Governor Brown, do not sign the death warrant of unhappy people

My daughter was the victim of assisted suicide, but she is not the only one.

Right now, a law hurriedly pushed through the California legislature after multiple defeats sits on the desk of Governor Jerry Brown and awaits his signature. As both a mother and a nurse I beg Governor Brown to veto it.

In 2009, I lost a beautiful, physically well 30-year-old daughter, Marie, to suicide after a 16-year battle with substance abuse and other issues. Her suicide was like an atom bomb dropped on our family, friends and even her therapists.
Despite all of our efforts to save her, my Marie told me that she learned how to kill herself from visiting suicide/assisted suicide websites and reading Derek Humphry’s book Final Exit. Derek Humphry is the founder of The Hemlock Society, now included with other assisted suicide groups and known as Compassion and Choices. The medical examiner called Marie’s suicide technique “textbook final exit” but her death was neither dignified nor peaceful.

Marie was not mere collateral damage in the controversy over physician-assisted suicide. She was a victim of the physician-assisted suicide movement, seduced by the rhetoric of a painless exit from what she believed was a hopeless life of suffering.

Adding to our family’s pain, at least two people close to Marie became suicidal not long after her suicide. Luckily, these two young people received help and were saved, but suicide contagion, better known as “copycat suicide”, is a well-documented phenomenon. Often media coverage or publicity around one death encourages other vulnerable people to commit suicide in the same way.

Think of Brittany Maynard, the young woman with a brain tumour who moved to Oregon to kill herself last November with a doctor prescribed overdose. Weeks before she killed herself, Ms. Maynard partnered with the well-funded Compassion and Choices organization to raise even more money to promote the legalization of physician-assisted suicide throughout the US.
There was an immediate and unprecedented media frenzy surrounding Ms. Maynard’s tragic story that routinely portrayed her pending suicide as “heroic” and even counting down the days to her suicide. Personally, I thought this looked like a crowd on the street shouting for a suicidal person on a window ledge to jump, but the narrative worked with much of the public.

One problem with the media frenzy is that it violated well-established public health standards for how we talk about suicide. The National Institute for Mental Health has warnings about reporting on suicide that include “Risk of additional suicides increases when the story explicitly describes the suicide method, uses dramatic/graphic headlines or images, and repeated/extensive coverage sensationalizes or glamorizes a death.” (emphasis added) Instead, the NIHM recommends including “up-to-date local/national resources where reader/viewers can find treatment, information and advice that promote help-seeking”.

However, Compassion and Choices even denies that physician-assisted suicide is suicide, insisting instead that the media use euphemisms like “aid-in-dying” and “death with dignity” in cases like Ms. Maynard’s. However, this defies common sense and even the definition of suicide as “the intentional taking of one’s own life.” Apparently, there are reasons for this:
A 2013 Pew Research Center poll showed that public opinion on physician-assisted suicide law is closely divided, with 47 percent of US adults approving and 49 percent disapproving. A Gallup poll article showed eliminating the term “suicide” in public polls on assisted suicide laws can increase support by as much as 20 percent. Changing the terminology of assisted suicide also allows immunity for assisting medical professionals and gets around standard life insurance policies that deny payouts for suicides occurring in the first two years of a policy.

I have been a registered nurse for 46 years, working in intensive care, oncology, hospice and home health among other specialties. Personally and professionally, I have cared for many people who attempt or consider killing themselves.
Some of these people were old, chronically ill or had disabilities. Some were young and physically healthy. A few were terminally ill. I cared for all of them to the best of my ability without discrimination as to their condition, age, socioeconomic status, race or gender. I will do anything to help my patients — except kill them or help them kill themselves.

It is outrageous that physician assisted suicide laws support privatized lethal overdoses for some suicidal people without even the oversight and protections we insist upon for a convicted murderer on death row. Suicide prevention and treatment works, and the standards must not be changed just because some people insist their desire for physician-assisted suicide is rational and even a civil right.

My Marie was one of the almost 37,000 reported suicides in 2009. In contrast, only about 800 assisted-suicide deaths have been reported in the past 16 years in Oregon. According to the Centers for Disease Control (CDC) suicide was the 10th leading cause of death for Americans in 2012, with “More than 1 million people reported making a suicide attempt in the past year” and “More than 2 million adults reported thinking about suicide in the past year.”. The CDC estimates that suicide “costs society approximately $34.6 billion a year in combined medical and work loss costs”, not to mention the emotional toll on families.

Obviously our real health-care crisis here is a staggering and increasing rate of suicides, not the lack of enough assisted suicides.

Yet, the assisted-suicide movement relentlessly continues to demand the participation of medical professionals like me and the approval of society for at least some suicides — for now. Those demands must be denied.

My daughter Marie was a victim of these demands to control life by embracing death. How many more people must we lose before we truly understand that evil never limits itself because evil always seeks to expand unless it is stopped. In the case of physician-assisted suicide, “No” can be a life-saving word.

Nancy Valko is a registered nurse living in St Louis, Missouri, and spokesperson for the National Association of Prolife Nurses. Recently retired from bedside nursing, she is now an advance legal nurse consultant. She writes and speaks on ethics issues around the US, and blogs at A Nurse’s Perspective on Life, Healthcare and Ethics.

This article is published by Nancy Valko and under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees.

Addendum: Mercatornet is a fascinating website about “navigating modern complexities” and encompasses a range of issues. I am pleased to have had a number of articles published there over the years including  “Organ donation: crossing the line- Linking the “right to die” with organ donation has opened a terrible Pandora’s Box”, “ Have death panels already arrived?” and “The campaign against conscience rights


In his September 23, 2015 article “Ontario doctors squeezed on conscientious objection to assisted suicide” Michael Cook states that

“The legalisation of physician-assisted suicide in Canada after February’s decision by the Supreme Court is starting to affect doctors. The College of Physicians and Surgeons of Ontario has quietly issued a directive that conscientious objectors must help them find someone willing to do so.”

Mr. Cook also writes that such a directive requires unwilling doctors to make

“an effective referral to another health-care provider” defined as ‘a referral made in good faith, to a non-objecting, available, and accessible physician, other health-care professional, or agency’.”


“It was approved by College Council in March despite overwhelming opposition to the demand for ‘effective referral’.”

Personally and as a nurse, I could not refer for either abortion or physician-assisted suicide. Not only do I oppose these actions but I also don’t know any ethical or scandal-free organizations or practitioners that perform death procedures.

And does “mandated referral” also mean that I am forbidden to give any accurate but negative information about these procedures? Probably.

Here is what happened to nurses in Oregon after the physician-assisted suicide law took effect and even though the Oregon Nurses Association (ONA) is part of the American Nurses Association which opposes against assisted suicide.

The ONA’s 1997 guidelines on the “Role of the Registered Nurse in Assisted Suicide” states that

“ONA supports the patient’s right to self-determination and believes that nurses will and must play a primary role in end-of-life decisions.”

And here are some excerpts from that paper concerning those “Nurses Who Choose Not To Be Involved”:

According to the ONA, such nurses may:

“Conscientiously object to being involved in delivering care. You are obliged to provide for the patient’s safety, to avoid abandonment and withdraw only when assured that alternative sources of care are available to the patient.” (Emphasis added)

I faced such a situation myself years ago when I was told that there was no other nurse available when I refused to comply with a death decision. I was almost fired.

Furthermore, according to the position paper, such objecting Oregon nurses may not:

“Subject your patients or their families to unwarranted, judgmental comments or actions because of the patient’s choice to explore or select the option of assisted suicide.” (Emphasis added)
“Subject your peers or other health care team members to unwarranted, judgmental comments or actions because of their decision to continue to provide care to a patient who has chosen assisted suicide.
Abandon or refuse to provide comfort and safety measures to the patient.” (Emphasis added)

My point is that mandated referral must be opposed. It is just another kind of required participation and denial of conscience rights that is intended to silence the objections of doctors and nurses and even threaten their careers.

But above all, conscience rights protect patients and their right to safe health care.


This February, The Supreme Court of Canada ruled unanimously that  the Canadian law that makes it illegal for anyone to help people end their own lives should be amended to allow doctors to help in specific situations. The court gave federal and provincial governments 12 months to craft legislation to respond to the ruling. Until then; the ban on doctor-assisted suicide stands. If the government doesn’t write a new law, the court’s exemption for physicians will stand.

Against this ghastly situation, however, there are welcome voices of opposition.

In a September article in the Canadian press titled “Quebec’s split over euthanasia a warning for Canada”, reporter Allan Woods writes:

But with time running out before Dec. 10 — the date that patients can begin requesting the procedure — hospitals and health-care providers are scrambling to draw up policies and find the staff who will carry out those patients’ wishes.
If that wasn’t tough enough, some of those who might be expected to lead the change — palliative care physicians and hospice administrators — have let it be known that they are instead digging trenches for the battle.

“The vocation of a palliative care hospice is to provide care, and that doesn’t include medical aid in dying,” said Élise Rheault, director of Maison Albatros Trois-Rivières.

Mr. Woods goes on to write that:

Quebec Health Minister Gaétan Barrette, a doctor himself, says the refusal by the province’s hospices to provide the procedure amounts to “administrative fundamentalism” and he accused palliative care doctors — who have a right under the law to conscientious objection — of acting like hospital owners rather than service providers.
“The law was very much framed as being in a continuum, along the lines of (euthanasia) being the end part of palliative care, so it is a logistical problem if the significant majority of palliative-care professionals are saying we will invoke conscientious objection,” said Dr. Eugene Bereza, director of the Centre for Applied Ethics at the McGill University Health Centre.

This horrific development in our neighbor Canada is a warning to those in the US, especially with a California law rammed though the legislature and now sitting on Governor Jerry Brown’s desk awaiting either his signature or veto.

How NOT To Prevent Assisted Suicide On World Suicide Prevention Day


Today is World Suicide Prevention Day and this week is the US National Suicide Prevention Week.

.According to the International Association for Suicide Prevention:

“We may not be able to pinpoint the exact figure, but we do know that each individual suicide is a tragic loss of life. It is hard to imagine the extreme psychological pain that leads someone to decide that suicide is the only course of action. Reaching out to someone who is struggling can make a difference.” (emphasis added)

All aspects of suicide, suicide prevention and the groups at risk are addressed by these organizations. Yet on the topic of preventing physician assisted suicide, there is only silence.

If indeed some suicides should be considered acceptable or even worthy, I have some suggestions on how NOT to prevent assisted suicide:

1. Change the terminology. Call your organization “Compassion and Choices” rather than The Euthanasia Society of America. Insist that physician assisted suicide now be called “death with dignity”, “aid in dying” or some other term that eliminates the word “suicide.”  Glamorize assisted suicide as “heroic” and “altruistic”. Refuse to even acknowledge the existence of suicide contagion and its devastating effects on surviving friends and families. Insist that only terminally ill people with 6 months to live and are in unendurable pain are eligible despite the evidence.

2. Change strategies as necessary. If most people in a state like California will not vote to legalize assisted suicide, find a judge to rule that a ban on assisted suicide is unconstitutional and hope that this will lead to a new US Supreme Court decision. Lobby professional health care organizations like the AMA, ANA and American Academy of Hospice and Palliative Medicine to take at least a neutral position on assisted suicide because some of their members are in favor of assisted suicide. Encourage articles in journals like Psychology Today promoting the idea of “rational suicide”. Promote positive statements on assisted suicide from celebrities like Hugh Grant, Dr. Mehmet Oz and Stephen Hawking.

3. Demonize the opposition. Call them “religious extremists” who are against individual choice and freedom. Accuse them of actually wanting people to endure needless suffering. Tell health care professionals that their conscience rights  are merely a right to ” to exercise their idiosyncratic convictions at the expense of patient care”.  Ignore disability organizations like Not Dead Yet.

4. Manage negative facts to persuade the media and thus the public to support assisted suicide. Publicize tragic stories like Brittany Maynard’s to raise even more money to legalize assisted suicide everywhere. Dismiss  or downplay stories about coercion, euthanasia on demand in European countries, ethical palliative and hospice care  and criticism of so-called “safeguards” and self-reported state statistics.

5. Most of all, ignore the lethal consequences of physician assisted suicide on individuals, health care itself and society.


September 6, 2015
Recently I read a Yahoo news article titled  “If I Knew My Daughter Had Down Syndrome, I Would Have Aborted Her – All Women Should Have That Right”  that broke my heart.
Beautiful pictures of this mom and her daughter accompanied her harsh words:

“Ohio is poised to become the second state in this country to ban abortion because of a fetal diagnosis of Down syndrome this fall. As a pro-choice woman who has a 7-year-old daughter with Down syndrome, I find this absolutely appalling.”
“This is an issue that hits close to home for me: If I had had a prenatal diagnosis, I would have obtained an abortion. Today, I am beyond grateful that I didn’t. But I cannot ever in any circumstances imagine insisting others not have that right.”

Here is what I wrote back in the comments section of this article:

I am an RN whose third child Karen was born in 1982 with both Down Syndrome and a heart defect. I was given a “choice” of whether or not to allow a surgery even though there was an up to 90% chance of success. I was outraged because that “choice” would not have been offered if my daughter did not have Down Syndrome. I knew then that I had to fight this medical discrimination not only for my daughter but for other children with disabilities.
Years later, a nice woman asked that, if I knew my daughter had Down Syndrome before birth, would I have chosen abortion. Instead of talking about how people with Down Syndrome were defying old, pessimistic predictions or how there was actually a waiting list of prospective adoptive parents for children with Down Syndrome, I asked the woman if she knew how abortions were done.
She said no so I asked her if she wanted to know. When she consented, I simply and clinically described how first, second and third trimester abortions were done. The woman responded with horror and said “You couldn’t do that to your child!”
That is exactly the point. It is not about what challenges a child may have but rather about deliberately killing an innocent child at any stage of life.
I would like to reassure the mom in this article that, while her feelings are understandable, she has apparently been a great mother to her daughter and should be proud of herself.
I would also like to encourage her to let go of any guilt over what she might have done, celebrate her beautiful daughter and please don’t discourage other mothers from choosing life for their child. Nancy V.


A friend of mine I will call “Mary” (not her real name) had an ultrasound of her unborn baby at 5 months that appeared to show anencephaly.  Anencephaly is a serious birth defect in which a baby is born without parts of the brain and skull. Most babies born with this condition die soon after birth.

However, Mary was also told that this pregnancy would kill her and, in a panic, she quickly endured 28 hours of hard labor with a prostaglandin-induced abortion before her baby was delivered. She never saw her baby.

Mary tried hard to put the tragedy behind her and decided to tell most of her friends that she had a miscarriage rather than an abortion. However, as she confided later, she half-expected to be somehow punished when she later had a son and it took several months after his birth before she could truly believe that her new son was healthy. But every Christmas she also secretly hung an ornament for her dead first child.

What Mary didn’t know was that her obstetrician apparently lied to her. First of all, she was not in any special physical danger from her pregnancy.

I later ran into an old friend who happened to be the doctor (not Mary’s obstetrician) who read her ultrasound. Since he also knew I was a friend of Mary’s, he asked how she was doing. He turned white and had to sit down when I told him about the abortion. It turns out that not only was Mary healthy but the ultrasound suggested only  the possibility of anencephaly. Such initial testing is too often wrong and should not be used as a definitive diagnosis.

I felt Mary had a right to know all this but she rebuffed my offer to tell her what I learned. However, five years later, she called and  said that although she didn’t want a lecture, she had a question that continued to haunt her: What did the hospital do with her baby’s body?

Abortion claims many victims because there is an enormous difference between dying and being killed no matter what the reason.

Pope Speaks on Forgiveness, Excommunication and Abortion; Confusion Ensues


By Nancy Valko, RN ALNC

September 2, 2015

A recent Reuters news article  “Pope to allow all priests to forgive abortion during Holy Year, stated that

In Church teaching, abortion is such a grave sin that those who procure or perform it incur an automatic excommunication. Usually only designated clergy and missionaries can formally forgive abortions.

That was news to many of us like Carol who wrote in a comment on the article:

Catholic priests have forgiven abortion for years! The Catholic church has always been concerned for the souls of women who have abortions! There are many Catholic programs for counseling and healing women who have had abortions. Check out Rachel’s Vineyard, one of many. This is just not news.

However, to many in the public and even some devout Catholics, the article seemed to show that Pope Francis and possibly the Catholic Church were softening on the issue of abortion.


As Cardinal Chaput of Philadelphia explains simply in an article “Chaput Praises Pope’s Abortion Stance“:

“For many years now, parish priests have been given permission to absolve the sin of abortion here in the Archdiocese of Philadelphia,” Chaput said in the statement. “But the practice has not been common in various other regions of the world.” (emphasis added)

Chaput added: “This action in no way diminishes the moral gravity of abortion. What it does do is make access to sacramental forgiveness easier for anyone who seeks it with a truly penitent heart.”

Questions and concerns about excommunication are addressed on pages 67-69 of Project Rachel Ministry: A Post-Abortion Resource Manual for Priests and Project Rachel Ministry Leaders. Here is an excerpt:

It is commonly thought that the Church excommunicates all Catholics who have procured a successful abortion. However, probably in a great many cases, mitigating or extenuating circumstances prevent the individual from incurring  the censure of excommunication. The tragedy of abortion triggers distinct and separate questions regarding the personal responsibility of one who has procured a successful abortion: has a sin been committed? If so, was the commission of that sin such that it also resulted in the incurring of a penalty?


Years ago when I was in home health, I was assigned to “Jane” (not her real name),  an elderly woman  who was dying of  heart disease. The doctor said he was amazed that Jane had lived this long in an assisted living apartment. The home health agency told me that this woman was a very difficult patient who had fired every nurse who saw her. I was told that I was a last resort to try to help her. I could only hope that I would be equal to the challenge.
Sure enough, on my first appointment, Jane was very critical and negative. She seemed immune to positive comments and encouragement.  I recognized that Jane was very troubled and I tried to find out more about her. I discovered that Jane was a widow with few if any friends and a daughter in California who could only visit occasionally.  Jane raged daily against the limitations that her disease caused and the the medical establishment in general.
However, after several visits, Jane slowly softened and even showed a glimmer of a sense of humor. I liked her spirit.

Part of my duties was to measure her swollen abdomen and legs to determine if the diuretic (water pill) was working as intended to lessen the workload on her heart.
Then one day as I was measuring her abdomen, she commented that she looked 9 months pregnant and uncharacteristically started sobbing. She told me that she had had an abortion over 60 years ago before she was married and lost who she assumed was a son. Now she felt God was punishing her by making her look pregnant. Out of shame, Jane had told no one-not even her late husband-about the abortion.
She admitted that she was afraid of dying because she knew she would then have to go to hell because she had committed the “unforgivable sin” of abortion. I was stunned.
I reassured her that there was no such thing as an “unforgivable sin” and that God is all-merciful. I also told her about Project Rachel, how I could help her contact them, and that she deserved the peace of forgiveness from God and especially from herself.

Slowly, her outlook changed and even though she never called Project Rachel (she insisted that our talks and contacting a priest were enough), her spirits lifted. She died peacefully a few days later.
Postscript: I was later told by a priest that he was reluctant to preach about abortion because he realized that some in his parish probably had had an abortion and he didn’t want to cause them more pain and drive them away from church.
I told him Jane’s story and said that if he did not discuss abortion, he was depriving his parish of understanding the damage abortion causes, the help of groups like Project Rachel and the mercy of God’s forgiveness.

I know Jane would be pleased.