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Family Consent On Euthanasia Form

The Family Consent on Euthanasia Form is a document that is used by families to provide their consent for a loved one to be euthanized. This form is used to ensure that all family members are in agreement with the decision to end the life of their loved one.

Time to complete

1 minute

Eligibility

Any family member of a patient who is considering euthanasia may fill out this form.

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Questions for Family Consent On Euthanasia Form

1.

What is your relationship to the patient?

The answer should be a text input.
2.

Do you agree with the decision to euthanize the patient?

The answer should be a single choice:
  1. Yes
  2. No
  3. Unsure
3.

What are your reasons for agreeing or disagreeing with the decision?

The answer should be a text input.
4.

Have you discussed this decision with all other family members?

The answer should be a text input.
5.

Are there any other factors that you feel we should consider before making this decision?

The answer should be a text input.
6.

Do you have any questions that you would like to ask us about this process?

The answer should be a single choice:
  1. Yes
  2. No
  3. Unsure
7.

Is there anything else that you would like to add?

The answer should be a text input.

Similar Ideas

  • Advanced directive
  • Do Not Resuscitate (DNR) order
  • Living will

Here are some FAQs and additional information
on Family Consent On Euthanasia Form

What is euthanasia?

Euthanasia is the act of deliberately ending a person's life in order to relieve them of suffering. This can be done either by administering a lethal substance or by withholding life-sustaining treatment.

What is the difference between active and passive euthanasia?

Active euthanasia involves directly causing a person's death, usually through the administration of a lethal substance. Passive euthanasia, on the other hand, involves withholding life-sustaining treatment, such as food and water, which ultimately results in the person's death.

Why do people want euthanasia?

There are a number of reasons why people may want to end their lives. Some people may be suffering from a terminal illness and want to avoid a prolonged and painful death. Others may simply feel that their quality of life is so poor that death is preferable.

Is euthanasia legal in the United States?

Euthanasia is not currently legal in any form in the United States. However, there are a number of states that have introduced legislation that would allow for some form of assisted suicide, which is a closely related concept.

How would a family consent to euthanasia?

If a family member is considering euthanasia, they would first need to discuss it with their doctor. The doctor would then assess the person's mental state and whether they are competent to make the decision. If the doctor believes the person is competent, they would then need to obtain written consent from the family member.

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