Discussion WRT to processes and safeguards of voluntary euthanasia (Part II)

[TAW122]

I've got lots of interesting responses on my other thread about why there must be screenings and safeguards placed for voluntary euthanasia, so I figured I have an thread specifically for addressing the process in more detail as well as clearing up myths and (potential) inconsistencies. As a quick recap, I will say that I support having voluntary euthanasia for everyone and that hasn't changed at all. Also, I will emphasize that all reasons for wanting to CTB are valid, just that some are subjected to a higher burden of acceptance before they are cleared to proceed because not all reasons are equal (some reasons are objectively minor and/or temporary). Note: This does NOT mean that said person's reason is completely invalidated or that it isn't considered; just that it would take more time as well as other criteria (proof that their quality of life is bad enough for them - it does get subjective but it's the best one can have, so a benchmark is needed as a start, then adjusted accordingly for each case.) to be met before approval. This is made to ensure that one has tried other solutions and truly wishes to give up as such a decision cannot be reversed (permanent) and also to cover the medical professional's legal liabilities as well as risk management for them.

Some additional facts:
The process of involuntary commitment is changed such that unless the suicidal is a direct threat to others' lives, well-being, and/or liberty, then authorities do not have the power or right to detain and forcibly lock the suicidal person into a psych ward or mental hospital. Furthermore, as voluntary euthanasia being a thing, no patient can be persecuted nor threatened with involuntary hospitalization, forced treatment, or detainment for merely requesting such a service.

With that said, here is the general process, in detail.

General Process walkthrough (voluntary euthanasia)
First off, a person who wants to die, has his/her reasons for wanting to do so, writes them down and documents them, then goes to an euthanasia clinic to present his/her case for it. The professional would then refer the person to a euthanasia entrance counselor who will speak to said person about the process and what it entails, asks the person why he/she wants it, and screens for any signs of coercion, alternative purposes (fraud, abuse, illegal activity, etc.), if so then the person is denied and would not be able to proceed. However, let's assume said person passes the screening, then he/she goes into a waiting period, this is to ensure that the person is adamant and (as close as) absolute in his/her willingness to euthanasia (it's possible for people to change their mind, if so, then the process is aborted, if not, then it proceeds as usual). During this waiting period, it will give the person time to say his/her goodbyes, get affairs and arrangements in order, and also for the medical professionals to prepare things on their end, including post-mortem procedures. After the waiting period is up, the patient goes back to the clinic, and then shortly afterwards is given the method (either drug or inert gas) for a peaceful, dignified exit. If at anytime before the administrating of said method the patient objects, changes mind, or refuses, then of course, as usual, the process will be aborted.

Below are a list of scenarios to illustrate the process I am talking about in more detail. Again, it is not conclusive nor applied to every single case, but just some general examples to what would be a reasonable benchmark and a typical case for getting approved, deferred, denied.

Scenario #1:
A person is unhappy with life in general and he/she recently just had an argument with his/her significant other. Said person decides to apply for euthanasia because of a conflict and through the entrance euthanasia counseling, the counselor screens said person and when the person gives his/her reasons, it is considered valid, however, the case would be deferred because due to the reason itself, while it may be a big deal for said person, a higher threshold must be met before he/her is allowed to proceed. This is because in most cases and most people, there are other solutions to solve said problem and said person must try to attempt resolve said problem before they are granted approval to proceed. Again, the person is not forced treatment, but encouraged to try other solutions which may include counseling, medication, and/or copes. Once documented and options exhausted, the person is then reviewed again, and now with evidence, the person presents his/her case again. Now the screener asks whether this person would like to continue trying to solve the problem or really wish to give up. The person decides he/she is ready to quit and shows that he/she does not wish to continue fighting a losing battle. (This also includes proving that the person didn't improve or has gotten worse). Once the threshold has been met, the hoops jumped through, the person is allowed to proceed. Then the rest of the process goes on as listed in the general process (waiting period, getting affairs and things together, preparing for the final moment of dignified, self deliverance). The person is free to change his/her mind at any time, then the process would be aborted like usual. The reason why the threshold is high is because objectively speaking the person is healthy and isn't suffering from an objective loss of quality of life (yes it's a benchmark but one needs a benchmark to start from, then adjust accordingly).

Scenario #2.1:
Similarly to scenario #1 above, but the person is under the influence of some family members who wish to get rid of the person in order for their selfish gain, money, and/or just malice. After the screener learns of this, the person is rejected and the responsible parties (said person's family members) are held legally responsible for trying to encourage suicide, possibly fraud, and other charges as well.

Scenario #2.2:
From Scenario #2.1, with just that the person is doing it fraudulently, but for his/her own gain and abusing the system, process. He/she is also rejected and held legally responsible for other similar crimes such as fraud, providing false statements and testimony, etc.

Scenario #3:
Person is suffering from various ailments, both physically and mentally. The person is semi-healthy, but has a chronic health problem that drastically reduces his/her quality of life below what most people have (objectively speaking) and said person is tired of life. He/she has been to multiple professionals to attempt to improve/cure the condition, but to no avail. The person presents his/her case to the euthanasia clinic and then the counselor screens it. The screening has a lower bar threshold to pass because the conditions are even worse than the previous one (objectively speaking). Said person is given a waiting period (albeit shorter) and the same as scenario #1 in terms of the process, saying goodbyes, getting affairs in order, and then finally, a dignified exit.

Scenario #4:
Person suffers from a terminal illness and is more than ready to check out. He/she goes into the euthanasia clinic and presents his/her case for euthanasia. The screener expedites the process knowing that the person is both subjectively and objectively suffering, doesn't have much time left, and would be better to minimize suffering for the patient and sooner to achieve, a dignified death. Screening is fast and threshold is quickly passed and the waiting period is significantly reduced and arrangements made swiftly, then the patient, whenever he/she is ready, takes the method to achieve a dignified exit.


Myths and misconceptions (this is just a list of the most common myths, but by no means is it conclusive):
1) But you claimed you are against mental health services, professionals, counselors, etc.
Yes, but keep in mind that I am referring to the current state of the mental health system and their protocol of present day, where euthanasia and right to die is forbidden, taboo, and that we are in a prohibitionist society. The screening that I am referring is strictly like an euthanasia entrance counseling, meaning that the patient requesting the service is doing so in his/her own free will (not being coerced), is really certain of his/her decision, and that the patient would release all liabilities, claims, and legal action against them.

2) Aren't you gatekeeping on others' right to die, self-determination, going against what you claimed in the past?
No, people are still free to have any reason they wish to CTB, but if they are going through a euthanasia process, not only is it important to keep official records that they themselves want said service, that their lives are objectively and subjectively bad (for liability and legal reasons, risk management, preventing the medical professionals or practice from being litigated), and ultimately, they would still be able to obtain the right to die. Another example is if during the process, the patient changes his/her mind, then the process would have to be aborted immediately, otherwise it would be considered murder, unlawful taking of another's life.

3) People could just CTB on their own if they can't receive this, why would they want to go through a process with many checks and hoops to jump through?
I never claimed that people could not CTB on their own, they could, but when they do so, they are risking failure, using methods that may result in collateral damage, and sure, there will always be people who do that; but with voluntary euthanasia as an option, they may choose that instead of just taking matters to their own hands. I also believe that in the current system, the way involuntary commitment, forced detainment of suicidal individuals is wrong and that in such a new society, if it is determined that suicidal person is not a threat to others, only to themselves, then they would be left alone unless they themselves request to be saved.

4) Couldn't 3rd parties, loved ones, or others in general just stop the person/interfere with said person's ability for euthanasia?
No, it would be considered a violation of not only the person's right, but medical decision and would carry a heavy legal penalty, especially if it is willingly and done so with malice. It would be akin to that of a serious legal offense (serious misdemeanor, possibly felony).

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There may be more, but these are the ones I can think of as of now.

 

[CynicalHopelessness]

So with this process a mentally ill person would have to let a party of random people decide whether their reason with CTB requires additional proofs, with added risk of them considering said person a fraud and threatening a sentence, and also risking their loved ones a sentence too if they try to stop them on emotion.

I guess the best strategy with such a system would be to jump on my own, and if I survive but get crippled, then apply for euthanasia.

 

[TAW122]

Not exactly. A mentally ill person, while would be screened out initially, but later if determined that said person could not get better, then he/she would be granted access to such services. My scenario is based on a real life example, the story of Aurelia Brouwers, who was allowed to die due to her circumstances. Of course, the criteria would have to objective to be universal, then decided on a case-by-case basis.

In regards to the risk of fraud, I am specifically referring to people who intentionally make false statements and/or try to obtain such services illegally (lying about age, lying about conditions and circumstances) would be prosecuted. The bar for that is set high as to not punish those who just desperately want to die versus those who have malevolent intentions.

Yes, I did mention that if loved ones interfere with the person's decision, especially after it is known, then they would be prosecuted for interfering with said individual's rights and medical decisions, directives. For example, if suppose said patient has gotten approval to proceed with the process, and after the waiting period, he/she goes to the clinic, and right before the dignified exit, his/her family interferes by storming the clinic and/or stops said person from taking the drug/method that would said person's life, then that would constitute as not only a violation of the person's right to die, but also his/her medical decision, directive. Granted, that is an more extreme case, but it is usually for cases where it is clear that the person has made the decision to die, but a 3rd party, loved one, or whoever willingly interferes with that person's decision. I am not referring to simply objections (which is fine and legal), but active interference and intervention against said person's rights and wishes.

Again, I don't claim such a system to be perfect, but there has to be a benchmark as a reference point to start with. Then with that, adjust accordingly.

 

[TAW122]

After careful thought, here is my new take for voluntary euthanasia, just to keep it simpler and without all the unnecessary crap. Yes, safeguards and checks will exist, but mostly to ensure that the person selecting it isn't doing so out of coercion or being pressured involuntarily (by a 3rd party), there will be a waiting period (especially for non-imminent cases) to ensure that the person is 100% ready and not likely to change his/her mind. Beyond that, if a person wishes to go, then after those criterion have been met, said person would then be able to proceed and go peacefully, with dignity.

With the first check and safeguard, to ensure that the person is doing so out of 100% free will and not under any pressure, coercion, influence, it may be a longer process if it is a vulnerable person, but ultimately, the check is to prevent people from abusing it (e.g. someone who pressures someone into suicide in order for them to gain inheritance and/or just to dispose of someone they hate).

The second check is to ensure that the person requesting it is not likely to change their minds and not rush to make any decision before carefully thinking it though. That may be longer for physically and psychologically health individuals as a bit more screening is involved to ensure that they tried other options first before going through. (e.g. someone who is physically healthy and has no other problems may have a longer wait period, but not exorbitant.)

With such criteria, of course, it is never perfect and there may be slight variations or nuances, but the general ideas and values are about as simple and objective as they can get. With voluntary euthanasia, there certainly has to be checks to prevent abuse as well as ensuring that the person really wants said service and is 100% committed to following through along with allowing the option to change his/her mind before the final moment. That is my stance on this and yes, while not everyone may agree with it (which is ok), it is in my opinion the fairest way to go, even as a benchmark.