The prosecuting authority in any jurisdiction
S FOR LIFE-ENDING DECISIONS
TO THE PROSECUTOR
THE DEATH TAKES PLACE
is that public official who is responsible for bringing criminal changes
whenever a crime might have been committed.
Thus, one possible safeguard to prevent any crime being committed
under the color of a reasonable life-ending decision
would be to report the plans for death to the prosecuting authority
before the last steps
towards death are taken.
If we take as our model for life-ending decision
of life-support systems,
we realize there would be too
achieved by such
to make it practical to report every case to the
When death occurs because the life-supports were removed,
the death-certificate will read "natural causes".
And the doctor who pronounces death will specify
just what diseases or conditions led to this death.
That statistical report of death goes to the department of health
or to some similar government agency that records all deaths.
What life-support systems were employed
will be recorded in the complete medical record,
but the final discontinuation of everything used in the ICU
is almost never mentioned on the death-certificate.
The prosecuting authority in any jurisdiction only
in suspicious deaths
or in deaths caused by criminal
The coroner or medical examiner is the public medical officer
who is responsible for investigating suspicious deaths,
especially deaths that take place outside of hospitals,
& other institutions that care for dying patients.
However, if the patient and/or proxies who are
planning a chosen death
want to make sure that they
will not be prosecuted for their actions,
it should be possible for them to present their plans for death
to the prosecuting authority for the purpose of being assured
that no prosecutions
will result from their actions.
The death-planning record should be sufficient proof
that this death will not be
a harm to the patient,
will not be an irrational action taken on the spur of the moment,
and that after the death has been achieved,
all who know the complete set of medical facts and recommendations
will find this death an
rather than a tragic and
At first, the prosecuting authority might have a
to any papers submitted proposing to help someone to die.
The prosecutor's job is to investigate
So when a packet of information comes in the mail
stating that such-and-such a patient is considering a voluntary death
or that the proxies are considering a merciful death for this patient,
then the prosecutor might first send the police to prevent any
But as more people exercise their legal options at
the end of life,
even the public prosecutor will become accustomed to such choices.
of all deaths in the United States
now include a meaningful element of choice.
Thus, it would be foolish to involve prosecutors in all of these
But when there are good reasons to raise doubts about the proposed
the prosecuting authority might well be involved.
After a questionable
death has taken place,
the prosecutor will become involved anyway.
So why not include this legal perspective
before any possible
crime has been committed?
Similar amounts of time will be needed for either kind of
but an investigation that takes place before death
has the possibility of preventing
a premature death.
Once the prosecutor has received
at least a summary
of the death-planning record,
including the documentation of the safeguards already fulfilled,
he or she will ask the following question:
If this death is achieved as planned,
will this be a crime harming
or will this be a wise,
end-of-life medical decision?
If any prosecutor automatically says "no" to all
plans for death,
that prosecutor should be re-educated about medical ethics
and the legal
options for making life-ending decisions.
These legal methods for choosing a timely death include:
(1) increasing pain-medication,
(2) terminal sedation,
(3) withdrawing all treatments and life-supports, &
(4) giving up water and food.
If the prosecutor cannot be 'brought up to speed',
he or she should be replaced.
What good is a prosecutor who does not know the law?
Large offices of prosecutors will probably appoint
specifically trained to review questionable life-ending decisions.
And if more than 20 safeguards have already been fulfilled,
there will probably be no reason to open a case-file concerning this
Especially if the death will take place
in a hospital, nursing home, or under hospice care of any kind,
the safeguards already fulfilled by the medical profession
will probably need no further review.
In Holland, after a few years of requiring reports
to the public prosecutor,
the Netherlands created 5 Regional Review Committees,
which now receive all reports of ‘euthanasia’ and ‘physician-assisted
Now a lawyer, a doctor, and an ethicist review each case
reported by the doctor who helped his or her patient to die.
Sometimes the committee asks for additional information,
but in the first decade of operation,
the Regional Review Committees have not referred any cases to
They now review about 2,000 doctor-assisted deaths per year,
which amounts to about 2% of all deaths in Holland.
In addition, Holland has trained some of its doctors
to be consultants
for all cases of ‘euthanasia’ and ‘physician-assisted suicide’.
These special doctors are available to all doctors
considering taking some life-ending action for a patient.
When the case was discussed with a euthanasia consultant beforehand,
the Regional Review Committees spend less time reviewing those cases.
In the United States, such prior advice is likely to be available from
ethics committee or a private ethical consultant.
Another alternative to asking for the opinion of
the public prosecutor
would be seeking the legal
opinion of a lawyer familiar with end-of-life law.
This lawyer could review all of the safeguards already fulfilled.
Which of these would most impress a prosecutor, judge, or jury?
In the vast majority of medical cases involving some
there will be no need for any kind of legal review before the death
The careful procedures already followed and the safeguards already
will ensure that this is a wise end-of-life medical decision
not any sort of crime
harming the patient.
However, some difficult end-of-life situations have
ended up in court.
If there is any possibility of a trial coming from the proposed death,
then it is much better to
get the lawyer involved before the death,
when he or she can prevent a
rather than have the more difficult task
of proving that the death was not premature
after the life-ending actions have already resulted in the patient’s
If the evidence already collected is weak in some respects,
additional medical facts and professional recommendations can be
to prove that this death will not be premature.
Either the lawyer hired to defend against a possible
of causing premature death or the public prosecutor
can review the facts and perhaps even interview the patient
and everyone else involved
to make certain that the proposed death will not violate any laws.
HOW REPORTING TO THE PROSECUTOR BEFORE THE DEATH
WILL DISCOURAGE IRRATIONAL SUICIDE
AND OTHER FORMS OF PREMATURE DEATH
Persons who are thinking about committing irrational
will have no inclination to inform the public prosecutor
before they proceed with their irrational plan to kill themselves.
And anyone who is planning to support an irrational suicide
likewise would not want this proposed criminal action
to be known by the prosecutor.
But when proxies are planning to withdraw
and if they are uncertain of their legal authority to do so,
they might ask for a legal opinion from the public official
who would normally be responsible for charging them with a crime
if their decisions or actions cause harm to anyone.
The very fact that they have been willing
to share their plans with the public prosecutor
should be taken as strong
evidence that they have no evil intent.
The prosecuting authority can examine all of the
created in the death-planning process.
And if the prosecutor finds some gaps or problems with the documents,
he or she can request more information.
All such deeper investigation should be for the
of preventing premature
And sometimes the public prosecutor will discover some factors
that will change the plans for death.
If the prosecutor believes that a crime is on the verge of
he or she can inform the doctor, the hospital, the proxies, etc.
that criminal charges will
be brought if the death proceeds as planned.
This will be one of the strongest ways of preventing premature death.
criminal penalties will remain in place.
Anyone tempted to encourage or cause a premature death
will know that there are criminal and civil penalties
that will be applied if someone does any harm to another,
even under the guise of a reasonable life-ending decision.
However, if the prosecutor sees no problems in the
he or she can issue a written
statement that in his or her opinion
no crime will be committed if
the death proceeds as planned.
And everyone involved in the death-planning process
can rely on this statement from the prosecutor
and proceed without fear that they might be prosecuted
after the death has been
This death-planning process was reviewed by the public prosecutor
before the death took place.
And the prosecutor issued a statement
assuring everyone involved that this death would not be a crime.
Created January 25,
2007; revised 4-12-2007; 3-21-2008; 7-9-2008; 3-4-2009; 10-14-2009;
2-10-2010; 5-21-2010; 5-21-2011; 12-16-2011; 1-31-2012; 2-23-2012;
3-10-2012; 3-23-2012; 8-2-2012; 8-22-2012; 12-6-2012; 5-21-2013
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