Is the American Nurses Association Ready to Drop Opposition to Assisted Suicide?

In 2013, the American Nurses Association (ANA) stated this : “The American Nurses Association (ANA) prohibits nurses’ participation in assisted suicide and euthanasia because these acts are in direct violation of Code of Ethics for Nurses with Interpretive Statements (ANA, 2001).” (Emphasis added)

But now in 2019, the ANA is proposing a new position paper to change this. Not only is the ANA attempting to change its previously used term assisted suicide to “aid in dying” (the approved term of Compassion and Choices), but also the Code of Ethics itself.

The draft position paper is titled “The Nurse’s Role When a Patient Requests Aid in Dying” There is an online form for public comments which must be submitted before April 8, 2019. There is no requirement that you have to be a member of ANA or even a nurse to make a public comment. The ANA can also be contacted by email at customerservice@ana.org or by phone at 1-800-284-2378.

There is much in the draft position that I find shocking both as a nurse and a patient. For example, the draft position begins:

“It is the shared responsibility of professional nursing organizations to speak for nurses collectively in shaping health care and to promulgate change for the improvement of health and health care” and “(t)he nurse should remain non-judgmental when discussing end of life options with patients, who are exploring AID” (a.k.a. physician-assisted suicide). (Emphasis added)

This statement flies in the face of the way nurses have traditionally cared for patients considering suicide, whether they are terminally ill or not. Unfortunately, this follows the lead of several medical, nursing and hospice/palliative care organizations that have changed their positions on assisted suicide to “neutrality” or even support.

The ANA draft also states, “The nurse has the right to conscientiously object to being involved in the AID process” but “Nurses are obliged to provide for patient safety, to avoid patient abandonment, and to withdraw only when assured that nursing care is available to the patient.”  (Emphasis added)

The draft suggests that such nurses can “ensure the ongoing care of the patient considering AID by identifying nurse colleagues willing to provide care.”

This is forced cooperation and does nothing to protect nurses’ conscience rights. Such a position would impact not only current nurses but also potential future nurses who have strong ethical principles against helping patients kill themselves.  Many nurses already are worried about the impact of other ANA positions, such as the 2017 “Nutrition and Hydration at the End of Life”  which states, “People with decision-making capacity have the right to stop eating and drinking as a means of hastening death. (Emphasis added)

In a section titled Social Justice, the draft position states:

“Nurses must continually emphasize the values of respect, fairness, and caring,”(ANA, 2015a, p.35). Statutes that allow AID are not present in every state, which presents geographic inequity in terms of access. Additionally, AID medication is expensive, which presents an additional barrier to access for those who cannot afford it, even if they live in a jurisdiction or state where this option is legal. Nurses act to reduce or eliminate disparities. While this is most commonly associated with health promotion and disease prevention, the current AID landscape raises questions of fairness which require ethical reflection.” (Emphasis added)

I find it outrageous to encourage nurses to become social justice warriors  fighting for more access to assisted suicide and cheaper lethal overdoses. And one recommendation in the ANA draft position eliminates all doubt about a radical departure from the 2013 Code of Ethics prohibition of  “participation in assisted suicide”: “Nursing research is needed to provide an evidence base for AID.”

NON-JUDGMENTALISM: IS IT REALLY IN OUR PATIENTS’ BEST INTERESTS?

When I first met “Frank” (not his real name) many years ago, I was puzzled. Frank was a terminally ill man who had just been admitted to my oncology unit for control of his “unbearable pain”. However, Frank didn’t seem to be in any physical pain.

I talked privately to Frank’s wife, Joan, who tearfully confided that Frank was cleaning his gun collection when he asked her if she would still be able to live in their home if, in his words, “anything happened”.

Joan said she knew he was talking about shooting himself and even though she was horrified, she said she thought the right thing to say was: “I will support any decision you make”. However, she later panicked and called the doctor to say that Frank was having unbearable pain. The doctor agreed to admit him and ordered morphine to be given as soon as he arrived.

When I suggested to Joan that Frank’s real question might not be about their home but rather about whether his lingering dying might be too hard on them both, she was stunned. This had never occurred to her. She said she loved Frank and she wanted to care for him until the end. I told her that she and her husband needed to talk.

Frank and Joan then finally had a long overdue open discussion about their sorrow and fears. I told the doctor what I discovered and when I last saw Frank and Joan later that day, they were holding hands and smiling as they left the hospital.

I learned that Frank died peacefully — and naturally — a few weeks later with his wife at his side.

I believe that this situation shows how being “non-judgmental” can itself be lethal. Unfortunately, the public as well as we healthcare professionals are being given the message that a patient’s “right to self-determination” is the most important ethical principle.

What I did with Frank and his wife was a lot like a recent UCLA project started when California legalized physician-assisted suicide. The project showed that “most of what patients needed was to discuss their feelings about their approaching death and process their grief and sense of loss.” The project also found that “only” 25% of these patients seeking assisted suicide went on to use assisted suicide.

When someone is suicidal, it should not matter whether they are terminally ill. Instead, we should treat them with the same care and concern we would give a physically healthy suicidal person.

Anything less would be discrimination and I am telling this to the ANA.

 

 

 

 

What about Ventilators and “Pulling the Plug”?

When I first became a registered nurse in 1969, ICUs (intensive care units) were still new. The first one I worked was set up in the former visitors’ lounge and we learned how to read EKGs (heart tracings) by using a book.

By the early 1970s, I worked in a surgical/trauma ICU where we used sophisticated ventilators like the MA-1. We were able to get almost all our patients off ventilators by weaning, the process of gradually lowering ventilator support until the patient can breathe on his or her own.

But in 1976, I was shocked by the Karen Quinlan case that changed everything.

Karen was a 21 year old woman who suffered brain damage after apparently taking drugs at a party. She was hospitalized and placed on a ventilator. When she was thought to be in a “persistent vegetative state”, her adoptive parents asked that her ventilator be removed. The doctors disagreed and they case eventually went to the New Jersey Supreme court that allowed the removal of the ventilator on the grounds of an individual’s right to privacy.  Shortly afterward, California passed the first “living will” to refuse “life support” if or when the signer is incapacitated.

Ironically, Karen lived 10 more years because, as some ethicists criticized, she was weaned off the ventilator instead of just abruptly stopping the ventilator.

My experience with ventilators became personal in 1983 when my baby daughter Karen died on a ventilator before she could get open-heart surgery. Unfortunately, one young doctor earlier offered to take her off the ventilator to “get this over with”. I reported him to the chief of cardiology who was furious with the young doctor.

In the 1990s, I returned to working in an ICU and was shocked by the development of the “terminal wean” for some patients on ventilators. Often the families were told that there was no hope of a “meaningful” life. The terminal wean involved abruptly disconnecting the ventilator and “allowing” the patient to die. I brought up at least trying regular, gradual weaning and oxygen as we did for the other patients on ventilators but I was ignored.

After I retired from bedside nursing, I was asked to be with an elderly man on a ventilator who had had a massive stroke and the family was told that he would never have any quality of life and would die soon anyway. I tried to bring up weaning but some members of the family were adamant.

When the ventilator was stopped. I held the man’s hand and prayed while he gasped for air and turned blue. I asked the nurse to at least giving him oxygen for comfort but she ignored me. Instead, she gave frequent doses of morphine intravenously until the man’s heart finally stopped after 20 minutes.

I am still haunted by this man’s death.

INFORMED CONSENT?

The medical definition of informed consent requires understanding “the purpose, benefits, and potential risks of a medical or surgical intervention…”.

But most people seem to have a vague understanding of ventilators when they sign a “living will” or other advance directives and thus have very little information about this often life-saving medical intervention.

As a nurse, I found that most people-especially the elderly-tend to automatically check off ventilators without understanding that a sudden problem with breathing can come from a number of treatable conditions that don’t require long-term use of a ventilator such as  asthma, drug overdoses, pneumonia and some brain injuries.

In some circumstances such as certain spinal cord injuries and late-stage neurodegenerative diseases like amyotrophic lateral sclerosis, the ventilator is  necessary long-term to live. But even then, people like Christopher Reeve and Stephen Hawking have used portable ventilators to continue with their lives. Some people with disabilities use small ventilators only at night.

It is important to know that ventilators move air in and out of the lungs but do not cause respiration-the exchange of oxygen and carbon dioxide that occurs in lungs and body tissues. Respiration can occur only when the body’s respiratory and circulatory systems are otherwise intact. A ventilator cannot keep a corpse alive.

It’s also important to know that not all machines that assist breathing require the insertion of a tube into the windpipe. Non-invasive positive-pressure ventilation like the BiPap successfully used for my elderly friend Melissa allowed her to use a face mask to assist her breathing until antibiotics cured her pneumonia.

WEANING FROM A VENTILATOR

Many patients are easy to wean from a ventilator but some patients are more difficult.

Years ago, I cared for an elderly woman with Alzheimer’s who needed a ventilator when she developed pneumonia. She had made her son and daughter her medical decision makers in her advance directive.

However, the doctors found it very difficult to try to wean the ventilator after the woman improved. They spoke to the family about removing the ventilator and letting her die. The daughter agreed but the son was adamantly against this.

The woman was totally awake after the sedation to keep her comfortable on the ventilator was stopped. She was cooperative and made no effort to pull out the tube in her windpipe. She just smiled when asked if she wanted the ventilator stopped.

Having known of some great respiratory therapists in the past who were able to successfully wean difficult patients from ventilators, I suggested that she be transferred. She was transferred and a week later we were told that she was successfully weaned from her ventilator.

About a year later, I encountered the woman again when she was recuperating after a routine surgery. Although her Alzheimer’s disease was unchanged, she was doing well in an assisted living residence.

CONCLUSION

As a student nurse, I was as initially intimidated by ventilators as anyone else. But as I learned how to use them and saw the constant improvements not only in the technology but also in our care of patients on ventilators, I came to see ventilators as a great blessing when needed.

And while we are never required to accept treatment that is medically futile or excessively burdensome to us, sometimes this can be hard to determine-especially in a crisis situation. Most of my patients on ventilators recovered but some could not be saved. We were surprised and humbled when some patients with a poor prognosis recovered while others who seemed to have a better chance died unexpectedly. There are no guarantees in life or death.

That is why my husband and I wrote our advance directives that designate each other as our decision maker with the right to have all current options, risk and benefits of treatment fully explained.

We don’t want an advance directive that could be hazardous to our health!

 

Dying Well?

I discovered that former San Francisco Chronicle reporter Katy Butler is now publishing yet another book on dying well (her first book “Knocking on Heaven’s Door” was a best seller) when I read her lead essay in the February 8, 2019 Wall Street Journal article titled “Preparing for a Good End of Life”.

However, I recognized her name from reading her 2014 interview with Compassion and Choices , the well-funded former Hemlock Society that promotes physician-assisted suicide .

In that interview, she urged people to back the 2014 “Better Care. Lower Cost Act” sponsored by Senator Ron Wyden of Oregon “to improve appropriate medical support for people with chronic illness” and to “advocate to reduce payments to doctors who perform futile ‘Hail Mary’ surgeries, tests and treatments near the end of life”. Ms Butler also added that “we have an epidemic of unnecessary suffering at the end of life, and what’s more, it’s expensive!” (All emphasis added)

In that interview, Ms. Butler also talked about how her mother was “exhausted from nonstop caregiving” and how they fought doctors to have her father’s pacemaker turned off after he developed dementia, couldn’t walk to the neighborhood pool, became deaf and “too blind to read the New York Times-his last remaining pleasure”. Ms. Butler said she was glad to learn “from Judith Schwartz at Compassion and Choices that we each have a constitutional right to refuse any medical treatment or ask for its withdrawal.” (Compassion and Choices also promotes VSED, the voluntary stopping of eating and drinking, as well as terminal sedation as two legal options to hasten death in states without physician-assisted suicide laws.)

SCARE TACTICS?

In the Wall Street Journal article, Ms. Butler flatly states-without a source-that “Pain is a major barrier to a peaceful death, and nearly half of dying Americans suffer from uncontrolled pain.” (Emphasis added)

However, in an article “Pain Control at the End of Life” , June Dahl, PhD, a professor of pharmacology at the University of Wisconsin at Madison, and a founder of the American Alliance of Cancer Pain Initiatives states that:

“Thanks to recent advances in pain treatments, roughly 90 to 95 percent of all dying patients should be able to experience substantial relief from pain.”

Although Ms. Butler doesn’t mention physician-assisted suicide specifically, she does strongly advocate taking control of how we die, especially as we get older, because “Advanced medicine is replete with treatments (ventilator, dialysis, defibrillators, feeding tubes, to name a few) that postpone death and prolong misery without restoring health“. (Emphasis added)

She writes that “The best way to achieve a peaceful death is by planning ahead and enlisting the help of loved ones.”

In the Wall Street Journal article, she approvingly writes:

“When Liz Salmi’s mentor lay unconscious on a ventilator in a dark, windowless ICU room, attended by a cacophony of hisses and electronic bloops, she and other close friends lobbied for a better setup. All monitors but one were silenced, a doctor removed the breathing tube, and nurses and aides gurneyed her dying friend quickly into the ICU’s “best room”—a sunny spot, with windows opening to the outdoors.” (Emphasis added)

In this instance, note that the friends-apparently not the family or a “living will”- lobbied  the doctor to remove (not try to wean off) the ventilator. I am not surprised since I have personally heard some doctors say that, if in doubt, it might be legally safer not to treat rather than treat a patient because of the risk of a future lawsuit.

These kinds of articles and books are being used as “end-of-life education” for both the public and professionals. Can this be dangerous?

CAN WHAT YOU SAY POTENTIALLY BE USED AGAINST YOU?

My own mother often told me “I never want to be a burden on you children”. Then she developed Alzheimer’s and a terminal thyroid cancer. I was asked if the family wanted her fed if she got worse. “Of course, if she needs it”, I responded. My mother should die from her condition, not from starvation and dehydration. I  never told the doctors her comment about not wanting to be a burden because she wasn’t a burden. Mom died shortly after she went to a nursing home for safety reasons and we spoon-fed her at the end. She had no pain, thanks to a short course of radiation and chemo that she tolerated. My last memory of my mother was her smiling and enjoying the attention of her family before she died in her sleep.

In 1990, 2 years after my mother’s death, Nancy Cruzan died after 12 long days without a feeding tube, even after the US Supreme Court ruled that Missouri could require “clear and convincing evidence” that she would not want a feeding tube if she was in a “vegetative state.” At the time of the decision, there was no evidence of this.

However, Nancy’s parents later returned to a Missouri court with some of Nancy’s former co-workers who testified that they recalled her saying she would never want to live ‘like a vegetable’.

Three years later in a letter published in the Journal of the American Medical Association by Dr. Ezekiel Emanuel, one of the future architects of Obamacare, acknowledged that this “proof” of Nancy Cruzan’s alleged statement rested only on “fairly vague and insubstantial comments to other people”.

However and most disturbing, he also wrote that:

“…increasingly it will be our collective determination as to what lives are worth living that will decide how incompetent patients are treated. We need to begin to articulate and justify these collective determinations.” (Emphasis added.) Source: The American Journal of Medicine January 1993 Volume 94 p. 115

CONCLUSION

As a hospice and critical care nurse, I strove to make sure dying patients and their families had a good death, either in a hospital or other institution or at home.

Personally, my husband and I also made a careful durable power of attorney document that only designates each other as our decision maker with the right to make decisions about our care rather than signing a “living will” to refuse potential future treatments or set possible future conditions like dementia where we would want treatment stopped or withheld. Instead, we want all current options, risks and benefits of treatment fully explained to the decision maker based on the current condition.

I also encourage people to check out information sites like the Healthcare Advocacy and Leadership organization (I am an advisor) and magazines like “Informed-A Guide for Critical Medical Decisions”  which has sections explaining ventilators, CPR (cardiopulmonary resuscitation), feeding tubes, use and misuse of opioids and sedatives as well as other end of life considerations.

Death is a journey we all will take someday. Especially in today’s world, we should protect ourselves and our loved ones by trying to ensure a truly good death.

The Most Important Thing I Told a Maryland Legislator

I just recently returned from a trip to Maryland where Jack Ames of Defend Life asked me to speak to various groups, hopefully including legislators, about opposing a current physician-assisted suicide bill in the Maryland legislature. The Maryland “End of Life Options” bill was, as usual, based on the first physician-assisted suicide law passed in Oregon with a few additional loopholes.

I was able to speak to many groups during my trip but unfortunately, I could not be scheduled to speak at the legislature’s committee meeting where people from both sides of the issue were able to speak.

However, one of the Defend Life people and I went to the statehouse to see if we could get in to talk to some legislators personally. We were only able to get to speak to one legislator and he was considered to be on the side of passing such a bill. We were told we only had 5 minutes to talk to him.

We were there for much longer.

We talked about our personal experiences, especially about my 30 year old, physically healthy daughter Marie who killed herself after a 16-year struggle with substance abuse using an assisted suicide technique she learned after reading pro-assisted suicide advocate Derek Humphry’s book Final Exit.

I told him about Marie’s death which was horrific instead of peaceful and that was like an atom bomb dropped on our family. I talked about the reality of suicide contagion which led two people close to Marie became suicidal but who were able to be saved. We talked about the increasing epidemic of suicides we have now  and how seductive is the message that killing ourselves can solve problems like not wanting to be a burden on our families. That is what my daughter told me and one of the biggest reasons given by people who have resorted to physician-assisted suicide.

I also told him about at least six problems with physician-assisted suicide laws that most legislators-and the public-don’t know but that are inherent in physician-assisted laws. These include such problems as the total immunity for doctors and the secrecy involved, mandatory falsification of physician-assisted suicide death certificates and the obvious medical discrimination between treating suicidal people who are physically healthy and suicidal people who are considered terminally ill and seeking physician-assisted suicide.

I also told him about my experiences as a nurse with suicidal people-some of whom were terminally ill-and how (except for my daughter) they all changed their minds with listening, support and referral to a mental health specialist. I also told him about a UCLA project started when California legalized physician-assisted suicide. The project offered an intensive intake process for patient requesting physician-assisted suicide conducted by trained psychotherapists and social workers instead of physicians and offering help and support for any needs the patient might have. Not only did the project show that “most of what patients needed was to discuss their feelings about their approaching death and process their grief and sense of loss”, but also that “only” 25% of patients went on to commit physician-assisted suicide.

When you combine this with the fact that an admitted 1/3 of terminally ill Oregon patients who obtain the lethal overdose for assisted suicide never take it and with no follow-up as to whether the diagnosis was wrong, people changed their minds or even what happened to the dangerous lethal medication in the home etc., it is obvious that lethal mistakes are being made.

THE MOST IMPORTANT THING I TOLD THE LEGISLATOR

However, what seemed to be the most important point that stunned the legislator was telling him that if he voted for the physician-assisted suicide bill, he would have to personally shoulder the responsibility for the lives subsequently lost that obviously could have been saved.

I told him that like other ethical medical professionals, my most profound fear was harming or worst of all killing a patient, however inadvertently. I told him that despite my decades of nursing, I always knew I would have to leave my profession if such a tragedy happened because I would be devastated and lose my confidence in my abilities.

I told him that now with the facts we gave him, it was up to him to vote responsibly and hopefully share our information with others.

CONCLUSION

Most people assume that legislators are always lawyers who carefully read and understand legislation before voting. Wrong!

And most people don’t understand that most legislators rely on lobbyists for their information. Well-funded groups like Compassion and Choices are able to afford lobbyists, activists, access to sympathetic media outlets, etc. that promote their physician-assisted suicide agenda while other groups like pro-life groups and disability advocates have to rely on passionate volunteers.

Years ago, a legislator here in my home state of Missouri said he felt his constituents were against a certain piece of legislation. Why? Because he said he had received 4 letters!

This was before the internet has made it easier to contact our representatives but this shows how powerful our individual efforts can be.

We need everyone to speak out and speak up, especially when it comes to dangerous legislative bills like physician-assisted suicide.

 

 

 

Why Can’t We Protect Babies who Survive Abortion?

I still remember my shock when nurse Jill Stanek came forward to describe how she discovered a baby with Down Syndrome born alive after a late-term abortion who was left in a dirty utility room to die at Christ Hospital in Oak Lawn, Illinois in 1999. She found that these second or even third trimester babies were sometimes born alive after an induced labor abortion. At great risk both professionally and personally, Jill Stanek fought this barbaric practice publicly and testified in Congress. This resulted in the passage of the Born-Alive Infants Protection Act of 2002.

Just a year later, Congress was finally able to pass The Partial Birth Abortion Ban Act of 2003  many years after it was discovered that abortionists could ensure the death of the baby by delivering the baby feet first except for the head and then suctioning out the baby’s brain.

But in October 2003, abortionist Warren Hern wrote an article explaining how he got around the new law:

“I reassured her (a patient) that I do not perform the “partial-birth” procedure and that there is no likelihood that the ban’s passage would close my office and keep me from seeing her. The fetus cannot be delivered “alive” in my procedure—as the ban stipulates in defining prohibited procedures—because I begin by giving the fetus an injection that stops its heart immediately.” (Emphasis added)

And just last year, the US House passed the Born-Alive Abortion Survivors Protection Act (H.R. 4712) that:

  • Requires health care practitioners present at the time a child is born alive during an abortion or attempted abortion to exercise the same degree of care to preserve the life and health of the child as any health care practitioner would provide to a child born alive at the same gestational age;

  • Requires that children born alive during an abortion or attempted abortion be transported and admitted to a hospital immediately following the administration of emergency care;

However and just days ago, this Act was blocked from unanimous consent in the US Senate by Democrats .

This happened despite the controversial on-air comments by Democrat Governor Northam of Virginia defending a bill allowing abortions up to birth. When asked what would happen if the baby was born after the abortion, Gov. Northam said that “the infant would be resuscitated if that’s what the mother and the family desired, and then a discussion would ensue between the physicians and the mother.” (Emphasis added)

In other words, the same infanticide by neglect that nurse Jill Stanek discovered in 1999.

The Virginia abortion bill thankfully died in committee but there is now a frenzy among abortion supporters to pass radical pro-abortion laws like New York’s in other states like Rhode Island  and Vermont that allow abortions up to birth, allow non-doctors to perform abortions and to prohibit any effort to “deny, regulate or restrict” abortion.

The most recent and extreme bill just passed the House in New Mexico. This bill redefines abortion as merely “health care” and even removes conscience rights for medical professionals who refuse to participate. Governor Michelle Lujan Grisham has promised to sign the bill into law if it passes the New Mexico Senate.

CONCLUSION

In my home town of St. Louis, Missouri, the US Supreme Court voted 7-2 in the infamous 1857  Dred Scott v Sandford decision about slavery which held that black people were an “inferior class of beings”  and thus ” had no rights or privileges but such as those who held the power and the Government might choose to grant them”.

It took a civil war and the Emancipation Proclamation to end this travesty. The Dred Scott decision is now remembered as a turning point that ignited a political firestorm.

Will these current outrageous efforts to also make unborn babies an “inferior class of beings” with “no rights or privileges” prick the conscience of the American people and become a turning point in the fight to restore respect for the lives of preborn human beings?

We must never give up trying!

Is Abortion Really the Best We Can do for Women?

As a nurse and a mother myself, it was awful to read about the newest and most radical abortion law voted in and just signed by New York governor Andrew Cuomo. The vote on this law was even met with a standing ovation in the New York legislature.

This bill would not only legalize abortions UP TO BIRTH but also revokes the requirement for medical care that must be provided afterwards if the baby survives an abortion attempt. Now, Rhode Island is poised to do the same thing.

The “right to abortion” is a central tenet of the “Women’s Rights” movement and most mainstream media complies by constantly insisting that women want and need abortion. Planned Parenthood and even Oprah Winfrey promote women to “Shout Your Abortion” to show that abortion is empowering and even necessary to women’s success.

But is this true?

“EMPOWERING WOMEN AND DEFENDING LIFE: AN INSEPARABLE CALL TO ACTION”

This is the title of a powerful article by a woman who started working at a crisis pregnancy center after she had received help there in the past when she was pregnant and money was tight.

As the anonymous author writes in FemCatholic:

“What I hadn’t realized was that, in situations of unplanned, crisis, or unwanted pregnancies, the staff set out not only to save the life of an unborn child or give women access to free pregnancy tests and resources (as important as those things are); the counselors want to give women hope, confidence, and the ability to look within and see their own strength. In short, they want to empower every woman they encounter.

My interviewer described to me the approach that counselors took in that initial appointment. She stressed that the goal of the appointment is never to convince the woman one way or another. Instead, counselors provide each woman with information regarding all options, and work to help her realize that she has the strength to do hard things, to be courageous in the face of this difficult situation, and to assure her that there are people ready to love and support her. If the woman chooses to she can continue meeting with a counselor regularly throughout her pregnancy for support, resources, and caring community.” (All emphasis in original)

The author also writes about her other experiences:

“I have worked at two different maternity homes, and have seen firsthand the freedom that women experience when they discover and engage their strength, gifts, passions, and sheer willpower. It is incredible to watch these empowered women getting and staying sober or clean, finishing or going back to school, applying for jobs, dreaming about their futures with hope rather than despair. Women are capable of amazing things! I honestly believe one of our greatest feminine gifts is the ability to carry on in the face of even seemingly impossible situations.” (All emphasis in original)

Her message is both simple and profound:

How can we, women who are passionate about empowering other women, begin to change the conversation, to advance true liberation for women in unplanned pregnancies?”

 

WHAT ABOUT THE “WORST CASE” SCENARIO WHEN THE UNBORN BABY IS DOOMED TO DIE?

In the latest Gallup poll on abortion, 67% of the people polled approve abortion “When the child would be born with a life-threatening illness”. (Of course, sometimes that diagnosis proves to be wrong.)

But is abortion really the best answer for these distressed parents?

The answer is no, according to a recent article in The Public Discourse titled “Do Women Regret Giving Birth When the Baby is Doomed to Die? by Professor Christopher Kaczor of Loyola Marymount University.

Professor Kaczor cites a 2018 article from the Journal of Clinical Ethics titled “‘I Would Do It All Over Again’: Cherishing Time and the Absence of Regret in Continuing a Pregnancy after a Life-Limiting Diagnosis that found:

“Absence of regret was articulated in 97.5 percent of participants. Parents valued the baby as a part of their family and had opportunities to love, hold, meet, and cherish their child. Participants treasured the time together before and after the birth. Although emotionally difficult, parents articulated an empowering, transformative experience that lingers over time.” (Emphasis added)

He also cites another study titled “We want what’s best for our baby: Prenatal Parenting of Babies with Lethal Conditions” from the Journal of Prenatal and Perinatal Psychology and Health that found:

“After the birth, and at the time of the baby’s death, parents expressed thankfulness that they were able to spend as much time with their baby as possible.”

In contrast, Professor Kaczor cites a meta-analysis (a statistical analysis that combines the results of multiple scientific studies) in a Journal of Obstetric, Gynecologic and Neonatal Nursing titled “The Travesty of Choosing after Positive Prenatal Diagnosis” as well as another study to state that:

“Couples experienced selective termination as traumatic, regardless of the prenatal test revealing the fetal impairment or stage in pregnancy in which the termination occurred.”

Professor Kaczor concludes from this:

“Women who receive a lethal fetal diagnosis deserve our compassion and support. Fortunately, organizations such as Caring to Term and Perinatal Hospice & Palliative Care provide information and support for these tremendously difficult situations. Unfortunately, doctors sometimes pressure women into getting abortions and do not share with them the information that is necessary to make an informed choice. Those who receive a lethal diagnosis deserve to know the truth that 97.5 percent of women who continue pregnancies when the baby is doomed to die have no regrets about doing so—and that abortion does not have similar outcomes. Numerous studies have come to the same conclusion: giving life rather than aborting is likely to lead to greater psychological benefit for women whose baby is doomed to die.

CONCLUSION

Many  years ago with my last child, I had abortion recommended to me by two different doctors but not because the baby had an adverse prenatal diagnosis. In my case, abortion was suggested  because, due to my first husband’s severe psychosis, I would most likely wind up supporting my children alone.

The doctors’ prediction about my husband’s prognosis proved to be correct. But I was outraged that these doctors could even think about encouraging an abortion and adding more trauma to a difficult situation. And I was also outraged that they thought I was too powerless to raise 3 children on my own. I wasn’t.

Because of that experience, I now know the power of the simple phrase “I am here for you” and I have said it myself to other mothers, especially ones who were given an adverse prenatal diagnosis.

I know that choosing life is the ultimate victory!

Roe v. Wade’s Disastrous Impact on Medical Ethics

This was published in the National Right to Life News January 2019 issue “The Consequences of Roe v Wade” on page 8.

Most people volunteer for the pro-life movement. I consider myself a draftee. For me, there was no “choice.” I became a conscript because of personal and professional experiences that followed in the wake of the Roe v Wade decision.

I was a young intensive care unit nurse when the Roe v. Wade decision came down in 1973. Like most people I knew, I was shocked when abortion was legalized. As a medical professional, I couldn’t imagine good doctors and nurses condoning — much less participating in — such a brutal act.

However, I quickly found that my medical colleagues were split on the issue. In a foreshadowing of what was to come, those supporting what was then said to be “only” early abortions were the most vocal and insistent.. Our formerly cohesive unit began to fray.

However, I was professionally offended by the pro-life argument that legalizing abortion would lead to the legalization of infanticide and euthanasia. It was one thing to deny the truth with an early and unobserved unborn baby but it was quite another to imagine any doctor or nurse looking a born human being in the eye and killing him or her.

How wrong I was!

INFANTICIDE AND MEDICAL DISCRIMINATION AGAINST PEOPLE WITH DISABILITIES

My eyes were opened with the 1982 Baby Doe case in Indiana. Baby Doe was a newborn baby boy with an easily correctable hole between his esophagus (food pipe) and trachea (windpipe). He was denied this lifesaving surgery by his parents and a judge because he also had Down Syndrome. He also was not fed. Six days later, Baby Doe starved and dehydrated to death while his case was being appealed to the Supreme Court.

When we read the story, my husband and I wanted to adopt Baby Doe. But all offers of adoption were refused.

When our daughter Karen was born a few months after Baby Doe, we were stunned that she had both Down Syndrome and a severe heart defect but I was determined that she would not become another Baby Doe.

The cardiologist told us that Karen had an 80-90% chance of survival with one open-heart surgery by age 6 months. He also gave us a “choice”- to let Karen die. I was outraged that he could even consider not treating my daughter like any other baby with the same heart defect.

Even worse, when my daughter was hospitalized with pneumonia at 4 months, I was tipped off that my trusted pediatrician had made her a “do not resuscitate” without my knowledge or consent because “Nancy is too emotionally involved with that retarded baby”. I then realized that “choice” was just an empty slogan that had infected medical ethics.

Although Karen survived that incident, she unfortunately died at age 5 1/2 months just before her scheduled surgery.

At last I finally joined the disability rights and the pro-life movements.

THE “RIGHT TO DIE” MOVEMENT

A few years after Karen, I was shocked by the so-called “right to die” movement that pushed “living wills” to refuse even food and water by tube if or when a person became incapacitated. I became involved in both the Nancy Cruzan and Terri Schiavo cases.

Both involved seriously brain-injured, non-dying young women declared “vegetative”, a dehumanizing term invented in 1972. I wrote an op-ed for my local paper predicting that the potential pool of victims would expand if death by starvation and dehydration was allowed.

I was thinking about my own mother who had Alzheimer’s and cancer and indeed I was asked at one point if our family was going to feed her. I replied that my mother would die naturally from her condition, not starvation and dehydration.

How far we have descended!nNow,  prominent doctors and the American Nurses Association are promoting what Compassion and Choices calls voluntary stopping of eating and drinking by mouth (VSED) as a legal option to  “speed up dying” for competent people with serious illnesses. “Living wills” to prevent even spoon feeding for people with dementia are also being developed.

PHYSICIAN-ASSISTED SUICIDE

The “right to die” movement ultimately did expand into the Compassion and Choices organization, the well-funded former Hemlock Society that promotes physician-assisted suicide by lethal overdose. In the late 1990s, Oregon became the first state to legalize assisted suicide. Now a handful of states and the District of Columbia have followed Oregon but the relentless effort to legalize physician-assisted suicide continues in the other US states.

Over the years, I had cared for many suicidal people and I saw the seductive effect of people like Jack Kevorkian, the infamous “Dr. Death”on them. As a nurse, I knew how dangerous it was to portray suicide as a “solution” to many at-risk people.

But it became personal when my 30 year old daughter Marie killed herself using an assisted suicide technique that she learned reading the pro-assisted suicide book “Final Exit”. My Marie had struggled with drug addiction for 16 years and despite our best efforts and those of her therapists, she finally succumbed to despair. She was the only suicidal person I ever lost.

I was not surprised when two people close to Marie became suicidal after her death. Fortunately, they were saved.

Suicide contagion is not a figment of someone’s imagination but a real phenomenon. It is no coincidence that the US suicide rate has skyrocketed since Oregon first legalized physician-assisted suicide.

EUTHANASIA

I also discovered that it’s only a short step from “I wouldn’t want to live like that” for assisted suicide to “No one should have to live like that” for euthanasia.

In 2003, Dr. Lloyd Thompson, then head of the Vermont Medical Society, escaped prosecution for intentionally giving a paralyzing, “life ending drug” to an elderly woman with terminal cancer whose breathing machine had been removed. The family had opposed prosecuting the doctor.

 Ironically and around the same time, I was threatened with the loss of my job after I refused to increase a morphine drip “until he stops breathing” on an older man who did not stop breathing as expected after his ventilator was removed. The patient was presumed to have had a stroke when he did not wake up from sedation after 24 hours. I reported the situation up the chain of command at my hospital but no one supported me. I escaped termination that time but I refused to back down.

An autopsy later showed that the man had no lethal condition or brain injury.

CONCLUSION

As the late Fr. Richard John Neuhaus wisely said  ” I believe in the slippery slope the same way I believe in the Hudson River. It’s there.”

But until and unless we are ready to recognize what we unlock when we legalize “just a little bit” of medical killing, we may find that the slippery slope has no bottom and that no one is safe.

And I saw it all start with the Roe v Wade decision legalizing abortion.

An Amazing Video of a Living, First Trimester Unborn Baby

Recently, I saw an amazing video in a post on the Nurses&Midwives4Life Ireland Facebook page showing a living, first trimester baby on a surgical field. The baby was moving its’ tiny head and limbs remarkably like a newborn baby. The image was both beautiful and heartbreaking since this little one could not survive.

The Speak Life video is covered with a warning that “This video may be sensitive to some people” and posted by Jonathan Van Maren, communications director for the Canadian Centre for Bio-Ethical Reform, with the caption ”This 8-second video of a first-trimester baby tells you everything you need to know about how wrong abortion is.”

I investigated further and it seems that the that the unborn baby was about 8 weeks old and that he or she had been removed after an ectopic pregnancy in which the unborn baby develops outside the womb.

Ectopic pregnancies can be life-threatening to both mother and child when the unborn baby develops in one of the Fallopian tubes leading to the womb, although there have been some rare cases where a baby develops in the abdomen and survives. Several years ago, I had an elderly patient who told me how her unborn baby survived decades ago when the doctors did not know that the baby was in the abdomen during her uneventful pregnancy until labor began. That is unlikely today since ultrasound images are routine during pregnancy.

A PICTURE IS WORTH A THOUSAND WORDS

Although the baby in the video could not survive after he or she was removed, the video itself is powerful evidence that abortion takes the life of a real human person even in the first trimester.

Most abortions are performed in the first trimester when women and the public are often told by organizations like Planned Parenthood that the unborn baby is just a “clump of cells”.  In the first trimester, most babies are aborted by either vacuum suction which destroys the little person or by  medical abortion using pills to first disrupt the attachment of the unborn baby to the mother and then expel the baby. However, abortion reversal is possible after the first set of pills.

Women who have abortions rarely see their baby after a first trimester abortion but it has happened, especially with medical abortion. This can be very traumatic to the woman. Contrast the look of the deceased first trimester unborn baby in the article titled “She took the abortion pill, then saw her 7-week-old baby” with the living first trimester unborn baby in the video.

CONCLUSION

Years ago, my late daughter Marie became unexpectedly pregnant and found out that the unborn baby was growing in one of her Fallopian tubes rather than her womb. She had to have emergency surgery when the tube ruptured.

Afterwards, the surgeon showed me the picture he had taken (unasked) during the surgery to remove the then deceased baby, my grandchild. The picture was personally so sad to see but I was comforted that the surgeon cared enough to take a picture of this tiny person.

After so many years and so many experiences as a nurse and volunteer in the pro-life movement, I believe that all women should be given the opportunity to know the truth about their unborn baby’s humanity as part of informed consent before abortion.

And I believe the rest of us should also have the opportunity to learn the same truth before we support legalized abortion.

This video of a living, first trimester unborn baby speaks louder than mere words.

“Life is Worth Living, Even if It is Painful and Short”

I was greatly moved by a December 21, 2018 op-ed in the Wall Street Journal by Gayle Somers titled “Life Is Worth Living, Even if It Is Painful and Short” with the subtitle “My son’s addiction caused great suffering and ended with a fatal overdose. I’ve never regretted his birth”

In this op-ed, Ms. Somers told the story of her son’s birth and eventual death 33 years later from an accidental overdose after a 14 year battle with drug addiction. That resonated with me since I lost my 30 year old daughter Marie to suicide using an assisted suicide technique after a 16 year battle with addiction.

But it was Ms. Somers’ wonderful statement “I’ve never regretted his birth” that caused me to write a letter to the editor that was published today:

“As someone who has lost a daughter to suicide and has also lost another daughter and a grandson to medical conditions, I really appreciate and agree with Gayle Somers’ op-ed “Life is Worth Living, Even if it is Painful and Short” (Dec. 22). My first daughter died at 30 after struggling with substance abuse for 16 years.

As a nurse and friend of bereaved parents, I also have never met a parent or grandparent who regretted the birth of his or her lost child.

I once was asked for advice by a bereaved mother after her 2-year-old son with Down Syndrome died unexpectedly. She wanted to know what might help her accept her son’s death with a hopeful outlook. From my own personal experience, I told her that solace comes when a lost child’s life rather than his death becomes the most important fact about him. The love itself never dies.

Nancy Valko

St. Louis

CELEBRATING LIFE

Ms. Somers also wrote in her op-ed that:

“These days pregnant women can take prenatal tests to learn about genetic defects their babies may have. Sometimes I’m grateful that no test allows you to see how a child’s life will unfold. All parents instinctively shrink from the excruciating expectation of a child’s suffering and, inevitably, their own suffering.

Some parents are so frightened at the prospect of raising a child with a genetic abnormality that they end the child’s life in the womb. While I understand this temptation—to spare the child the struggle, to spare yourself the pain—reflecting on the time I spent with my son convinced me that life is worth it despite the suffering.”

This also resonated with me since I lost my 5 1/2 month old daughter Karen who had Down Syndrome and a severe heart defect just before her scheduled surgery in 1983.

Two years later, I was pregnant again and the doctor strongly urged me to have an amniocentesis to test for Down Syndrome. I refused not only because of the unnecessary risk to the baby but also because I knew I would love this baby regardless of any condition or lifespan. Because of Karen, I was not afraid to welcome this baby.

Happily, my daughter Joy was born healthy and now has a baby daughter of her own to share with us.

CONCLUSION

Over the years, I’ve been inspired by many parents who have lost children of all ages. Some of these children died of natural causes and some from medical malpractice, tragic accidents, suicide and even murder.

The pain of losing a child is naturally devastating, especially at first. However, I have seen those same parents also rise up and honor those children’s lives by helping others or fighting injustices.

I consider Ms. Somers one of those inspiring parents, especially how she ended her op-ed by writing:

“Even knowing what we know now about how our children’s lives would end, all of us would choose life, no matter how short, no matter how painful. We welcomed our children into our families. We gave them names, and then, one day, we began to learn how to do what all parents must do—love without limits, comfort during the pain, not shrink from the suffering, give thanks for the gifts our children are to us.”

 

 

The Trouble with Planned Parenthood

In a stunning December 20, 2018 New York Times article  titled “Planned Parenthood Is Accused of Mistreating Pregnant Employees”, former employees of the $1.5 billion dollar ($543.7 million in government grants and reimbursements) organization assert that they were discriminated against because of their pregnancies.

The New York Times has long been one of the staunchest supports of Planned Parenthood as a great champion of “reproductive choice” through abortion, so it is ironic that their article paints a terrible picture of how the organization treats its own employees when they make the reproductive choice to have a child.

The New York Times interviewed several current and former employees of Planned Parenthood who described discrimination that violated state or federal laws against pregnancy discrimination by declining to hire pregnant job candidates, refusing requests by expecting mothers to take breaks and in some cases pushing women out of their jobs after they gave birth.

Perhaps the most heartbreaking story was that of  Ta’Lisa Hairston, an employee who became pregnant but later started battling high blood pressure that threatened her pregnancy. However, her multiple medical orders stating she needed frequent breaks  were ignored by management. Her hands swelled so much that she couldn’t wear the required plastic gloves and her doctor ordered bedrest. When she returned with orders not to work over 6 hours, she worked a much longer shift and few days later had to have an emergency C-section at 34 weeks. She resigned after repeated calls urging her to return to work before her guaranteed 3 months under the Family and Medical Leave Act was up.

Dr. Leana Wen, the new head of Planned Parenthood, says that the organization is looking into the allegations and will be “conducting a review to determine the cost of providing paid maternity leave to nearly 12,000 employees nationwide.”

While the New York Times article admits that “most Planned Parenthood offices do not provide paid maternity leave”, it counters that “(d)iscrimination against pregnant women and new mothers remains widespread in the American workplace.” The Times also blames “conservative lawmakers (who) routinely threaten to kill” Planned Parenthood’s taxpayer funding, making the organization’s financing “precarious”.

THE REAL TROUBLE WITH PLANNED PARENTHOOD

Planned Parenthood tries to downplay its’ role as the largest provider of abortion in the US by touting  services like breast cancer screening (without mammograms), birth control pills and devices, pregnancy tests, etc. to low-income women even though the reality is that there are many more places, such as federally qualified community health centers (which do not provide abortions) that provide more comprehensive health care services than those offered by Planned Parenthood.

But the larger problem is that it is hard to reconcile two completely opposite philosophies: an unborn child is nothing more than tissue that can be removed by abortion if a woman so chooses vs an unborn child is a living human being deserving of protection. Planned Parenthood is firmly on the side of the first philosophy.

Thus, as Live Action found when it contacted 97 facilities at 41 Planned Parenthood affiliates, it is almost impossible to find a Planned Parenthood clinic that offers prenatal care as well as abortion, not to mention Planned Parenthood’s current campaign to encourage women to “Shout Out Your Abortion”.

So it perhaps it should not be a surprise that a pregnant employee who wants her unborn baby might pose a challenge in a Planned Parenthood abortion clinic.

 

 

Why is the US Supreme Court Ducking the Issue of States Defunding Planned Parenthood?

As a nurse, I have always known that medical ethics and the law are very much entwined. But when the US Supreme Court unexpectedly legalized abortion in the 1973 Roe v Wade decision, I started really studying the legal system and how it impacts medical practice beyond just the medical malpractice cases that I knew about.

When I studied the actual Roe v Wade decision itself, the dissenting opinions, commentaries, amicus briefs, etc., I was appalled to find that the decision was basically political and not based on established science and facts.

That sad knowledge has insulated me from hopelessness with many subsequent US Supreme Court decisions involving abortion and other life issues. I have always felt that the truth about human lives-born and unborn-will eventually win.

But I have to admit that I was surprised that the majority of the current Supreme Court justices ruled against even hearing the Gee v Planned Parenthood of Gulf Coast case involving conflicting federal court cases decisions about states defunding Planned Parenthood in their Medicaid programs.

The Gee v Planned Parenthood case involved the issue of whether patients may sue states in federal court for restricting or removing providers from their Medicaid programs. The case does not directly involve abortion since the federal Hyde amendment prohibits Medicaid funding for abortion, a prohibition that Planned Parenthood itself insists “hurts women on Medicaid” and wants eliminated. Planned Parenthood also admits that:

Most of Planned Parenthood’s federal funding is from Medicaid reimbursements for preventive care, and some is from Title X. At least 60% of Planned Parenthood patients rely on public health programs like Medicaid and Title X for preventive and primary care.” (Emphasis added)

According to a Lozier Institute Report, in its latest report 2016-2017, Planned Parenthood received “$543.7 million in funds from all levels of government in that fiscal year…primarily from the Medicaid program”.

Several state laws have already excluded Planned Parenthood as Medicaid providers, especially after the reports of illegal harvesting of organs from aborted unborn babies and fraudulent billing. Federal law does give states substantial leeway to administer their Medicaid programs but does not define the term “qualified” for providers and states can exclude providers “for any reason…authorized by state law”. The law does allow for an appeal and judicial review for excluded providers.

According to the Wall Street Journal:

“But Planned Parenthood has leapfrogged state adjudication by recruiting plaintiffs to sue in federal court to vindicate their putative right to their preferred provider. Five appellate courts including the Fifth, Sixth, Seventh, Ninth and Tenth Circuits have recognized a private right of action while the Eighth has not.” (Emphasis added)

This split in court decisions needed to be resolved by the Supreme Court because it involves basic questions about the state-federal relationship.

Only four Supreme Court judges were necessary to vote to hear the case but 6 judges voted not to hear the case, surprisingly two of whom were considered conservative.

Justice Thomas who voted to hear the case was scathing in his rebuke of the 6 judges who voted not to even hear the case saying:

“So what explains the Court’s refusal to do its job here? I suspect it has something to do with the fact that some respondents in these cases are named ‘Planned Parenthood.’ That makes the Court’s decision particularly troubling, as the question presented has nothing to do with abortion.

Some tenuous connection to a politically fraught issue does not justify abdicating our judicial duty. If anything, neutrally applying the law is all the more important when political issues are in the background…The Framers gave us lifetime tenure to promote ‘that independent spirit in the judges which must be essential to the faithful performance’ of the courts’ role as ‘bulwarks of a limited Constitution,’ unaffected by fleeting ‘mischiefs.’” (Emphasis added)

The Supreme Court’s refusal to even hear the case is more than disappointing. Continuing the legal confusion about states’ rights will almost certainly lead to more litigation against states that pass laws excluding Planned Parenthood from Medicaid programs. As the Wall Street editorial states, “If the Justices duck every case remotely implicating gender politics, substantive constitutional issues will go unresolved and individual rights may be impaired.”

CONCLUSION

Ironically, although the brief by Planned Parenthood of Gulf Coast  to the Supreme Court insisted that their clinics “..provide essential medical care to thousands of low-income Louisiana residents through Medicaid” and “offer a range of services, including annual physical exams, screenings for breast cancer and cervical cancer, contraception, pregnancy testing and counseling, and other preventative health services”, the reality is that there are many more places, such as federally qualified community health centers (which do not provide abortions) that provide more comprehensive health care services than those offered by Planned Parenthood.

On a personal note, several years ago my late daughter Marie secretly went to a Planned Parenthood clinic for a possible sexually transmitted disease. She finally admitted this to me when her symptoms grew worse. I immediately took her to my own gynecologist who had to perform surgery to remove part of her cervix to deal with the damage.

Planned Parenthood had missed the diagnosis.

Support the Fighting Irish Doctors and Nurses

I have always been proud of my Irish heritage so I was especially shocked when a voter referendum in Ireland in May, 2018 overwhelmingly approved removing Ireland’s long-standing, constitutional protections for unborn babies and left the details up to the Irish government.

Before this, Ireland’s Eighth Amendment protected both unborn babies and their mothers equally as deserving a right to life. This made Ireland one of the safest places in the world for pregnant mothers and their unborn babies and with one of the lowest maternal mortality rates in the world.

However, much of the campaign to legalize abortion focused on the “high numbers of women ordering abortion pills online or forced to travel to Britain for a termination.” As one supporter said, that “showed that abortion was already here, we are just trying to make it safe and regulated.”

Now the lower house of the Irish parliament has just passed a bill that, if subsequently passed by the upper house, would legalize abortion for any reason for the first 12 weeks of pregnancy and up to six months for a wide variety of circumstances. The bill would also force taxpayers to pay for abortion and force even Catholic hospitals to provide them. It also strictly limits conscience protections for medical professionals and forces them to refer for abortion. The lower house also rejected amendments to ban sex-selection abortions, require parental consent for girls under 16 and require basic medical care for infants born alive after abortion.

Note that these radical developments occurred after the national vote in May. A poll by Amárach taken in October found that 60% of Irish residents oppose taxpayer-funded abortions, 80% say health care workers should not be forced to carry out abortions against their conscience and 69% of those surveyed believe doctors should be obliged to give babies that survive the abortion procedure proper medical care rather than leaving the babies to die alone.

Perhaps critically, Facebook also banned outside ads as Ireland was voting on abortion, saying that “We feel the spirit of this approach is also consistent with the Irish electoral law that prohibits campaigns from accepting foreign donations,”

DOCTORS AND NURSES PUSH BACK.

Although Irish government leaders want medical professionals ready to begin aborting unborn babies by January 1, 2019, the medical community is balking.

Doctors against abortion petitioned the government stating that “forcing a doctor to make a referral for an abortion against their conscience is simply wrong” and dozens of Irish doctors stormed out of an emergency meeting about abortion because they said their conscience rights protections were being ignored.

And almost 500 Irish nurses and midwives signed a petition to Health Minister Simon Harris urging him to protect freedom of conscience and support the amendments concerning conscience rights protections.

So far, the minister has ignored their requests.

However, the pro-abortion National Women’s Council of Ireland is urging the passage of the new abortion law as soon as possible “despite fears the existing bill does not go far enough to decriminalize abortion or prevent protests at abortion facilities”.

CONCLUSION

As a fellow pro-life nurse, I applaud Nurses and Midwives4Life Ireland who stated that:

“We are dedicated, hardworking nurses and midwives who care for patients from conception to natural death. We have a conscientious commitment to life which accords with the values inherent in Our Code of Professional Conduct and Ethics. We respect and defend the dignity of every stage of human life and we have a responsibility to make every valid or reasonable effort to protect the life and health of pregnant women and their unborn babies.”

I also sent a message of support to the Facebook page of Nurses and Midwives4Life Ireland .

I also support Irish Doctors for Life and its Facebook page that states its “aim is to educate and support doctors, health care professionals and others who are concerned about the ethical questions relating to patient care and practitioner responsibility at all stages of life.”

I personally have seen the terrible destruction of some of our most basic medical ethics principles after abortion was legalized here in the US in 1973. This issue not only divided doctors and nurses but also eventually led to the increasing acceptance of assisted suicide and euthanasia.

We need to support all medical professionals throughout the world who work to care for and protect all human life.

Physician-Assisted Suicide and the Fight for the Soul of Healthcare

Despite the US Supreme Court’s unanimous rejection of a constitutional right to physician-assisted suicide in the 1997 Vacco v. Quill decision , the well-funded   pro-assisted suicide organizations like the Hemlock Society (now called Compassion and Choices) remained undeterred in their efforts to legalize assisted suicide throughout the US.

Along with its efforts to pass physician-assisted suicide laws, Compassion and Choices also focused on changing the health care system itself by influencing health care professionals and especially their organizations.

Thus, Oregon became the first state to pass a physician-assisted suicide law (by voter referendum), but only after the Oregon Medical Association changed its position from opposition to neutrality and despite the American Medical Association’s long-standing opposition to physician-assisted suicide.

However, only a few other states eventually did legalize assisted suicide over the next 20 years either by legislation or voter referendum while most states rejected physician-assisted suicide, even after almost yearly efforts in legislatures and overwhelmingly supportive mainstream media coverage.

But now Compassion and Choices is touting  that “(a) growing number of national and state medical organizations have endorsed or adopted a neutral position regarding medical aid in dying (physician-assisted suicide) as an end-of-life option for mentally capable, terminally ill adults.” (Emphasis added)

For now at least, the American Medical Association (AMA) itself continues to oppose physician-assisted suicide  despite strong pressure from groups like American Association of Family Physicians to take a neutral stance. If the AMA does change its stance to neutrality, it won’t take long until groups like Compassion and Choices finally realize their goal of “integrating and normalizing medical aid in dying (aka physician-assisted suicide) suicide as an additional end-of-life option“.

Nurses are also not immune to the efforts to convince health care professionals to accept or be neutral on physician-assisted suicide. For example, a “policy dialogue” at the American Academy of Nursing’s annual conference in Washington, DC. was covered in a May 2018  article in the American Journal of Nursing titled “Assisted Suicide/Aid in Dying: What is the Nurse’s Role?” (reprinted in full by Death with Dignity). The article included this disturbing news

“In 2018, the American Nurses Association (ANA) will be updating its current position statement “Euthanasia, Assisted Suicide, and Aid in Dying”. (Emphasis added)

Ominously and just last year the ANA approved VSED (voluntary stopping of eating and drinking) stating that “people with decision making capacity have the right to stop eating and drinking as a means of hastening death.” (Emphasis added)

Not surprisingly, our government is also not immune to the aspirations of Compassion and Choices. In its “Federal Policy Agenda / 2016 & Beyond” , Compassion and Choices set the following priority:

Establish federal payment for palliative care consultations provided by trained palliative care professionals who will advocate for and support the values and choices of the patient….”

Compassion and Choices lists as one of its accomplishments that it:

Pioneered the medical model of aid in dying that helps ensure that doctors can ethically practice aid in dying in an open, legitimate and accessible way, and integrates the option into patients’ end-of-life care. The culmination of that work was the publication of clinical criteria in the Journal of Palliative Medicine in December 2015. (Emphasis added)

Now, a Compassion & Choices’ website even has a video presentation based on this article  titled  “Understand the Clinical Practice of Aid in Dying”  for doctors and other clinicians. The presentation even offers continuing medical education credits.

We may now be seeing the potential results of this agenda in the current  “The Palliative Care and Hospice Education and Training Act” that is endorsed by Compassion and Choices . The bill was passed in the US House of Representative and is currently in the Senate health committee as SB693. If passed, the bill would authorize grants and contracts to promote education, research and the development of faculty careers in hospice and palliative care. (I have already contacted my home state senator about the potential problems with this legislation.)

CONCLUSION

Several years after Oregon voted to legalize physician-assisted suicide, I began to notice a stark difference between my fellow health care colleagues who supported legalizing physician-assisted suicide and those who didn’t. Doctors and nurses who supported such laws often spoke about patients who “needed to die” even though those patients never even mentioned wanting to die. They often tried to get out of caring for or even talking to difficult patients. In contrast, those doctors and nurses who were appalled by physician-assisted suicide were the ones who patiently listened to patients and addressed their fears and hopes, treated relatives as part of the care team and actively advocated for the best care for their patients.

But with Compassion and Choices’ leaders like Barbara Coombs Lee, one of the architects of Oregon’s assisted suicide law, even arguing against strong conscience rights protections for those of us who refuse to participate, it may become impossible in the future to even find a health care professional committed to protecting the life of every patient.

All of us, both medical and lay people, must speak out against physician-assisted suicide before our health care system becomes irreparably corrupted.

Now Even Family Assisted Suicide?

Her obituary  stated that Tessa was 55 years old and the divorced mother of two adult children when she died on May 14, 2002 in San Francisco, California after a nearly four year fight with breast cancer . She had been a real estate agent and later worked as controller in her son’s company.

Her son was Gavin Newsom, who just won the race for California governor November 6, 2018.

However and just the day before, a November 5, 2018 article in The New Yorker titled “Gavin Newsom, the Next Head of the California Resistance gave a different version of Tessa’s death:

“Newsom’s sister, Hilary, said that when their mother had breast cancer, in her fifties, he was difficult to reach. ‘Gavin had trouble explaining to me how hard for him it was to be with her when she was dying, and I had trouble explaining to him how much I needed him,’ she said. ‘Back then, he seemed like the kind of guy who would never change a diaper.’

In May, 2002, his mother decided to end her life through assisted suicide. Newsom recalled, “’She left me a message, because I was too busy: ‘Hope you’re well. Next Wednesday will be the last day for me. Hope you can make it.’ I saved the cassette with the message on it, that’s how sick I am.’ He crossed his arms and jammed his hands into his armpits. ‘I have P.T.S.D., and this is bringing it all back,’ he said. ‘The night before we gave her the drugs, I cooked her dinner, hard-boiled eggs, and she told me, ‘Get out of politics.’ She was worried about the stress on me.’” (Emphasis added)

Sadly, a previous 2016 San Francisco Chronicle article entitled How Gavin Newsom’s family tragedy led to ammo-control initiative” quoted Gavin Newsom on an earlier suicide tragedy in his mother’s life:

“My grandfather committed suicide, but not before putting his daughter — my mother — and her twin against the fireplace and saying he was going to blow their brains out,” Newsom said.”(Emphasis added)

THE CRAZY HISTORY OF CALIFORNIA’S PHYSICIAN ASSISTED SUICIDE LAW

I admit I was puzzled when California governor Jerry Brown signed a new law in September, 2018   titled  “AB-282 Aiding, advising, or encouraging suicide: exemption from prosecution”. This amended the 2016 physician-assisted suicide law that “Every person who deliberately aids or advises, or encourages another to commit suicide is guilty of a felony” to “A person whose actions are compliant with the provision of the End of Life Option Act (physician-assisted suicide) shall not be prosecuted under this section.” (Emphasis added)

For many years, California was especially targeted by assisted suicide groups like Compassion and Choices, the former Hemlock Society, for the legalization of physician-assisted suicide because of its size and influence. By 2015, there had been 8 failed attempts for legalization of physician-assisted suicide.

However, the Brittany Maynard tragedy started a media frenzy around the 30-year-old newlywed with an aggressive brain tumor when she announced that  she and her family left California for Oregon to commit assisted suicide where it was legal and picked November 1, 2014 for her assisted suicide. Brittany Maynard also became a spokesperson to raise funds for Compassion and Choice’s campaign to legalize assisted suicide throughout the US. Her family continued to vigorously fight for a physician-assisted suicide law in California after her assisted suicide in Oregon.

Significantly and because of the Brittany Maynard tragedy, most mainstream media outlets have now dropped the term “physician-assisted suicide” in favor of more palatable terms like “death with dignity” and “physician aid in dying.”

Surprisingly though, another attempt to pass  the “End of Life Options Act” in California failed in the 2015 legislature-until a sudden extra and controversial legislative session was called to pass it. This new law was signed into law by Gov. Brown and took effect in June 2016.

However in May 2018 and after at least 111 assisted suicide deaths, a Superior Court judge overturned the law, ruling it unconstitutional because of  how it was improperly passed in the special legislative session.

Physician-assisted suicide was again illegal until a month later when California’s 4th District Court of Appeals granted the state’s request to reinstate physician assisted suicide while it considers the case.

Then, as I mentioned before, Gov. Brown signed the law to prevent prosecution of anyone involved in an assisted suicide, including family members.

CONCLUSION

According to Findlaw:

“If you’re not a licensed physician, then assisting someone with suicide is most definitely a crime. But in states that have enacted “right to die” or “death with dignity” laws, eligible patients may request lethal drugs and administer them on their own.” (Emphasis added)

But the reality is that very few cases of a friend or family member assisting a suicide are prosecuted and even then, the penalty is light or nonexistent.  So-called “safeguards” are useless.

There is no chance that Governor Newsom will be prosecuted or even investigated for allegedly assisting his mother’s death in 2002 (long before California legalized physician-assisted suicide). But the new California law that forbids prosecuting anyone involved in a physician-assisted suicide who “aids or advises, or encourages suicide” further reinforces the dangerous myth that assisting  suicide is a victimless and even loving act.

Should a Mental Health Exam be required before Physician-assisted Suicide?

When I read the October 27, 2018 MedPage news article titled “Assessing Competency in Aid-in-Dying Patients (aka physician-assisted Suicide)-Should a Competency Exam by an Outside Doctor be Required?”, I was struck by one case cited by psychiatrist Richard Martinez, MD, professor of psychiatry and law at the University of Colorado Denver who opposes mandatory mental health exams as “an invasion of privacy ” …”(t)o mandate an interaction with a stranger”. Dr. Martinez also contends that “Depression should not be an exclusionary decision.” (Emphasis added)

Dr. Martinez cited the case of a young man who had a severe spinal cord injury after a fall and was on a ventilator to breathe. Doctors took him off sedation and asked if he wanted to live. He said no so the ventilator was removed and he died.

Although Dr. Martinez acknowledged that “people who work with people with spinal cord injuries have argued for a waiting period” and that this was a very difficult case in bioethics, he still maintained that, in the end, the issue is really about choice. (Emphasis added)

When I read this, I remembered when “Aaron” (not his real name) was admitted to our intensive care unit with a severe spinal cord injury after a car accident. This was in the early 1970s, long before the “right to die”/physician-assisted suicide movement became known to the public.

I was there when the doctors told Aaron that his legs were permanently paralyzed and he would never walk again. Naturally, this 18 year old young man was devastated. It didn’t take long before he told us he wanted to die. We were not surprised by this  normal reaction and the doctors wanted to stabilize him medically before ordering a psychiatric consult if he persisted in wanting to die.

One day while I was bathing Aaron, I asked him if many people complimented him on his legs. Aaron was puzzled but answered “No”. Then I asked him if his legs were the most important part of him. After a pause, he smiled a little and said probably not.

Then I talked with him about what he would still be able to do once he was medically stable and what he might be able to do in the future with rehabilitation and medical advances. Aaron looked a little less forlorn. I reassured him that we doctors, nurses and his wonderful family would be there every step of the way and I predicted how much better he could feel with time and more information.

But what really made a difference was when Aaron’s parents told me how much he enjoyed poker. So one quiet night, I started a midnight poker game in Aaron’s ICU room with the nurses taking turns between caring for the patients and playing. It was great to see Aaron finally laughing and making fun of how badly we played.

Even though we were caught by an unexpected visit from administrators and I had to promise never to do this again, it was worth it. When I last visited Aaron after he left our unit, he was laughing and talking to his friends. And making plans.

Supporters of physician-assisted suicide claim that one of their strongest safeguards is, as the Oregon physician-assisted suicide law states, that “If, in the opinion of the attending physician or the consulting physician, a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, either physician shall refer the patient for counseling.” (Emphasis added) But only the evaluation of a patient’s competence to make such a decision- not the diagnosable mental disorders that afflict more than 90 percent of people who die by suicide- is required .

However, now that supposed “safeguard” is being questioned by some psychiatrists in this new MedPage article reporting on a panel discussion during the 49th annual American Academy of Psychiatry and the Law (AAPL) meeting.

In the article, psychiatrists like Anna Glezer, MD, an associate professor of psychiatry and of ob/gyn at the University of California San Francisco (UCSF) who supports requiring a mental health exam stated:

“A psychiatrist can help identify potentially treatable psychiatric symptoms that may relieve elements of patient suffering, and detect family agreement versus family conflict that may require further intervention and counseling,”

and

‘”I’ve done a case where I didn’t say ‘This person meets the criteria or doesn’t,’ but [instead said] ‘These are my concerns,'” she said. In this case, the patient had lost her husband within the past year “and I thought grief might be compounding her decision-making capacity.” (Emphasis added)

Dr. Ariana Nesbit, a psychiatrist at the San Diego Central Jail says PAD (physician-assisted death aka physician-assisted suicide) is a complicated issue, stating that:

Our goal is often thought to be to prevent suicide, and we still conceptualize suicidal ideation as a symptom and pathological. As someone who just recently finished training in three very liberal states, I can tell you that at no point during my training was I ever taught how to figure out whether someone’s suicidal ideation, or their suicide attempt, was rational, so we don’t have any widely accepted method for determining this.” (Emphasis added)

Dr. Nesbit also cited a study titled “Prevalence of depression and anxiety in patients requesting physician’s aid in dying: cross sectional survey” that found 26% of patients requesting physician-assisted suicide did meet depressive disorder criteria but three of them were approved for physician-assisted suicide anyway. The authors concluded that “Although most terminally ill Oregonians who receive aid in dying do not have depressive disorders, the current practice of the Death with Dignity Act may fail to protect some patients whose choices are influenced by depression from receiving a prescription for a lethal drug.” (Emphasis added)

During a question and answer session, Annette Hanson, MD, adjunct assistant professor of psychiatry at the University of Maryland in Baltimore, questioned whether PAD itself was a good idea. “We’re not just consulting psychiatrists — we’re members of a profession,” she said. “We’re shapers of healthcare policy that will affect everyone in the country … including people who are institutionalized, including people who don’t have physical illnesses.” (Emphasis added)

Dr. Hanson told how she was contacted by a colleague who asked her how to do such an mental health exam on a patient seeking assisted suicide in Switzerland. because of an “irreversible neurological condition”.  Dr. Hanson said, “It turned out the ‘irreversible neurologic condition’ was schizophrenia”. Dr. Hanson concluded that “So the publicity surrounding the right-to-die movement is hurting our psychiatric patients.” (Emphasis added) She also added that “the American Psychiatric Association also considers [PAD] to be unethical, and re-emphasized that in [amicus] briefs to the Supreme Court.”

Another MD talked about self-care for doctors after making mental health exams for physician-assisted suicide, saying that she deliberately tried “not to find out what happened to the patient” but still often found out what happened to the patients she evaluated when she would see an announcement about a memorial service

CONCLUSION

I am glad that I became a nurse decades before state legalized physician-assisted suicide. Back then, I saw what happened with patients like Aaron when we didn’t have the assisted suicide “option”: Patients received a chance for the best life possible and we received a chance to show how much we cared.

 

 

 

 

Talking to Patients

As I have related before, back in the early 1970s when I was a new ICU nurse, I was teased for talking to comatose patients. I was even asked if I talked to my refrigerator. I explained that if hearing was truly the last sense to go, it made sense to talk to the patients and explain what we were doing just as we would for any other patient. The other nurses thought this was ridiculous-until “Mike”.

“Mike” was a 17-year old boy who was admitted to our intensive care unit in a deep coma with massive injuries caused by a terrible car crash. The neurosurgeon on duty pronounced, “He won’t live until morning and it’s a good thing, because he’d be a vegetable.” I was shocked that he said this in front of “Mike”!

But “Mike” didn’t die. I kept talking to him and eventually he could even move a finger on command. But he would not respond to the neurosurgeon, even with tests to see if he would move with pain stimuli.

Later on, when “Mike” was able to breathe on his own, he would even say “Hi” for me on command but it was only after I repeatedly begged that Mike finally said “Hi” to the neurosurgeon. The neurosurgeon called this a “miracle” but shortly after that, Mike was transferred to a nursing home. None of us ever expected to see him again.

However, about 2 years later, a handsome young man strode into our ICU and asked “Do you remember me?” It was Mike! He said he had driven 60 miles to tell us thanks for saving his life and we all dissolved in happy tears.

I told him that he wouldn’t remember this, but he would move and say “Hi” for us nurses but not for the neurosurgeon. Mike got very serious and said “I remember him calling me a vegetable and I wouldn’t move for him!

After that, every nurse on our unit was told to talk to every comatose patient as if he or she was totally awake and soon we found more patients who unexpectedly woke up or improved.

And no one ever teased me about talking to “comatose” patients again.

Throughout the decades since, I have talked to other patients who were considered comatose or otherwise unconscious, not just to patients with a major brain injury but also to patients approaching death and to patients sedated while on a ventilator for breathing. I’ve always considered this talking and explaining just basic respect for every patient. I was pleasantly surprised when I followed up with patients and families after they left our ICU and found many who remembered and told me how much this had helped them.

“OBSERVATIONS FROM ICU PATIENTS WE THOUGHT WERE ASLEEP, BUT WERE NOT”

So I was thrilled to see this title for a new Journal of the American Medical Association (JAMA) learning audio for doctors with stories from patients about what they experienced in an ICU while their treating doctors and nurses thought they were “asleep”.

In the audio, most of the patients were on sedation while on a ventilator and assumed unaware. One such woman related how she became so angry at her doctor’s attitude that she wanted to throw something at him and was frustrated when she couldn’t. Another man related how painful it was when the electrodes checking for his level of sedation were used without explanation or warning. Another complained about hearing nurses talking about her mom and dad poorly and their lack of empathy.

But there were also good stories about nurses or doctors taking the time to explain what was happening, talking as if the patient could hear everything and helping patients communicate without words. One doctor told about how his own father was in a hospital for an extended time and his dad remembered hearing the doctor talking about all the things he couldn’t do instead of what he could do. This doctor says that his father’s discouraging experience made him a better doctor.

The audiotape also explains how difficult it can be to not over- or under-medicate people, especially when it comes to pain, confusion and anxiety. The audiotape recommends that health care professionals try to avoid long acting drugs with potential side effects and continuous medication infusions and to use simple tools to assess delirium, confusion and anxiety.

The audiotape also recommends that health care professionals “treat patients like real persons”, “take the time to explain”, “be careful to assess level of awareness”, “realize that every action and word have real consequences” and that the “human element” is the most important.

CONCLUSION

Being in an ICU can be especially stressful for patients and their families and I hope this information is helpful. Medicine can do wonders today but it is the human connection that provides the best environment for healing for both patients and their families.

My Review of “Gosnell: The Trial of America’s Biggest Serial Killer”

I just saw the movie “Gosnell: The Trial of America’s Biggest Serial Killer” and was moved to tears even though I already knew much of the story about the notorious Philadelphia abortionist who ran an outrageously filthy clinic where he executed late-term babies who survived abortion by callously cutting their spinal cords. I also knew that some of the women died, suffered serious complications or contracted diseases from dirty instruments during the 30 years Dr. Kermit Gosnell ran his politically protected clinic.

This PG 13 movie scrupulously avoids sensationalism but through great acting, writing and accurate depictions of the clinic and Gosnell himself (actual pictures were shown at the end of the movie), the enormity of the evil cannot be ignored.

The movie starts much like an episode of “Law and Order” portraying a drug bust but then expands as police raid Gosnell’s abortion clinic for evidence of illegal prescription drug sales and find even greater problems. After the initial reluctance to prosecute by the District Attorney because the case involves abortion, a courageous assistant district attorney puts her job on the line to prosecute Gosnell.

The trial of Gosnell is riveting, especially when an expert witness abortionist describes how to correctly perform a late-term abortion that is unnervingly similar in callousness to Gosnell’s. The testimony of girls as young as 15 when they were trained by Dr. Gosnell to be his unlicensed assistants is also devastating as they describe an aborted baby swimming in a toilet or another struggling to keep breathing. The trial is very contentious but a stunning development late in the trial determines the result.

I highly recommend seeing this movie that even opened the eyes of people like Ann McElhinney who was neutral on abortion until she worked on this film.

CONCLUSION

Although one of the most shocking aspects of the Gosnell trial was his cutting the spinal cords of babies who survived abortion, Kermit Gosnell was not the first known abortionist to deliberately end the lives of babies who survived abortions.

In 1999, nurse Jill Stanek was shocked to discover a live baby boy left to die after an induced-labor abortion  and found this was a common practice in her hospital. Her courageous testimony led to the 2002 “Born-Alive Infants Protection Act” which extended legal protection to infants born alive after an abortion.

However, the lack of legal enforcement power in this Act led to the current “Born-Alive Abortion Survivors Protection Act that not only requires physicians and abortion facilities to afford “the same degree” of care to a baby born alive during an abortion that would apply “to any other child born alive at the same gestational age,” including transportation to a hospital, but also mandates fines and the possibility of imprisonment for medical professionals found to be noncompliant.

This bill was passed in the US House of Representatives this year and sent to the Senate where (because of procedural hurdles), it might need 60 votes to pass and be signed into law by President Trump.

Although it might be difficult to pass the Act now because of the political entrenchment of abortion supporters in the Senate, passing this law would provide at least one fitting endnote to the horrors of Dr. Kermit Gosnell’s clinic.

American Academy of Family Physicians Urges the American Medical Association to Drop Opposition to Physician-assisted Suicide

Compassion and Choices, the former Hemlock Society and now well-funded promoter of assisted suicide and other death “choices”, is celebrating the new resolution by the American Academy of Family Physicians (AAFP) to oppose the American Medical Association’s (AMA) long-standing opposition to assisted suicide.

The AFFP, the second largest component society of the AMA with over 131,000 members, just approved a new resolution adopting a position of  “engaged neutrality toward medical-aid-in-dying (aka physician-assisted suicide) as a personal end-of-life decision in the context of the physician-patient relationship.” (Emphasis added)

But as Dr. Rebecca Thoman, campaign manager for Doctors for Dignity for Compassion and Choices explained when the Massachusetts Medical Society adopted the same policy in 2017:

A “‘neutral engagement’ position is even better than a simply neutral position. It means if Massachusetts enacts a medical aid-in-dying law, the medical society will offer education and guidance to physicians who want to incorporate medical aid in dying into their practices.” (Emphasis added)

Now, yet another physician-assisted suicide bill is expected to be introduced next year in the Massachusetts legislature.

The AAFP resolution also stated that:

“By supporting the AMA’s opposition to medical aid in dying, some members feel the AAFP is telling them that they are unethical

and that

“the American Academy of Family Physicians reject(s) the use of the phrase ‘assisted suicide’ or ‘physician-assisted suicide’ in formal statements or documents and direct(s) the AAFP’s American Medical Association (AMA) delegation to promote the same in the AMA House of Delegates.” (Emphasis added)

CONCLUSION

In 1994, Oregon became the first state to pass a physician-assisted suicide law. This came after the Oregon Medical Association changed its position from opposition to neutrality. 21 years later and after multiple failed attempts, the California state legislature approved a physician-assisted suicide law after the California Medical Association changed its opposition to neutrality.

The unfortunate message sent-and received- was that if doctors themselves don’t strongly oppose physician-assisted suicide laws, why should the public?

Still, it was a surprise that in June 2018, the American Medical Association House of Delegates rejected the AMA’s Council on Ethical and Judicial Affairs (CEJA) strong report recommending that the AMA continue its long standing policy opposing physician assisted suicide. Instead the delegates “voted 314-243 to refer the matter back to the trustees for further deliberation”.

With the crucial help of a supportive media, Compassion and Choices started this momentum towards acceptance of physician-assisted suicide and other death choices like VSED (voluntary stopping of eating and drinking), terminal sedation and withdrawal of even spoon-feeding, affecting not just doctors but also nurses and other health care professionals and institutions.

In addition, Compassion and Choices also opposes conscience rights, even stating that  the new Federal Conscience and Religious Freedom Division:

“is not about freedom; it’s about denying patient autonomy. Under their proposed rules, providers are encouraged to impose their own religious beliefs on their patients and withhold vital information about treatment options from their patients — up to, and including, the option of medical aid in dying. And your federal tax dollars will be used to protect physicians who make the unconscionable decision to willfully withhold crucial information regarding their care from a patient and abandon them when they are most vulnerable.” (Emphasis added)

However, here are a few ways any of us can help turn around this dire situation:

When the most basic medical ethic of not killing patients or helping them to kill themselves can be discarded in favor of “choice” or “quality of life”,  none of us of us can afford to be neutral- or silent-on this life or death issue.