EE FOR LIFE-ENDING DECISIONS
PHYSICIAN AGREES TO PROVIDE
After the primary-care physician has reviewed
the medical facts and opinions
collected for planning death,
the doctor might approve a chosen
This safeguard will normally be one of the last to
—after the opinions of the patient, family, proxies, ethics committee,
have all been properly gathered and distributed
to everyone legitimately involved in planning for death.
This approval by the primary-care physician
always been recognized as a safeguard,
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
central professional to approve the
If this safeguard is not used, others become more important.
(Providing or authorizing life-ending chemicals
is a legal option in only a few locations on the planet Earth.
The Netherlands, Oregon, & Washington are three well-known examples.
Elsewhere the doctors might recommend and provide
other means of
such as increasing pain-medication, terminal sedation,
disconnecting life-support systems,
or giving up eating and drinking.)
Exactly which chemicals should be used
to achieve a
peaceful and painless death
can be decided by the professionals
most centrally involved in the
But the purpose of the life-ending chemicals
should be plainly stated
Therefore, in order to avoid even subtle or subliminal misunderstanding,
the chemicals to be used to cause death
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 "life-ending", "lethal", etc.
The purpose of these chemicals is not to medicate the patient
but to cause the immediate
death of the patient.
Every language has ways of discussing ending human life.
These are death pills or
The purpose of the life-ending chemicals must be
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
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.
And the physician who provides the life-ending
must make sure that everyone involved in planning this death
fully understands just how death will be caused by the lethal 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?
And where communication is especially difficult,
a video presentation of dying by this method
might make it clear to all concerned
just what will happen when the gentle poison is used.
Exactly how the lethal chemicals will be
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 chemicals to cause death
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 choosing death with the assistance of a physician.
These many safeguards were created
specifically to prevent
people from killing themselves irrationally.
After the lethal
have been obtained,
strict controls should be in place to make sure
that the lethal substances are not used
other member of the household
for the purpose of committing
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 shooting themselves.
But the same reluctance might not apply to taking death pills.
Whenever a physician provides life-ending chemicals
this physician is acting as a gate-keeper.
The physician names
the patient when providing the lethal chemicals.
If and when these deadly chemicals are used by the qualified patient,
the resulting death will not
in the professional opinion of the physician
who approved using lethal chemicals to cause death.
Because this gate-keeping function approves the timing of
the physician who provides the life-ending chemicals
might decide in principle to
cooperate in this planned death
some months or even years
before the best time for death.
The doctor might decide that some specific milestones
marking the inevitable decline towards death must be passed
before the lethal chemical will be provided.
It might even be wise to put
this agreement into writing,
so that everyone concerned will know
that the physician will provide the lethal chemicals
if and when the patient declines to the point
where a chosen death would be the wisest course of action.
any death is caused by some means
NOT under the control of the
then the physician is not as direct a
participant in that death.
When life-ending chemicals provided by a physician
then all should know that the physician who provides the lethal
is taking professional responsibility for causing the resulting death.
In the professional judgment of the physician,
this death is taking place
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 chosen 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
Because it is always possible for some
doctors to abuse this power,
we need ways to prevent such misuse of lethal chemicals:
"Preventing Doctors from Misusing
their Prescribing Power to Cause
note on language:
This safeguard has carefully and intentionally avoided the following
"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
And the provided chemicals need not be obtained from a licensed
Thus, the laws regulating prescriptions
should not apply.
Some opponents of the right-to-die will attempt to prevent chosen death
by means of controlling the prescribing power of doctors.
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 and
such terms from the professions of medicine and pharmacy should be
discussion of the misleading "medication"
An alternative to this safeguard
would license only some
doctors to provide life-ending chemicals:
AGREES TO PROVIDE LIFE-ENDING CHEMICALS.
Created March 18,
2007; revised 3-20-2007; 3-22-2007; 9-26-2007; 10-3-2007;
8-26-2008; 9-10-2008; 9-24-2008;1-29-2009; 1-30-2010; 2-12-2010;
2-3-2012; 2-7-2012; 2-11-2012; 2-23-2012; 3-24-2012; 8-3-2012;