WE PERMIT HELPFUL DEATHS,
DEATHS WILL FOLLOW:
THAT SLOPE IS TOO SLIPPERY
When the idea of voluntary death is first
suicide is the first
idea that appears in the minds of most people.
Several minutes of explanations or several paragraphs of writing
are required to convince the listener or the reader
that it might be possible to permit
while at the same time discouraging
Here are the four basic differences:
1. Irrational suicide harms
Voluntary death benefits
2. Irrational suicide is not
based on reason.
Voluntary death is wise and reasonable.
3. Irrational suicide is often
Voluntary death is well-planned.
4. Irrational suicide is regrettable
Voluntary death is admirable
If you want to
explore these concepts more completely, read:
Will this Death be an "Irrational Suicide" or a "Voluntary Death"?
linked below constitute the operational
by which several
other persons can evaluate the plans for death
to see whether this chosen death
would be an irrational
suicide or a voluntary
Likewise, whenever the words "merciful death" appear,
the first idea that comes to mind is mercy-killing.
Much explanation is required to convince the listener or the reader
that it might be possible to permit
while at the same time continuing
Here are the same four basic differences:
1. Mercy-killing harms
Merciful death benefits
is not based on reason.
is wise and reasonable.
is often capricious.
is regrettable and lamentable.
is admirable and laudable.
If you want to
explore these concepts more completely, read:
Will this Death by a "Mercy-Killing" or a "Merciful Death"?
The safeguards linked below constitute the
by which several
other persons can participate
in examining the proposed death to see whether
it would be a mercy-killing
(harmful criminal behavior)
or a merciful death
(helpful compassionate behavior).
This set of worries about the right-to-die
is traditionally called the "slippery-slope argument".
If we permit some forms
of life-ending decisions,
then we will begin slipping down a hill to disaster
without the possibility of stopping ourselves.
A chain of terrible
consequences will follow
if we take even the first step down the slippery slope.
If this were true,
that we could not prevent
deaths if we permit
then (so the argument goes),
we should never take the first step onto the slippery slope:
We should not permit even obviously good deaths
because someone will distort the principles allowing beneficial deaths
so that harmful deaths
will be inevitable.
The safeguards are the sand that can be put on the
so that it will be safe to walk down the hill.
As long as the safeguards prevent us from slipping out of
the trip down the icy sidewalk will be safe.
Wise safeguards carefully applied can
permit wise deaths and
prevent foolish deaths.
Changing the metaphor,
wise safeguards are the guard-rails on the mountain road
preventing cars from crashing off the road and down the cliff.
The slippery-slope argument would simply close the road
so that no car would be able to reach the desired destination.
Advocates of the slippery-slope argument
want to construct roadblocks
rather than guard-rails.
SAFEGUARDS TO DISCOURAGE IRRATIONAL SUICIDE AND MERCY-KILLING
The following 18 safeguards call upon the considered
of a wide variety of neutral
persons who can help
to separate those deaths that would be harmful irrational suicides
from wise life-ending decisions that would create helpful voluntary deaths
and to separate those deaths that would be harmful mercy-killings
from wise life-ending decisions that would create helpful merciful deaths.
These safeguards are arranged beginning with the
most powerful and effective.
blue title links to a
complete explanation of that safeguard.
The red comments explain
how that safeguard deals with the specific worry
that permitting wise
life-ending decisions for some patients
might lead to foolish deaths
for other people.
FROM FAMILY MEMBERS
QUESTIONING THE CHOSEN DEATH
Family members can usually be assumed
to be choosing
in the best interests
of the patient.
(If some relative has mixed motives,
such as greed,
the other safeguards become more important.)
But when most family members agree
that death now would
be better than death later,
this is reason to believe that the life-ending decisions
are being carefully and wisely made.
In their written statements,
family members show that they have considered the alternatives
and decided that a chosen death is the best option.
IF INVITED BY
THE PATIENT AND/OR THE PROXIES
When special advocates for disadvantaged groups have
more distant doubters (who do not know the details of the terminal
will be more likely to accept the choices
made by the persons who are making what might be life-ending decisions.
Each death-planning process differs from other situations of
When an advocate for a disadvantaged group approves one merciful death,
it does not mean that the next proposed death will also be a
This special advocate is asked for a written opinion
explicitly for the purpose of
on the basis of group identity.
There must be no slippery slope leading from one wise merciful death
for a member of a minority group to approving other deaths
STATEMENT OF CONDITION AND PROGNOSIS
mercy-killer almost never asks for a written statement from a doctor.
When the terminal-care physician
explains in writing
the medical condition and
prognosis of the patient,
this is the factual basis for wise
The very process of obtaining such
a professional medical opinion
will prevent some premature deaths
correctly called "mercy-killings".
PHYSICIAN REVIEWS THE CONDITION AND PROGNOSIS
independent physician reaches the same conclusions,
this is further evidence
supporting the decision for
This second professional opinion
is another check
to make sure that no mistakes occur
because the physical condition of
the patient was misunderstood.
When a terminal
patient is being cared for in a hospital or hospice,
several professionals and
volunteers will be observing whatever happens.
Careful medical records will be
kept of all decisions and procedures.
And the fact of approving one death in the hospital
should not suggest that every proposed death will be approved.
Both hospitals and
hospice-programs are committed
Only when meaningful life is no
will these helpers
approve a chosen death.
ABILITY TO MAKE MEDICAL DECISIONS
When there is
some reasonable doubt
about the patient's decision-making capacity,
a psychological professional might
be called upon to evaluate that patient.
This psychologist or psychiatrist
should be capable of
separating the irrational urge to
from any wise end-of-life medical decisions.
And this professional's written
(the specific content of which
will not become
should go some way toward
convincing distant critics
that this life-ending decision was
DIRECTIVE FOR MEDICAL CARE
An Advance Directive was probably created some years
And it explains the patient's
settled values concerning life and death.
The proxies appointed in the Advance Directive
are carrying forward the
plans established by the patient.
Even if the patient has questionable decision-making capacities
toward the end of his or her life,
the personal medical ethics contained in the Advance Directive
can be re-affirmed by everyone who reads that 'living will'.
DEATH FROM THE PATIENT
And if the patient is fully capable of making
the patient's explicit, detailed request for death
will prevent any cascade of terrible consequences.
Only this patient will be
helped to die.
There is no general principle of putting all seriously-ill patients to
This death was explicitly
requested in writing by this patient.
CONSENT FROM THE PATIENT
When a specific plan for death is set forth,
the patient should be asked to approve or disapprove this plan.
Some modification might be required
before the patient will give informed consent.
But if and when the patient has given written, informed consent,
no stranger should claim that the
patient was railroaded into death.
The patient who is suffering near the end of life
should explain his or her specific forms of suffering
so that all decision-makers will understand the need for
methods of relieving suffering should be tried
before the final decision is made
that voluntary death or merciful death is the best remaining option.
COMMITTEE REVIEWS THE LIFE-ENDING DECISION
Institutional ethics committees are created
for the purpose of giving
impartial reviews to all medical decisions,
including those decisions that will lead to the patient's death.
The members of any ethics committee
should not be involved in the personal life of the patient.
But they should consult with the patient whenever possible
to make sure that the patient and/or the proxies
are making wise decisions.
The fact of an
ethics-committee review can be made public.
But the details of their deliberations should be kept private.
MEMBER OF THE CLERGY APPROVES OR QUESTIONS THE CHOICE FOR DEATH
Likewise, any member of the clergy
who is asked to
review a life-ending decision
need not share the details of his or her thinking with the
But it will be reassuring to distant critics to know
that a member of the clergy was consulted
and did agree with the terminal-care plan.
OTHER MORAL PRINCIPLES
APPLIED TO THIS
And even more explicitly, religious experts might
apply their principles
to the end-of-life situation at hand.
These religious authorities might create a written document,
showing how the religious or moral principles
led to the decision they endorse.
(And in order to avoid public debate of private religious matters,
the specific contents
of any such documents should be kept private.)
But religious and moral experts are welcome
to present and explain their general
end-of-life moral principles
as fully and completely as they please.
REPORT TO THE
PROSECUTOR BEFORE THE DEATH TAKES PLACE
When the terminal-care plans are reaching their
the complete death-planning record (or a summary of it)
might be provided to the prosecuting authority.
If the prosecutor finds nothing that needs further explanation
and nothing that would lead to a criminal prosecution,
he or she can issue a statement declaring that there will be no prosecution.
And everyone can proceed with the plan for a wisely-chosen death.
Since the prosecutor knows the applicable laws,
this will be the most decisive way to separate harmful criminal acts
from acts of mercy that
clearly benefit the patient.
If the prosecutor approves of the plans for death in advance,
how could any critic claim that a harm was committed?
CRIMINAL PENALTIES FOR CAUSING PREMATURE DEATH
But if the report to the prosecutor was incomplete
the law still provides for penalties
if it can be shown that the death in question was premature.
And all people who might be tempted to commit a mercy-killing
should be reminded as frequently and clearly as possible
that mercy-killing is a
And even when the standards for a criminal conviction are not
it might still be possible for a civil court to conclude
that a wrongful death
RECORDING AND SHARING OF ALL MATERIAL FACTS AND OPINIONS
A careful death-planning process will be open and
All people who have a legitimate right to be involved in the process
will receive all of the documents created to fulfill the safeguards.
When a life-ending decision emerges from due consideration
for all of the alternatives to a chosen death,
there will be no taint of an
DEATH-PLANNING COORDINATOR ORGANIZES THE SAFEGUARDS
When a death-planning coordinator is employed,
this individual will organize and preserve all of the records
showing which safeguards were fulfilled and by whom.
These records do not become
But the fact that a certain number of safeguards were fulfilled
might be disclosed to satisfy distant doubters
that this death was wisely and compassionately chosen.
If these 18
safeguards do not seem sufficient
to discourage irrational suicides and mercy-killings,
there are several more listed in the complete catalog of safeguards:
Each of these descriptions contains a few paragraphs
explaining how that safeguard will discourage
irrational suicide and other forms of premature death.
Created February 25, 2007; revised
2-21-2008; 11-13-2008; 1-24-2009; 2-4-2010; 11-21-2010;
9-20-2011; 12-22-2011; 1-27-2012; 2-21-2012; 3-27-2012; 5-29-2012;