D FOR LIFE-ENDING DECISIONS
PHYSICIAN'S STATEMENT OF CONDITION AND PROGNOSIS
The physician who is primarily responsible
supervising the care of the patient
issues a written statement explaining all relevant aspects
patient's physical condition,
with special attention to the facts that are likely to lead to death.
The physician includes a good faith estimate
likely course of the patient's current condition
if the patient continues to receive
all presently-provided supportive
care and medical treatments.
The physician will also include a good faith estimate
of the likely
course of the patient's condition
if the life-supports and medical treatments are discontinued.
And if additional forms of life-support and treatment might be relevant,
the physician should also include the likely impact of such medical
If the patient is probably dying,
the primary-care physician could include this fact
in the statement of condition and prognosis.
Or a separate certificate
of terminal illness could be created.
Copies of this physician's statement of condition
shall be provided to all persons who have a legitimate interest
medical care of the patient.
But copies shall not
be made available
to the general
public or to the news media.
When and if the patient's condition changes
the physician then having primary responsibility for the care of the
shall issue a new
written statement of the patient's condition and
This new statement might take the form of additional facts and
added to the original statement of condition and prognosis.
The doctor’s explanation of the medical situation
should be in language that can easily be understood by laypersons.
All medical terms and expressions should be translated into plain
The terminal-care doctor should meet with the patient and/or the proxies
to answer all of their questions about the patient’s medical condition
and all remaining options for further treatment and supportive care.
Those who will be making the end-of-life decisions for this patient
need a complete understanding of all the relevant medical facts
and the professional medical recommendations.
HOW THE DOCTOR'S WRITTEN STATEMENT OF CONDITION AND PROGNOSIS
DISCOURAGES IRRATIONAL SUICIDE AND OTHER FORMS OF PREMATURE DEATH
Sometimes patients and/or their families panic
when they receive a bleak diagnosis.
They might begin to believe that death is imminent
when there are still several months or even years
remaining in the
possible life-span of the patient.
Sometimes patients and their families do not fully understand
been told to them only verbally.
When the patient and the family have a written statement
patient's condition and prognosis,
they can more calmly consider the facts and the possibilities.
And they can ask for further elaboration and explanation
of some parts of the physician's statement they do not fully
Complete information is essential for making wise medical decisions.
Most suicidal persons will not ask for a written
statement from a
This safeguard will not
prevent most suicidal people from killing
but it will prevent them from using the medical system
as a cover for
their irrational acts of self-killing.
And if some suicidal people ask for a physician's statement
condition and prognosis, some of them will discover
that they do not have
as serious a medical
as they might have believed in their darkest moments.
When patients and/or their proxies make medical
based on an imperfect grasp
of the medical facts and prognosis,
they might choose what would turn out to be a premature death.
A clear statement of the patient's condition and prognosis
will be the foundation of any and all future medical decisions.
If proxies want the patient dead for
the primary physician's written statement of condition and prognosis
will be evidence against their harmful decision for death.
The proxies will not be able to claim
that they had a different view of the condition and prognosis of the
Anyone who is guilty of causing a premature death
will not be able falsely to claim
that their action was supported by the physician.
Thus, the physician's statement of the patient's medical condition
will prevent at least some
that would have resulted in a premature death.
And if the primary-care physician is required to
for a gentle poison, the physician will not cooperate
unless he or she is convinced that a
is the best option for this patient, given all the medical
Created January 14,
2007; revised 3-18-2007; 3-5-2008; 2-5-2010; 5-9-2010; 9-9-2010;
5-27-2011; 12-15-2011; 1-29-2012; 2-22-2012; 3-22-2012; 8-1-2012;