E FOR LIFE-ENDING DECISIONS
REVIEWS THE CONDITION AND PROGNOSIS
In order to base life-ending decisions on
a second doctor should examine the patient and issue a written
summarizing the patient's problems and possible outcomes.
This should be an independent
from a doctor who specializes in the disease of the patient,
who actually examines the patient in person
as well as all of the relevant written medical records.
The second doctor should also read all of the death-planning record
that has been created up to that day.
Sometimes doctors give professional second
based mainly on the reputation
of the first doctor.
If the second doctor merely endorses the opinion of the first,
the consultation adds nothing.
But if the second doctor makes an independent assessment,
he or she might be able to give more perspective
on the condition and prognosis of the patient,
which could cause the people who are deciding
(either the patient or the proxies) to explore other options
that might not have been suggested by the first doctor.
In some cases it will be wise to obtain
more than one additional
If the statements of all doctors point to the
—for instance, that the patient is likely to die soon
no matter what new treatments or life-supports are used—
then the deciders should feel more confident
about making a life-ending decision.
If a certificate
of terminal illness is required,
any additional physicians asked to consult
can either sign the same certificate or issue their own certificates.
In addition to writing their independent
of the patient’s
medical situation and prospects under various treatment options,
these other physicians should also meet with the patient and/or proxies
in order to answer all questions and offer further explanations
of the likely course of events for this patient.
Having several doctors review and explain the
situation of the patient
reduces the chances of misunderstanding by the patient and/or proxies
and of doctors failing to consider some experimental medical options.
HOW A SECOND DOCTOR'S WRITTEN STATEMENT
CAN DISCOURAGE IRRATIONAL SUICIDE AND OTHER PREMATURE
Anyone who is considering irrational suicide
will probably not seek a written statement from any doctors.
And if the first doctor missed any hidden suicidal tendencies,
the second doctor might be able to uncover any such factors.
A separate safeguard suggests a psychological
evaluation of the patient.
The independent prognosis of the second doctor
will either confirm or challenge the predictions of the first doctor.
Even if the first doctor foresaw only decline and death,
the second doctor might know about other treatments worth trying.
Also, if anyone is concerned that the patient might
because of withdrawing life-supports,
assisting in a voluntary death, or granting a merciful death,
such persons should be assured by the number of professionals involved
that the chances of fraud or coercion are minimal.
These doctors are affirming
that in their professional judgments
the patient has reached the
end of his or her life.
And it might be in the best interests of everyone concerned
to allow this life to expire or to facilitate a peaceful and painless
Created January 17,
2007; revised 3-7-2008; 3-12-2008; 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;
8-19-2012; 11-6-2012; 5-22-2013
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