Every person deserves to have dominion over and choice in their end-of-life experience. No individual should be forced to endure prolonged suffering merely to prevent the inevitable outcome of death. Just as no person is coerced to choose death, no person should be forced to choose life. The Death with Dignity (DWD) policy ensures every American is guaranteed a choice in their death, as granted in life.
This policy enacts a permissive federal standard for eligible patients nationwide the ability and access to participate in the Death with Dignity program through the voluntary self-administration of a lethal dose of medication, expressly prescribed by a physician for that purpose. Ten states currently have enacted DWD policies with another ten states having proposed similar or opposing legislation. States that enable access to DWD will not enforce a residency requirement. There is no state or federal “program” for participation in the Death with Dignity Act (DWDA). People seeking DWD do not “submit an application” to their State or Health Authority of residence; qualified patients and their licensed physicians implement the DWDA on an individual basis. No person or patient is compelled to participate. The DWDA requires the state’s Health Authority to collect data about DWDA participation and to issue an annual report.
Only licensed physicians may prescribe lethal doses of medications. The medicine used will be determined by the licensed physician on an individual basis to qualified patients. Any mandated waiting period will be waived for patients whose life expectancy does not exceed the waiting period. Though the medication will be prescribed by the doctor, it will be administered by the patient.
The physician will not be legally required to be present upon the administration of the medication. However, a patient may request the presence of the physician as long as the physician does not administer the medication. This may take place in the patient’s home, or in a medical facility of their choice. An unconscious [or comatose] patient must have voluntarily opted to participate on their own behalf, prior to their unresponsive condition. The overall cost for any office visits relating to the request, a psychological consultation (if necessary), and the cost of the prescription will be covered under your Universal Healthcare plan. Please see the Environmental and Infrastructure policy for more information about the processing of remains and end of life preparation.
Any deviations noted in the received guidelines must be reported to the overseeing Medical Board. If a formal investigation is warranted, physicians may be subject to disciplinary action. To balance the confidentiality of patients and their families/or loved ones and ensure complete statistical information, it is recommended that physicians and/or medical examiners record the underlying terminal disease as the cause of death and mark the manner of death “natural”.
Eligible Patients must:
- Be at least 18 years old
- Be capable of making and communicating informed health care decisions for themself
- Be able to self-administer the prescribed dose of medication either orally or by pushing through an NG tube.
- Have been diagnosed with a terminal illness that will lead to death within the next 12 months.
- Have attended at least 6 months of therapy with an applicable medical professional to ensure this is the best decision for the patient. The patient will then have an additional 6 months to get all end of life plans in order.
- Months 1-5: Patient attends therapy alone with physician.
- Month 6: Selected love ones of patient added to therapy sessions, if applicable.
- Months 7-12: Continued therapy with patient and selected loved one(s), if applicable, and end of life services planned and completed.
It is up to the attending physician to determine whether these criteria have been met. Consultation may not be required in every instance, but those that do require one can be accommodated either in person or via telehealth/remotely depending on individual, patient circumstances.
By establishing clear guidelines and safeguards, the government aims to provide a compassionate and regulated framework for euthanasia, balancing the principles of autonomy, wellness, and respect for human life. These guidelines prioritize the rights and well-being of patients while upholding ethical standards and legal principles.
Terms Defined:
- Active Euthanasia: Killing a patient by active means, for example, injecting a patient with a lethal dose of a drug. Sometimes called “aggressive” euthanasia.
- Passive Euthanasia: Intentionally letting a patient die by withholding artificial life support such as a ventilator or feeding tube.
- Voluntary euthanasia: With the consent of the patient.
- Involuntary euthanasia: Without the patient’s consent, for example, if the patient is unconscious and their wishes are unknown. Some ethicists distinguish between “involuntary” (against the patient’s wishes) and “nonvoluntary” (without the patient’s consent but wishes are unknown) forms.
- Self-administered euthanasia: The patient administers the means of death.
- Other-administered euthanasia: A person other than the patient administers the means of death.
- Assisted: The patient administers the means of death but with the assistance of another person, such as a physician.
- Physician-assisted suicide: The phrase “physician-assisted suicide” refers to active, voluntary, assisted euthanasia where a physician assists the patient. A physician provides the patient with a means, such as sufficient medication, for the patient to end their life.
There are many possible combinations of the above types, and many types of euthanasia are morally controversial. Some types of euthanasia, such as assisted voluntary forms, are legal in some countries.
Some instances of euthanasia are relatively uncontroversial. Killing a patient against their will (involuntary, aggressive/active, other-administered), for instance, is almost universally condemned. During the late 1930’s and early 1940’s, in Germany, Adolf Hitler carried out a program to exterminate children with disabilities (with or without their parent’s permission) under the guise of improving the Aryan “race” and reducing costs to society. Everyone now thinks this kind of euthanasia in the service of a eugenics program was clearly morally wrong.
Guidelines for Euthanasia
Voluntary Choice: Euthanasia can only be considered for individuals who are of sound mind and have made a voluntary, informed decision to end their life. This decision must be made without any external pressure or influence.
Terminal Illness or Unbearable Suffering: Euthanasia may only be considered for individuals who are suffering from a terminal illness or experiencing unbearable physical or psychological pain that cannot be alleviated through any available medical treatments or palliative care.
Multiple Medical Opinions: The decision for euthanasia must be supported by multiple independent medical opinions confirming the patient’s diagnosis, prognosis, and the irreversibility of their condition. A minimum of 2 physicians are required to approve of and sign the documentation.
Informed Consent: Before proceeding with euthanasia, the patient must be fully informed about their condition, treatment options, prognosis, and the potential risks and benefits of euthanasia. They must provide explicit and informed consent in writing.
Counseling and Support: Patients considering euthanasia must have access to counseling and support services to help them explore their options, cope with their illness, and make an informed decision. This includes psychological support for both the patient and their family members/loved one(s).
Safeguards Against Abuse: Strict safeguards must be in place to prevent abuse and ensure that euthanasia is not coerced or administered without proper authorization.
Respect for Cultural Beliefs: We recognize the diversity of cultural beliefs regarding euthanasia and respect the rights of individuals to hold differing views. This includes the environment the patient wishes to be in and the setting up of their farewell space. Efforts must be made to accommodate these beliefs while upholding the principles of autonomy, dignity, and compassion.
Ongoing Review and Evaluation: We will periodically review and evaluate the implementation of these guidelines to ensure their effectiveness, and address any emerging issues or challenges.
Disclaimer: Participation in any of the mentioned methods may void the patient’s life insurance or other benefits. This policy is not subject to the terms and conditions of the patient’s benefits, and the patient would need to be in direct contact with the benefit provider for further information.
Resources:
Death with Dignity – Take Action
Assisted Suicide in the U.S.
https://deathwithdignity.org/states/