USE OF SAFEGUARDS FOR LIFE-ENDING DECISIONS
Even before new legislation is passed
to protect people who make wise end-of-life decisions,
it is possible to apply selected safeguards
in order to make certain that we are making
the best possible
The laws of any society are created after most of
have already accepted some new standard of
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 could 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 decision based on reasonable principles.
The use of brain-death
as a criterion for the death
of a patient
was debated in the medical community for a few years
before some states changed their laws
to permit what had by then become a standard medical practice.
A more controversial medical practice
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 affirmed in advance (possibly 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
then the doctors would have an even stronger case
for going ahead with organ-transplantation
even while most of the biological
functions of the donor's body
In other words, permitting an earlier declaration of death
(using the criterion of permanent unconsciousness)
would allow transplantation while
the organs are still
Allowing permanent unconsciousness or brain-death
to be optional
definitions of death
would also allow donors' bodies to be used as living cadavers.
SAFEGUARDS TO SEPARATE
MERCY-KILLING FROM MERCIFUL DEATH
From time to time, the news media report that a
parent, spouse, or child
has been killed by a loving relative because the suffering became too
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 have considered their
options in their own heads.
But usually they have not asked an ethics committee,
They fear that bringing any other people into the decision-making
will only hopelessly complicate the problems
and perhaps result in a decision they do not like.
But would it be possible for someone who wants to
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:
Which of these would be most useful to a layperson
in attempting to make wise life-ending decisions for an ailing
Each of these recommended safeguards
includes a discussion of how fulfilling that safeguard 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 anyone can use.
And if the safeguards are fulfilled in good faith,
then some previous inclinations towards 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 by a community of caring persons
(both lay and professional) who offer alternatives other than death.
One safeguard that would have prevented almost every
a clergy-person chosen by the patient and/or the
No responsible minister, priest, or rabbi is going to approve
But when all of the medical facts and family opinions suggest
that it would be better for the patient to be granted a merciful death
rather than imposing a prolonged and meaningless
then some clergy-persons can agree with the life-ending
Religious leaders have seen the consequences of bad end-of-life choices.
And all religious leaders will have to face their own deaths.
Thus, it will be difficult—but
fulfill this 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 if the gathered facts and opinions point the other way,
the clergy-person can issue a statement disapproving
the proposed death
because it would more accurately be described as a "mercy-killing".
Another safeguards calls for an actual trial of
If the person who is tempted to commit a mercy-killing
agrees to professional palliative care for the suffering relative,
then the urge to kill
as a means of relieving suffering might be
And if such a palliative-care trial does not yield
the desired results
it does not
satisfactorily relieve the suffering—
then everyone will be more justified in making life-ending decisions,
which might result in a "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
(3) Merciful death is carefully
planned, not 'decided'
at a moment of crisis.
(4) Merciful death is admirable
and commendable, not regrettable
These four differences are worked out in greater detail here:
Will this Death be a "Mercy-Killing" or a "Merciful Death"?
Even before laws are changed, a merciful death will
by fulfilling the most relevant of the 26 recommended
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 plan for death.
And any jury-trial that follows a questionable
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 recommended safeguards:
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 choosing a merciful death.
And in cases 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
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
for separating a harmful
from a helpful benefit
to the patient—merciful
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 clarify our own
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.
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
should help to create 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
(1) Voluntary death is a benefit
to me, not a harm.
(2) Voluntary death is a reasonable
choice, not an irrational
(3) Voluntary death is well-planned,
not a capricious 'choice'.
(4) Voluntary death is admirable
and commendable, not regrettable
The following on-line essay explores these differences in detail:
Will this Death be an "Irrational Suicide" or a "Voluntary Death"?
If we seriously apply the most relevant of the 26 suggested
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
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
And having fulfilled the safeguards to our own
we can comfortably choose the best
means and the best
time for our own death.
"Choosing Your Date of Death:
How to Achieve a Timely Death—Not too Soon, Not too
Following these reasonable and workable procedures
is what it means for ordinary people
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.
March 1, 2008; Revised 3-3-2008; 3-12-2008; 4-4-2008; 2-12-2010;
1-11-2012; 1-28-2012; 2-22-2012; 3-22-2012; 8-1-2012; 8-19-2012;
See the 26
be applied even by laypersons
mercy-killing, irrational suicide, & all other forms of premature