Month: August 2015

A Modest Proposal on Assisted Suicide

nancyvalko assisted suicide, bereavement, medical ethics

On August 26, 2015, the Wall Street Journal published letters to the editor responding to Dr. William Toffler’s great August 18 opinion article titled “A Doctor-Assisted Disaster for Medicine-As a physician in Oregon, I have seen the dire effect of assisted-suicide laws on patients and my profession”.

The letters to the editor were overwhelmingly critical of Dr. Toffler’s position. Here are some excerpts:

“On May 5, my mother, at age 73, chose to take her life using the medicine provided by her doctor to end her life. She couldn’t breathe, could barely walk and was skin and bones when she finally died. She had been a vocal advocate of the Death with Dignity Act and had spoken with all her physicians years before this ever became a real issue for her. ”  Portland, Oregon. (emphasis added)

“As a patient, I am not worried about “death doctors.” I am worried about doctors who use any treatment available to prolong life without having a matter-of-fact discussion with the patient about what the quality of that prolonged life will be.” Beaverton, Oregon (emphasis added)

“My personal experience in medical practice during the last 63 years is that those physicians who are against physician-assisted suicide have never spent month after month nor year after year with a dying patient who is suffering intolerable pain.” (emphasis added)

In response, here is the letter to the editor I sent to the Wall Street Journal today:

A MODEST PROPOSAL ON ASSISTED SUICIDE

With all the rancor about physician-assisted suicide, I would like to make a modest proposal.

First of all, take the medical professionals out of assisted suicide.

Capital punishment opponents have successfully challenged lethal injection executions on the basis that even that direct termination of life is “cruel and inhumane” and sometimes fails to render an inmate unconscious, causing much suffering. How can we then justify an oral overdose that cannot guarantee rapid unconsciousness, a quick termination of breathing and heartbeat or a lack of complications?

Secondly, if the suicide is then assisted by a family member or friend, eliminate any profit incentive by barring the person assisting from receiving any proceeds from an insurance policy or provision in a will. Families and friends who say no can instead concentrate on obtaining adequate symptom relief and support for their loved ones.

Unfortunately, the assisted suicide message of a victimless choice is seductive not only to people with life-threatening medical conditions but also to physically healthy people of all ages dealing with despair, disability, mental illness and the frailty of old age.

Almost 6 years ago, my physically healthy but addicted daughter killed herself using a technique the medical examiner called “textbook final exit”. My daughter read Final Exit, a book written by Derek Humphry, the founder of the Hemlock Society now known as Compassion and Choices.

My daughter’s suicide was neither quick nor peaceful and it devastated her family and friends. However, none of us regret the years of efforts to save her and none of us would have sat at her deathbed supporting her alleged choice while she struggled to breathe.

Sincerely,

Nancy Valko, RN ALNC

New Doctor-Assisted Suicide Bill Introduced in California After Prior Bill and 2 Court Challenges Fail

nancyvalko assisted suicide, euthanasia, medical ethics

Last October when Compassion and Choices (the former Hemlock Society) rolled out Brittany Maynard’s tragic assisted suicide story along with the establishment of a Brittany Maynard Fund to raise money to legalize doctor-assisted suicide throughout the US, the group was confident that this would be the tipping point in a movement that had stalled in other states.

The state of California was considered a sure thing for doctor-assisted suicide especially because Brittany Maynard and her family left California which had repeatedly rejected doctor-assisted suicide for Oregon, the first state to legalize such suicides. Nevertheless, People magazine and other mainstream media praised Ms. Maynard “heroism” in supporting doctor-assisted suicide and touted the “success” of such laws in the few states that had legalized it.

However, efforts to pass Senate Bill 128 failed in the California legislature this summer after efforts by disability, pro-life and other organizations to educate both legislators and the public about the dangers of doctor-assisted suicide.

Undaunted, Compassion and Choices then supported efforts to reverse the ban against assisted suicide with lawsuits filed by several terminally ill patients in two courts. However both courts, one in San Francisco and one in San Diego,  refused to overturn California’s ban on assisted suicide.

The well-funded pro-assisted suicide groups are nothing if not tenacious so it should not be a surprise that they have now unveiled a “new” and “improved”  doctor-assisted suicide bill called AB 15 End of Life Option Act with more so-called “safeguards”.

The reassurance of safeguards are critical to the selling of doctor-assisted suicide to a public understandably squeamish about allowing doctors to help some people to kill themselves.

 WHAT SAFEGUARDS?

There have been many articles about the problems with these alleged safeguards but they are rarely covered in mainstream media articles. The latest and one of the best is then August 15, 2015 US Conference of Catholic Bishops’ paper titled  “Assisted Suicide Laws in Oregon and Washington: What Safeguards?”,

For example, here is a portion of the paper that gives the real facts behind the alleged psychological counseling safeguard:

Despite medical literature on the frequent role of depression and other psychological problemsin choices for suicide, the prescribing doctor (and the doctor he selects to give a second opinion)are free to decide whether or not to refer suicidal patients for any psychological counseling.Even if such counseling is provided, its goal is to determine that the patient is not suffering from“a psychiatric or psychological disorder or depression causing impaired judgment.” Ore. Rev.Stat. 127.825; Rev. Code Wash. 70.245.060. The doctors or counselor can decide that, since depression is “a completely normal response” to terminal illness, the depressed patient’s judgment is not impaired…..
From 1998 to 2012, on average only 6.2% of patients who died under the Act in Oregon were referred for counseling to check for “impaired judgment.” Of 108 patients who died under the (Oregon) Act in 2007 and 2009, none was referred for psychological evaluation. In Washington, only 4% of patients are known to have been referred for such counseling in 2014 (six of the 167 who died from any cause after receiving the prescription); the state does not report whether any of those who actually ingested the lethal drugs had been referred for counseling.
 In another section, the paper relates what happened with an Oregon physician despite the alleged safeguard that an assisted suicide request must come from a competent, terminally ill person:
An Oregon emergency room physician was asked by a woman to end the life of her mother who was unconscious from a stroke. He tried to stop her breathing or heartbeat in several ways,finally giving a lethal dose of a paralyzing drug to the older woman who died minutes later. The state board of medical examiners reprimanded the doctor but he faced no criminal charges for this direct killing–which news reports called a case of “assisted suicide”–and he later resumed medical practice.

WHY SHOULD WE CARE?

Unfortunately, even my home state of Missouri which has laws against assisted suicide had a case similar to the one referenced here about the Oregon physician who gave a lethal overdose. This 2001 Missouri case involved a nurse. The nurse gave a lethal overdose without a doctor’s order to a patient who had a stroke the day before but wouldn’t stop breathing when taken off a ventilator. After the patient’s son voiced support for the nurse, she was only sentenced to 5 years’ probation.

The point is that when so-called “safeguards” are accepted (and routinely ignored) in states that do have legalized doctor-assisted suicide amid an aggressive national campaign to legalize doctor-assisted suicide as a civil right, there has been a chilling effect on prosecutors and juries even in other states that have rejected assisted suicide as long as “compassion” is given as the reason for ending life.

Ominously, in other countries like Belgium and Holland, the practice of doctor-assisted suicide for the terminally ill adult has  evolved over the years to now include children, people with mental illness and even people who are only “tired of life.”

Are we willing to risk a similar fate here?

Medical Professionals, Planned Parenthood and Fetal Tissue from Aborted Babies

nancyvalko abortion, family planning, fetal tissue, medical ethics, organ donation, Planned Parenthood

On August 6, 2015, the Medscape website for medical professionals had an article: “Reader Poll: “Should Medical Societies Support Federal Funding for Planned Parenthood?” with 3 questions:

1. Do you agree that Planned Parenthood should continue to receive federal funds for non-abortion-related care?
2. Do you believe that these 18 medical societies were justified in stating their support for Planned Parenthood?
3. Do you believe that it is ethical for Planned Parenthood to donate aborted fetal tissue for use in medical research?

Not surprisingly, given how these questions are worded, a large majority voted yes.

The Medscape article referenced a letter to Congress dated 8/3/2015 by 18 medical societies supporting continued funding for Planned Parenthood.
However, when I accessed the letter, it surprisingly says nothing about fetal tissue research.

I am including the actual letter and its signers below.

I wonder if these groups’ members feel the same way. I checked on two groups and couldn’t find the letter on the American Congress of Obstetricians and Gynecologists or Society’s for Adolescent Health and Medicine’s websites.

I would encourage members of these groups as well as other ethical doctors and nurses to contact to contact these organizations to encourage them to protest this position (and the use of aborted babies for fetal tissue research), especially since it appears that many medical professionals are unaware of the issues involved.

I have seen this before.

Even though the American Nurses Association did not sign this letter and a current search shows no position on Planned Parenthood or fetal tissue use on its website, I was a member of the American Nurses Association (ANA) years ago and tried to work within that organization at a state level on several ethical issues. I read every issue of ANA’s Journal of Nursing, particularly the political section. When the ban on partial birth abortion came up in Congress, I read nothing about it in the Journal.

Awhile later, I was watching a political talk show and one of the panelists mentioned that the ANA was against the ban. That was news to me so I searched for the information on the internet. It took some time but I finally found the letter.

I tracked down the public relations director of the ANA and called her. At first, she said that she didn’t know what I was talking about but eventually found the information herself and seemed surprised.

I told her that I no longer could be a member of ANA not only because of its’ stance on partial birth abortion but also because of the secrecy. We members were not polled or even informed. I also told her that I would encourage other ANA members to also leave if the ANA did not change its position or inform its membership.

The PR person apologized. I gave her my phone number and encouraged her to have someone from the ANA contact me.

I never heard back from them.

We need accountability from our professional organizations, especially since these organizations claim to represent the interests of groups of medical professionals.

———————————————————————————————————————————————–

In a letter dated August 3, a group of 18 medical societies, including the American Congress of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, ask the Senate and House leadership to continue to allow Planned Parenthood to participate in federal health programs.

https://filemanager.capwiz.com/filemanager/file-mgr/acog/Provider_Ltr_in_Support_of_Planned_Parenthood_Funding_Updated.pdf

August 3, 2015

The Honorable Mitch McConnell
Senate Majority Leader
S-230, U.S. Capitol Building
Washington, DC 20510
The Honorable John Boehner
Speaker of the House of Representatives
H-232, U.S. Capitol Building
Washington, DC 20515
Dear Leader McConnell and Speaker Boehner:

As organizations representing health care professionals and the people they serve across the country, we strongly oppose any effort to prevent Planned Parenthood health centers from participating in federal health programs, including Medicaid and the Title X family planning program. Any proposal to exclude Planned Parenthood from public health programs will severely curtail women’s access to essential health care services, including family planning, well-woman exams, breast and cervical cancers screenings, and HIV testing and counseling. At a time when we should be focused on improving the health of all people, it is frustrating to witness ongoing attempts to cut off access to life-saving preventive care.
Planned Parenthood health centers play a crucial role in improving the health and lives of people across the country. In fact, 2.7 million people rely on Planned Parenthood for health care. For many women, Planned Parenthood is their only source of care—offering basic preventive services that are fundamental to women’s health and well-being. Each year, Planned Parenthood health centers provide nearly 400,000 cervical cancer screenings and nearly 500,000 breast exams.

Additionally, Planned Parenthood provides over 2.1 million contraceptive services and nearly 4.5 million tests and treatments for sexually transmitted infections, including HIV. These services improve women’s health, prevent an estimated 516,000 unintended pregnancies, and decrease infant mortality.
Policies that would exclude Planned Parenthood from public health funding would hurt millions of women and undermine health care access in communities across the country. Approximately 60 percent of Planned Parenthood patients access care through Medicaid and Title X, in addition to those who rely on other essential programs, including maternal and child health programs and Centers for Disease and Prevention (CDC) breast and cervical cancer screening programs.

In some states, Planned Parenthood is the only provider participating in Title X, and more than 50 percent of Planned Parenthood health centers are located in a medically underserved or health professional shortage area. Because federal law already requires health care providers to demonstrate that no federal funds are used for abortion, prohibitions on funding for preventive care at Planned Parenthood health centers will only devastate access to these life-saving services.

Every day, we see the harmful impact that unequal access to health care has on women and communities across the country, and we therefore strongly support policies that improve access to affordable, quality health care. Policies that would deny Planned Parenthood public health funds only serve to cut millions off from critical preventive care, and we strongly oppose any effort to do so. Should you have any questions, please contact ACOG Government Affairs staff, Rachel Gandell at 202-863-2534 or rgandell@acog.org.

Sincerely,

American College of Nurse-Midwives
American Congress of Obstetrician and Gynecologists
American Medical Women’s Association
American Medical Student Association
American Public Health Association
American Society for Reproductive Medicine
Association of Reproductive Health Professionals
Association of Women’s Health, Obstetric and Neonatal Nurses
Doctors for America
GLMA: Health Professionals Advancing LGBT Equality
National Alliance to Advance Adolescent Health
National Association of Nurse Practitioners in Women’s Health
National Family Planning and Reproductive Health Association
National Hispanic Medical Association
National Physicians Alliance
Physicians for Reproductive Health
Society for Adolescent Health and Medicine
Society for Maternal-Fetal Medicine
cc: Senate Minority Leader Harry Reid
House Minority Leader Nancy Pelosi

Pope: ‘By No Means Excommunicated,’ but Divorce and Remarriage Contradicts the Sacrament

nancyvalko faith, marriage

In an 8/5/2015 article in the National Catholic Register titled “‘By No Means Excommunicated,’ but Divorce and Remarriage Contradicts the Sacrament”, statements by Pope Francis have set off a firestorm of controversy once again in Church circles. Some fear that Church teaching on marriage will be changed or watered down.

As the article states:

Echoing his predecessors on the need to care for divorced-and-remarried persons, Pope Francis said Christians should help these persons integrate into the community, rather than treating them as though they are excommunicated.

“The Church well knows that such a situation contradicts the Christian sacrament,” the Pope said in his Aug. 5 general audience in St. Peter’s Square. Nonetheless, he added, the Church should always approach such situations with a “mother’s heart; a heart, which, animated by the Holy Spirit, seeks always the good and the salvation of the person.”
“It is important that they experience the Church as a mother attentive to all, always disposed to listen in encounters,” he added.
The community is to welcome persons who have divorced and entered into new unions, the Pope said, so that “they may live and develop their adherence to Christ and the Church with prayer, listening to God’s word, frequenting the liturgy, the Christian education of their children, charity, service to the poor and a commitment to justice and peace.”

As someone who has experienced the trauma of divorce personally, I do believe that priests and the parish communities could be much more supportive to the parent and, especially, any children involved.
After my divorce, I met many Catholic divorced women who, whether or not they remarried, felt isolated from the rest of their parish and some even erroneously believed that they could not receive Communion even when they had not remarried. Sadly, every one of these women reported receiving little or no emotional or spiritual support from their parish priest even though some had reached out to their priest before the divorce. Many even left the Church, often for a more welcoming Christian church.
This is a situation that can be helped by sensitivity and deliberate outreach from priests and parish members. I assume that is what Pope Francis was talking about when he emphasized the need for a welcoming presence for people and their children dealing with divorce-even those who have remarried without an annulment.
I do support the annulment requirement based on Church teaching about the sacrament of marriage. Even though the annulment process can be painful at times, the questionnaires and personal interactions with the priests and people helping with the process can result in new insights, understanding and even a sense of closure and forgiveness.
I was granted an annulment from my first marriage years ago and long before I unexpectedly remarried 20 years after my divorce. I feel the annulment process was overall a positive experience and enabled me to marry my wonderful husband Kevin with no reservations. I certainly would not have remarried without the annulment.

I do recommend exploring an annulment after divorce, especially when a remarriage is being contemplated. An “Annulment FAQs” page can be found on the US Conference of Catholic Bishops.

Those Catholics who remarried without an annulment should not assume that they have no recourse. I strongly encourage them to contact a Church authority for guidance.

TWO ARTICLES ABOUT ASSISTED SUICIDE MAY PREDICT ULTIMATE COURSE OF MEDICALIZED DEATH

nancyvalko assisted suicide, medical ethics, mental health

A July 31, 2015 article in Medscape (a subscription website for medical professionals) titled “Assisted Suicide for Mental Illness Gaining Ground” admits that:

“Euthanasia (referred to as assisted suicide in the Netherlands and Luxembourg, where it is also legal in cases involving suffering due to medical and psychiatric illness) has been legal since 2002 in Belgium, and the law was extended in 2014 to include emancipated children with suffering due to terminal illness.

Through a required process, patients must show their illness to cause “unbearable or untreatable suffering”; however, the definition is acknowledged to be subjective, Dr Thienpont told Medscape Medical News.

“By its nature, the extent to which the suffering is unbearable must be determined from the perspective of the patient him- or herself and may depend on his or her physical and mental strength and personality,” said Dr Thienpont.

Despite the ongoing criticism that very few assisted suicide requests in the US are referred for psychological/psychiatric consultations, this article examines a July 27, 2015 British Medical Journal article ““Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study”   that tries to make the case that mental illness itself can be grounds for assisted suicide.

In the meantime, an Irish website thejournal.ie has an August 2, 2015 poll asking “Poll: Would you consider euthanasia while still healthy?” based on a story about a healthy nurse who  legally ended her life in a Swiss clinic:

“A HEALTHY NURSE from England has opted to die via assisted suicide, rather than growing old.
Gill Pharaoh (75), a former palliative care nurse, chose to die at a Swiss clinic so she wouldn’t become a burden on her family or the health service.

In an interview with the Sunday Times shortly before her death, Pharaoh said her children struggled to cope with her decision, but understand where she is coming from.

Her husband accompanied her to the clinic.”

Unfortunately, the countries in Europe that have legalized euthanasia/assisted suicide apparently are the “canaries in the mine” warning us of a relentless march towards the acceptance of euthanasia on demand in the US and potentially worldwide.