to change his or her
5. The people offering these opportunities shall
6. that the patient was giving several chances
the death-planing process.
8. Does the patient decline each opportunity to
9. and reaffirm his or her determination to choose
1. W. PHYSICIANS
REVIEW THE COMPLETE DEATH-PLANNING RECORDS
2. When most of the other statements
3. the physicians most responsible for the patient's
4. will read and
respond to each statement
make a final recommendation.
6. If authorized by law, and if the
terminal-care physician is convinced
7. that in his or her professional judgment
now would be better than death
9. this physician
is permitted to write a prescription
10. for life-ending
chemicals to be taken by the patient
11. for the purpose
of causing a peaceful and painless death.
1. X. COMPLETE
RECORDING AND SHARING OF ALL MATERIAL FACTS AND OPINIONS
2. The death-planning process
should be honest and open.
3. The written
statements of all persons involved
4. should be
shared freely among all persons
5. who have
legitimate rights to take part in planning this death.
6. The fact of such open sharing and
—with signed and
recorded opinions from many
8. should help to prove that this is a
9. not a hidden or secret conspiracy to cause a premature
PATIENT IS CONSCIOUS AND ABLE TO CHOOSE DEATH
2. While not a required to prove the
life-ending decision was wise,
3. if the patient
remained conscious until the last moment of life
4. and possibly took some
life-ending action by his or her own hand
5. then this death was not
DEATH-PLANNING COORDINATOR ORGANIZES THE SAFEGUARDS
2. If the process of planning the patient's
3. has employed a death-planning
4. or if someone volunteers to organize the
5. this level of organization for the death-planning
6. will be evidence that the chosen death was a
7. And the complete collection of death-planning
8. should be permanently stored in case there is ever
9. to review this life-ending decision.
10. The death-planning
records shall not be made available
11. to the public, to any government officials
12. (except as might be required by law-enforcement
13. or to any news-gathering organizations.
1. Section VI. Recording of Deaths
2. The commissioner of health of
(or other authority responsible for keeping records of deaths)
the medical examiner of each county,
5. and the prosecuting authorities throughout this
6. shall establish three new statistical categories
7. as defined by this law:
8. (1) voluntary deaths (as
distinct from irrational suicides),
9. (2) merciful deaths (as
distinct from mercy-killings), and
10. (3) premature deaths (a form of homicide).
11. Physicians responsible for
filing death certificates
12. shall also conform to these definitions.
13. If the medical examiner finds
the death-planning record
14. fulfills the definition of a voluntary death in
15. that death shall be recorded for all purposes
16. as a voluntary death, not an irrational suicide.
17. And if the death-planning record explains the reasons
18. for the voluntary death to be a fatal disease,
19. that fatal disease, illness, or condition
20. shall be recorded
as the primary cause of death,
21. with the additional notation
22. that the patient chose a voluntary death
23. rather than waiting for natural processes to
kill him or her.
24. If the medical examiner finds
the death-planning record
25. fulfills the definition of a merciful death in
26. that death shall be recorded as a merciful death,
27. not any form of homicide, including causing
28. And if the death-planning record explains the
29. for the merciful death to be a fatal disease,
30. that fatal disease, illness, or condition
31. shall be recorded as
the primary cause of death,
32. with the additional notation that the proxies
chose a merciful death
33. rather than waiting for natural processes to
kill the patient.
34. No new statistical category
need be established
35. for recording deaths that result from
36. the withholding or withdrawal of life-support
37. These deaths will automatically be recorded
38. as caused by the underlying disease, illness, or
39. But the record should also show that a careful
process was followed
40. in reaching the decision to remove the life-support
Revised several times
in January, 2007; revised 2-17-2007; 3-9-2007; 3-29-2007; 12-31-2007;
4-4-2008; 8-25-2008; 2-23-2009; 1-13-2010;
2-28-2012; 3-16-2012; 4-8-2012; 4-11-2012; 9-6-2012; 4-6-2013
The above draft
legislation was first created in
1995 by James Park.
It was revised by him in 2004, 2005, 2007, 2008, 2009, 2010, 2012,
Some of the safeguards embodied in Section V
were originally published in a small book by James Park entitled
Ten Safeguards for
Life-Ending Decisions, 1995.
Here is an updated summary of that book,
now called "Fifteen Safeguards for Life-Ending Decisions":
Several advantages of
this form of legislation
in contrast to the more conventional laws allowing life-ending chemicals
are discussed here:
of the Premature-Death Approach to the Right-to-Die
Other safeguards might
also be included in any state
or national law
defining and prohibiting encouraging
or causing premature death.
A website discussing such safeguards was established in January 2007:
The above draft will be further revised
following the suggestions of any readers.
Send your suggestions to James Park, e-mail:
If and when any state or national legislatures adapt any similar laws
repealing, replacing, or supplementing laws against assisting
such laws will be listed here, with appropriate links.
If other such
suggestions exist on the Internet,
they can be linked from here.
Different versions of the provisions above
can also be offered here.
Completely different approaches to achieving the
are also welcome.
Let's be as creative as we can be.