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Lawmakers have drafted a legislative outline to lay the groundwork for recognizing the concept of dignified death for people near death and for waiving prosecution of medical practitioners who take such patients off life support.

The nonpartisan parliamentarians’ league on death with dignity held a general meeting the same day and plans to use the draft to deepen discussions on the issue with an eye toward submitting a bill to the Diet, members said.

But the Japan Medical Association has expressed opposition, saying, “It is doubtful there is national consensus on the issue being legislated, and it may disrupt the medical scene.”

The association wants the the outline to be just that, not codified by law.

The lawmakers plan to discuss the issue with the association and other related groups, the league members said.

The draft, compiled by the House of Representatives’ Legislative Bureau from a number of points of agreement reached by the group, proposes allowing physicians to take patients off life support if two or more other doctors confirm a “near-death situation.”

But this would only apply to patients who have declared in writing in advance that they do not want life-prolonging treatment.

Patients who would be allowed to make such a declaration must be aged 15 or older, according to the draft.

League members pointed out during the meeting the lack of provisions in cases in which the patient’s desire is not known.

“Will (doctors face prosecution) if they suspend treatment when the patient’s will is unknown?” one member asked.

A Justice Ministry official answered, “When there is no declaration of intent, the decision will be made respectively based on the law.”

The lawmaker group formed in April 2005 with nearly 50 members of the Diet from both the ruling and opposition camps. It is headed by former Foreign Minister Taro Nakayama, a member of the ruling Liberal Democratic Party in the Lower House who is also a physician.

The bill for suspending life-support measures in near-death situations defines the “state of near death” as one in which every appropriate medical treatment offers no chance of recovery for a patient who is very close to the end of life.

It also defines life-support measures as medical procedures not for treatment of illnesses but for only sustaining life, including nutritional and hydration support.

The draft proposes that confirmation of a near-death state be done by two or more physicians with broad experience, excluding the attending doctor.

The draft requires physicians and medical institutions to formulate documents certifying such a decision was made properly. It also requires them to store for five years those documents plus records on suspending life-support measures. Violators of the procedure would face a 500,000 yen fine.

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