Right-to-Die Legislators

New name for the book?

I am considering starting a NEW page
for the book called here "Creating New Right-to-Die Laws".

The NEW name for the book might be:

"NEW END-OF-LIFE LAWS".

All of the present chapters of the book
would remain the same.
The chapter names and letters would remain.
All of the current columns would remain.
But new columns would be added as needed.

The Table of Contents would be reorganized,
so that each chapter has a separate listing,
with its columns named.

What do regular readers think
of there proposed changes?

The original page would remain:
Right-to-Die Legislators.

SAFEGUARD FF FOR LIFE-ENDING DECISIONS

SPECIFICALLY-LICENSED
TERMINAL-CARE PHYSICIAN
AGREES TO PROVIDE LIFE-ENDING CHEMICALS

Note: This safeguard is suggested as an alternative to the safeguard called
PHYSICIAN AGREES TO PROVIDE LIFE-ENDING CHEMICALS.
As such, it incorporates everything from that safeguard
but adds that only a special, licensed sub-set of physicians
would be authorized to provide life-ending chemicals to cause death.
A break indicates the beginning of the new part added for this safeguard.
Both safeguards EE and FF end with the same explanation
of how physician-provided lethal chemicals would prevent premature death.

After the primary-care physician has reviewed
all the medical facts and opinions collected for planning death,
the doctor might approve a chosen death.

This safeguard will normally be one of the last to be fulfilled
—after the opinions of the patient, family, proxies, ethics committee, etc.
have all been properly gathered and distributed
to everyone legitimately involved in the death-planning process.

This approval by a terminal-care physician
has not 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
one central professional to approve the life-ending decision.
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 early examples.
Elsewhere the doctors might recommend and provide
other means of choosing death,
such as increasing pain-medication, inducing terminal coma,
disconnecting life-support systems,
or giving up water and other fluids.)

Exactly which chemicals should be used
to achieve a peaceful and painless death
can be decided by the professionals
most centrally involved in the life-ending decision.
But the purpose of the life-ending chemicals
should be plainly stated for all to understand.
Therefore, to avoid even subtle or subliminal misunderstanding,
the chemicals to be used to cause death
should never 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 liquids—not "medications".

The purpose of the life-ending chemicals must be fully explained
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 unconscious
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 chemicals
must make sure that everyone involved in the death-planning process
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 gentle poison?

And where communication is especially difficult,
a video presentation of dying by this means
might make it clear to all concerned
just what will happen when the gentle poison is used.

Exactly how the lethal chemicals will be administered 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.

The following are the new paragraphs added for this alternative safeguard:

Not all licensed physicians will provide life-ending chemicals.
Only physicians with special training in terminal care,
who actually take care of patients in the last phases of their lives,
(and perhaps who are involved in hospice care)
will be authorized to provide life-ending chemicals
for the purpose of achieving a peaceful and painless death.

Licensed physicians who wish to have this additional authority
will be required to apply for a special license,
which could be provided by the same licensing authority
that licenses all physicians.
That licensing authority should establish the exact qualifications.
Or the qualifications could be specified in the law
that authorizes some physicians to provide life-ending chemicals
for the purpose of achieving a peaceful and painless death.

Perhaps only 5% of all licensed physicians in any jurisdiction
will apply for this special license to give lethal chemicals.
This means that the other 95% of doctors
will not be associated with using lethal substances to bring death.
Other doctors who agree that a life-ending decision
is the best course of action under the circumstances
and who believe that gentle poison will be the best method of dying
will have to refer their patients to those terminal-care physicians
who are specifically trained and licensed to provide gentle poison.
This provides one additional level of professional approval.

Giving only specific physicians the power to provide death pills
will also protect all physicians from the suspicion
that they might be secretly planning for the patient's death.
Some physicians oppose right-to-die laws
because they fear that their patients will no longer trust them
if the patients know that all doctors have the power to cause death.
Many medical associations have also taken official stands
against what used to be called "physician-assisted su***de"
because they say that doctors must not kill.

Using this specific safeguard should relieve the fears
of both physicians and their patients
that doctors might cause death without proper safeguards.

Ordinary doctors would not be authorized to provide gentle poison.
They would have to discuss the possibility of chosen death
with the patient and/or the proxies
before referring the patient to a terminal-care physician
who has a special license to provide life-ending chemicals.

Non-reporting of chosen deaths would become less common
because the terminal-care physicians authorized to provide gentle poison
would be the ones submitting reports of such methods of achieving death.
And because they have specifically applied to provide lethal chemicals,
they will not worry about getting a 'bad reputation'.

All other doctors could continue to affirm
that they are only involved in those forms of medical care
that are intended to cure the patient
or to ease the passage into death without using life-ending chemicals.

HOW A DOCTOR PROVIDING LIFE-ENDING CHEMICALS
DISCOURAGES IRRATIONAL SU***DE
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 chemicals has been obtained,
strict controls should be in place to make sure
that the lethal substances are not used
by some other member of the household
for the purpose of committing irrational su***de.
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 su***de by shooting themselves.
But the same reluctance might not apply to taking death-pills.

Whenever a physician provides life-ending chemicals for a patient,
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 be premature
in the professional opinion of the physician
who approved using gentle poison to cause death.

Because this gate-keeping function approves the timing of death,
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 gentle poison
if and when the patient declines to the point
where a chosen death would be the wisest course of action.

Whenever any death is caused by some means
NOT under the control of the physician,
then the physician is not as direct a participant in that death.

When life-ending chemicals provided by a physician are used,
then all should know that the physician who orders the gentle poison
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 recommendations
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 end.

Because it is always possible for some doctors to abuse this power,
we need ways to prevent such misuse of lethal chemicals:
"Will My Doctor Prescribe an Overdose of Drugs?"
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-PRESC.html

A note on language:
This safeguard has carefully and intentionally avoided the following words:
"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 diseases, etc.
And the provided chemicals need not be obtained from a licensed pharmacy.
Thus, the laws regulating prescriptions should not apply.
Some opponents of the right-to-die
will attempt to prevent voluntary death and merciful 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 honest,
such terms from the professions of medicine and pharmacy should be avoided.
See further discussion of the misleading "medication" terminology.

PHYSICIAN-PATIENT RELATIONS, TERMINAL CARE--DECISION MAKING---safeguards to prevent doctors from abusing their authority to prescribe drugs 13 recommended safeguards to prevent over-prescribing drugs at the end of life

SAFEGUARD EE FOR LIFE-ENDING DECISIONS

PHYSICIAN AGREES TO PROVIDE
LIFE-ENDING CHEMICALS

After the primary-care physician has reviewed
all the medical facts and opinions collected for planning death,
the doctor might approve a chosen death.

This safeguard will normally be one of the last to be fulfilled
—after the opinions of the patient, family, proxies, ethics committee, etc.
have all been properly gathered and distributed
to everyone legitimately involved in planning this death.

Approval by the terminal-care physician
has not always been recognized as a safeguard,
because it was assumed to be so central to the process
as defined in laws permitting the use of life-ending chemicals.
But it is important for at least
one central professional to approve the life-ending decision.
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 early examples.
Elsewhere the doctors might recommend and provide
other means of choosing death,
such as increasing pain-medication, terminal coma,
disconnecting life-support systems,
or giving up water and food.)

Exactly which chemicals should be used
to achieve a peaceful and painless death
can be decided by the professionals
most centrally involved in the life-ending decision.
But the purpose of the life-ending chemicals
should be plainly stated for all to understand.
Therefore, to avoid even subtle or subliminal misunderstanding,
the chemicals to be used to cause death
should never 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 liquids—not "medications".

The purpose of the life-ending chemicals must be fully explained
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 unconscious
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 chemicals
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 gentle poison?

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 administered 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 SU***DE
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 chemicals have been obtained,
strict controls should be in place to make sure
that the lethal substances are not used
by some other member of the household
for the purpose of committing irrational su***de.
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 su***de by shooting themselves.
But the same reluctance might not apply to taking death-pills.

Whenever a physician provides life-ending chemicals for a patient,
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 be premature
in the professional opinion of the physician
who approved using gentle poison to cause death.

Because this gate-keeping function approves the timing of death,
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 gentle poison
if and when the patient declines to the point
where a chosen death would be the wisest course of action.

Whenever any death is caused by some method
NOT under the control of the physician,
then the physician is not as direct a participant in that death.

When life-ending chemicals provided by a physician are used,
then all should know that the physician who orders the gentle poison
is taking professional responsibility for choosing 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 recommendations
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 end.

Because it is always possible for some doctors to abuse this power,
we need ways to prevent such misuse of lethal chemicals:
"Will My Doctor Prescribe an Overdose of Drugs?"
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-PRESC.html

A note on language:
This safeguard has carefully and intentionally avoided the following words:
"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 diseases, etc.
And the provided chemicals need not be obtained from a licensed pharmacy.
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 older 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 honest,
such terms from the professions of medicine and pharmacy should be avoided.
See further discussion of the misleading "medication" terminology.

An alternative to this safeguard
would license only some doctors to provide life-ending chemicals:
SPECIFICALLY-LICENSED TERMINAL-CARE PHYSICIAN
AGREES TO PROVIDE LIFE-ENDING CHEMICALS.

SAFEGUARD DD FOR LIFE-ENDING DECISIONS

THE PATIENT MUST BE AN ADULT RESIDENT OF THE STATE

The patient who is considering life-ending decisions
must be at least 18 years of age
and a legal resident of the state (or country)
in which the life-ending decision is proposed.

Birth certificate, driver's license,
& other commonly-accepted proofs of age and residence
should be easy for the patient to provide.
When the patient is registered for hospital or hospice care,
the questions of age and address are usually already settled.

These safeguards are often assumed rather than specified.
But a few circumstances make them relevant.

For example, if there is some question raised
about the assumed age of the patient,
then it might have to be proved that the patient is an adult
—at least 18 years old in most places—
so that it is clear that the patient is the primary decider
and not the parents of the patient or some other guardian.

Likewise, if the patient is not a legal resident of the state (or country)
then various problems could arise for any providers of services.

And many states (and countries) do not want to attract
patients from other places coming to their state (or country) in order to die.
This has not happened in Oregon,
which does have a residency requirement.
But it has happened in Switzerland, which does not require residency.

HOW ADULTHOOD AND RESIDENCY DISCOURAGE
IRRATIONAL SU***DE AND OTHER PREMATURE DEATHS

Irrational su***de is known to be a problem for teen-agers.
So requiring patients to be at least 18 years of age
will discourage some teen-agers from using right-to-die laws
as a cover for what most people would call an irrational su***de
—a self-killing that is harmful, foolish, capricious, & regrettable.

When a child has a condition that makes him or her
a candidate for chosen death,
the parents of that child are the legal deciders for him or her.
Because the parents are already adults,
they are assumed to be wiser than their children.

Children need adult guidance in making most decisions in life,
especially when the children are very young
and when the decisions are irreversible—such as choosing death.
Preventing children from even thinking of death as the escape
should encourage them to seek other ways to solve their problems.
In almost all cases, when teens choose death, it is too soon.

The residency requirement of some states and countries
can discourage people of unstable mind and unsettled address
from rather foolishly hoping
that going to a place where chosen death is permitted
will be the answer to all of their problems.
The state or country should not help such persons to die.

However, if a certain state or country legalizes the right-to-die
by outlawing causing premature death
rather than establishing some process of applying for death,
then being an adult or a resident is not relevant,
since people of any age or residence can suffer premature death.
When anyone is harmed by the behavior of anyone else
the age or address of the victim should not be considered.

SAFEGUARD CC FOR LIFE-ENDING DECISIONS

FAMILY MEMBERS DISCUSS
THE LEVEL OF PERSONHOOD IN THE PATIENT

Even while the patient still has some capacity for medical decisions,
the family (perhaps members specifically designated as proxies)
might find themselves discussing to what degree the patient
has lost some characteristics that made him or her a person.

These universal marks of personhood include:
(1) consciousness, (2) memory, (3) language, & (4) autonomy.

(1) If the patient is permanently unconscious,
then memory, language, & autonomy are obviously also missing.
And if there is strong medical certainty
that the patient will never return to consciousness,
that individual's life as a person is over forever.

(2) Memory is a mental capacity that might gradually fade away.
The patient is still conscious every day
but cannot remember important things about himself or herself
that used to constitute being that specific person.
And the patient might not recognize family members.
When memory is almost completely absent,
the family might say that the person they knew is now gone.

(3) Language is also a capacity of personhood
that the family members might notice declining.
Is it difficult for the patient to express himself or herself?
Eventually the patient might lose the capacity
to understand words that are spoken to him or her.
Alzheimer's disease might remove the ability to read and write.

(4) Autonomy could be the first mark of personhood to disappear.
The patient who used to direct his or her life
might now become dependent on others for all decisions.
Does the individual still make plans and carry them forward?
In some ways, such loss of autonomy makes the patient like a child.

These four marks of personhood are discussed completely
in a small book called:
When Is a Person? Pre-Persons and Former Persons.
This book contains about 200 questions
divided into the four marks of personhood described above.
These questions would be a comprehensive way to discuss personhood.

The same 200 questions also appear in another book:
Your Last Year: Creating Your Own Advance Directive for Medical Care.

And a shorter presentation of these basic themes
appears on the Internet here:
"Losing the Marks of Personhood:
Discussing Degrees of Mental Decline".
This essay briefly explains the four marks of personhood.

HOW DISCUSSING THE PERSONHOOD OF THE PATIENT
DISCOURAGES IRRATIONAL SU***DE
AND OTHER FORMS OF PREMATURE DEATH

When the patient is just beginning
to lose the capacities that make anyone a person,
there might be some danger of irrational su***de,
since the patient's mental powers are declining.
If there were irrational urges toward self-killing
in the patient's thinking before the onset of Alzheimer's,
these might become more dangerous
if the patient loses perspective on his or her life.

If the patient's 'reasons' for choosing death become questionable,
the decision-making power should shift to the proxies,
who presumably are operating with all of their mental powers.

Some objective actions such as better supervision
might be necessary to avoid the danger of an irrational su***de.
And if the patient definitely becomes suicidal,
then a 24-hour su***de-watch might be necessary.

When the patient can no longer make wise medical decisions,
the proxies gain the power to choose all future courses of action.
We would hope that the patient has appointed the best proxies
while the patient was still able to make medical decisions.
But if not, then family members might be asked less formally
to make all future decisions for the patient.

Since the proxies have the best interests of their patient in mind,
they will not approve or cooperate in any irrational su***de.
But they will have the power to make wise end-of-life decisions.

If there is ever any doubt about the wisest course of action,
here is another essay that articulates the differences between
irrational mercy-killing and wise merciful death:
Will this Death be a "Mercy-Killing" or a "Merciful Death"?

The proxies will ask themselves
when would be the best time for this patient to die.
There might be some further marks of decline
that would be significant factors
for choosing between keeping the patient alive
and allowing nature to take its course.

The proxies want to choose a last day for the patient
that is not too soon and not too late.
And besides considering the decline from full personhood,
the proxies will use several other safeguards
to decide the best day of death for this patient.

SAFEGUARD BB FOR LIFE-ENDING DECISIONS

NOTIFY FAMILY OF LIFE-ENDING DECISION

Usually we will communicate with our families
when we are coming to the end of our lives.
The people who are closest to us will know about our health conditions
and they might already be deeply involved in our medical decisions.

If we have appointed family members to be our proxies,
these persons will obviously be involved in any end-of-life decisions.

But we might come to the end of our lives
when our only remaining family members are distant and uninvolved.
In such cases, it might be wise for us to notify them
that we are considering bringing our lives to an end.

In deciding which people we might notify,
we can think of all the people who will learn about our deaths later.
Which relatives and friends will gather for funeral or memorial services?
Which of these would want to know when we are dying?

Any such notification will give others the opportunity to respond
in any ways that seem appropriate to them.
Some will want to know more about the circumstances
that are leading us to consider choosing death.
They might have some matters they want to complete with us
before we begin the final process that will bring death.

+++++++++++++++++++++++++++++++

Continue reading this safeguard BB here:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-KIN.html

SAFEGUARD AA FOR LIFE-ENDING DECISIONS

INFORMATION ABOUT PALLIATIVE CARE
AND OTHER ALTERNATIVES TO IMMEDIATE DEATH

Patients and/or their proxies
who are seriously considering voluntary death or merciful death
need as much information as possible about the alternatives.
Choosing immediate death might not be the best pathway.

Pain control is an option appropriate for almost any patient.
The doctors can explain the various means of controlling symptoms
that might improve the patient's quality of life.
Sometimes uncontrolled pain is driving the patient toward an early death.
In fact, untreated pain might lead to irrational su***de.

Nursing home care or some other assisted-living arrangement
might be worth exploring if the patient knows
that he or she cannot continue to live at home
because that has become too difficult for other members of the family
or because it is no longer possible to live alone.
Some specific nursing homes might be visited
to see which might be good alternatives to choosing death now.
Bad nursing homes are all too common.
But there are some good nursing homes.
The patient and/or family should not make any life-ending decisions
based on incomplete information about nursing homes.

Hospice care is also a valid alternative to immediate death.
The patient might not like the idea right away.
But some printed information about hospice philosophy and practice,
a visit with a representative of a hospice program,
and/or a visit to a residential hospice
might offer some new perspectives on the hospice option.

Often patients are poorly informed about palliative care.
They might associate hospice-care too closely
with the hospital treatments they have experienced.
And they want no more invasive medical procedures.
But the comfort care offered by a hospice program
is not nearly as burdensome as the endless round
of tests and procedures performed in the hospital.
When the patient understands all of the benefits of palliative care,
he or she might agree to give hospice-care an honest try.

(A trial period of actually receiving palliative care is another safeguard.)

HOW INFORMATION ABOUT PALLIATIVE CARE
AND OTHER ALTERNATIVES TO IMMEDIATE DEATH
CAN DISCOURAGE IRRATIONAL SU***DE
AND OTHER FORMS OF PREMATURE DEATH

Persons who are feeling desperate because their lives are ending
are sometimes tempted to commit irrational su***de
because they have incomplete or inaccurate ideas
about the process of dying.
If they can be calm enough to listen to
a presentation of the alternatives to hasty death,
they might decide that killing themselves immediately
is not their best pathway towards death after all.

Both patients and their proxies
sometimes attempt to make end-of-life decisions
overshadowed by particularly terrible deaths they have witnessed.
If they believe that this patient will have a horrible death,
they might be tending toward choosing death prematurely.
However, the case of this particular patient
might be different enough from the terrible death they want to avoid
that none of the suffering they fear
need necessarily be a part of this patient's pathway towards death.

Fears about repeating terrible deaths can be used constructively.
Instead of committing irrational su***de to avoid a similar fate,
the patient and family can carefully consider alternative pathways.

Actually trying some alternative living arrangements
will be better than just thinking abstractly about other places to live.
If the patient actually tries adjusting to a nursing home,
everyone might be pleasantly surprised that it works well.
And when that way of life is no longer meaningful
or if other circumstances make life worse,
then the patient and/or the proxies can choose death at that time.

What further life-meanings does the patient want to realize?
What additional experiences would be enriching?
Does the patient wish to distribute any assets or possessions before death?
Would it be wise to begin clearing out the patient's home before death?
This might result in more meaningful ways
of disposing of everything that will remain after the patient's death.

Carefully considering some good alternatives to dying-right-away
can help some patients and their families
to choose a meaningful, positive pathway towards death
that is definitely better for everyone than choosing immediate death.