Assisted-dying laws: What defines "terminal" in terminal illness?

Several US states now have laws that permit physicians to aid patients who wish to die. AIUI, they typically (always?) set a number of requirements, one of which is that the patient must be diagnosed with a terminal illness that will cause death within a set period of time (six months is an oft-cited figure).

Question: how rigorous is that requirement understood to be? Is it that death is expected soon despite all conceivable medical interventions, or death is expected soon only if no treatment is applied, or is there some squishy middle ground?

For example, suppose a patient requires a gastrostomy to take nutrition. with this intervention, they could live for years, but without it they would die in a couple of weeks. For the purpose of assisted-dying laws, would this count as a terminal illness with a life expectancy of less than six months?

IANAL, but I assume it means that the person is going to die, no matter what is done, within a certain period of time. I’m amazed how doctors can tell someone they have 3 weeks or 2 months to live, and are usually fairly accurate. They know enough about the course of the disease to be able to predict how long someone is going to be around.

So if the law says within 6 months I think an experienced doctor, or group of doctors, should be able to determine the probability of someone dying within that time frame, or any other given time frame, based on their expert diagnosis.

My state (WI) defines “terminal condition” as an incurable condition caused by injury or illness that reasonable medical judgment finds would cause death imminently, so that the application of life-sustaining procedures serves only to postpone the moment of death.

From Chapter 154, Declarations to Physicians and do-not-resuscitate orders Wis. Stats. Database

The state seems to leave it up to my reasonable medical judgment as to what time frame imminently falls into. Thanks, state! I’ve lost some sleep over that one on a few occasions. But not on most of them, I will admit.

As an aside, a railroad *station *is one in which the line continues, usually in both directions, while a *terminal *is the terminus of the line. That’s why it’s properly Grand Central Terminal - everything stops there, only to go back the way it came - and while a *terminal *illness is one you can’t continue from.

When a family member was diagnosed with a terminal condition, I was a bit surprised to discover that the Social Security Administration (US) has an entire program and set of procedures/guidelines for terminal illnesses. The program is generally referred to as TERI. If an individual qualifies for TERI, he/she is normally and automatically entitled to disability benefits.

Sadly, the diagnosed condition was explicitly listed in the TERI guidelines. (TERI actually discourages the use of the term “terminal illness,” but one would certainly understand it that way.) In a sense, the SSA was telling me that the condition was terminal while the treating physicians were trying to offer us some hope.

This came up when I did my living will.

“Terminal condition??!! Life is a terminal condition!”

Always a controversial subject and proper guidelines are necessary for doctors to avoid accusations of negligence, while not prolonging life beyond common sense.

We had the Liverpool Pathway which was an attempt to achieve this.

Currently, consultants are expected to come to an agreement with all concerned. This still leaves the occasional court case where a relative is determined to keep a patient on life support for ever.

related: I found out that when you go to hospice, they become the people who deal with all the insurance paperwork. Takes a lot off the family.

Is that true in general? Maybe you have contact with an especially good hospice.

When my 92-year-old mother-in-law was dying, at home, my husband lived with her to care for her. There was also a hospice worker who came at some interval (I don’t remember how often). When MIL died, the hospice worker took care of all of the paperwork.

I think it’s true in general that hospice deals with paperwork but there may be some exceptions.

I know you are in great pain and see no point in continuing living, but you still have 8.5 months until nature will take you.
Call me in 2.5 months, and we can talk about the barbiturates then.

I know it was a miracle that this Puritanical* country has even broached the subject of “permitting” people to die at will, Ummm - I really DO NOT need your “permission”.

So don’t bury me on consecrated ground - BFD.

  • ever wonder why they were called “Puritans”? They really did think they were more “pure” than all others; they got their asses kicked out of the known world!