Month: January 2016

God Bless the Dedicated Marchers for Life

nancyvalko abortion

This year I was scheduled to go to Washington DC to speak at the Cardinal O’Connor Conference for Life at Georgetown University the day after the annual March for Life commemorating the tragic anniversary of the Roe v. Wade decision and the 58 million lives lost by abortion.

Unfortunately, my flight was cancelled because of the impending snowstorm. However, I did watch the proceedings live on the EWTN network and I salute all of you who marched, especially the hundreds of St. Louis ‘Right-to-Life’ teens who were unfortunately later  trapped in the east coast snow storm! See their story at http://fox2now.com/2016/01/22/hundreds-of-st-louis-right-to-life-teens-trapped-in-east-coast-snow-storm/

 

 

“Good” News about Dying in America?

nancyvalko assisted suicide, conscience rights, euthanasia, medical ethics

This month Medscape, a subscription news service for medical professionals, published the article “Good News about Dying in America” by Dr. George Lundberg. Dr. Lundberg is the former editor of the Journal of the American Medical Association (JAMA)  and editor-at-large of Medscape itself as well as a member of the Institute of Medicine of the National Academies.

But the title “Good News about Dying in America” is ironic because this article is really a homage to the pro-death movement. In the article, Dr. Lundberg approvingly chronicles a recent history of the “right to die” movement in the US including the rise of legalized physician-assisted suicide and his part in it.

Although he writes that he is not looking forward to his own death, he maintains that

To accomplish medical and cultural change, one needs to work at the levels of moral beliefs and ethical standards with professional and individual leadership.Subsequent changes in state and federal laws and regulations may be needed. Economic drivers can move it along. But first, you have to get their attention.” (Emphasis added)

Dr. Lundberg congratulates himself for getting this attention started by publishing the anonymous 1988 JAMA article “It’s Over Debbie”  which Lundberg claims is a “factual tale of a caring physician using intravenous morphine to end the horrid pain-wracked life of a young woman with terminal ovarian cancer.”

However, when you read this short article, you read about a doctor in training who, under the cloak of anonymity, writes about being on call at a hospital and awakened in the middle of the night to see a patient he had never met before. He describes “a 20-year-old girl named Debbie was dying of ovarian cancer. She was having unrelenting vomiting apparently as the result of an alcohol drip administered for sedation.” He writes that her condition was“a cruel mockery of her youth and unfulfilled potential” but that Debbie’s only words to him were “Let’s get this over with”. An older, dark-haired woman staying with Debbie was assumed by the young doctor to be her mother.

Then, in the anonymous doctor’s own words, he writes :

The patient was tired and needed rest. I could not give her health, but I could give her rest. I asked the nurse to draw 20 mg of morphine sulfate into a syringe. Enough, I thought, to do the job. I took the syringe into the room and told the two women I was going to give Debbie something that would let her rest and to say good-bye. (Emphasis added)

After giving Debbie the the lethal overdose, the doctor writes:

I waited for the inevitable next effect of depressing the respiratory drive. With clocklike certainty, within four minutes the breathing rate slowed even more, then became irregular, then ceased. The dark-haired woman stood erect and seemed relieved.

Quite a different story from what Dr. Lundberg  proudly portrays as a caring act. Is the deliberate killing of a newly met patient without request, explanation or actual consent by a doctor in training really part of Dr. Lundberg’s  vision of “(t)he cultural change we need now is to allow death to occur when its time has come and to do so with dignity and without undue pain and suffering for the patient to the greatest extent possible?”

Dr. Lundberg writes further on other “breakthrough” moments in medicalized killing after the “It’s Over Debbie” article:

Next was Dr Timothy Quill and his disclosure in the New England Journal of Medicine in 1991 that he prescribed barbiturates at the request of a leukemia patient to allow her to end her life. Then, beginning in 1990, Dr Jack Kevorkian and his suicide machine assisted in the deaths of more than 100 patients; the right message writ large but by a deeply flawed messenger. (emphasis added)

As a medical professional myself, it is horrifying that such influential medical people not only have embraced the concept that it is acceptable and even compassionate to medically kill people, but now promote it.

And there is a jarring apparent lack of empathy and understanding of the challenges serious illness poses to patients and their families at the end of Dr. Lundberg’s article:

hospitals interested in their patient safety statistics might do well to note that much of what is chalked up as deaths related to medical error is actually occurring with the frail elderly, often in critical care units (CCUs). Many of these patients probably should not be in the CCU anyway. Maybe not even in hospitals. …. Help your safety statistics; let the dying die at home. (Emphasis added)

While Dr. Lundberg’s article is appalling to those of us who refuse to kill our patients or help them kill themselves, it is important for all of us to understand that many of our alleged “experts” are leading us into a cultural as well as medical and legal war over human extermination.

Some Canadian Veterinarians Offer to Teach Doctors about Euthanasia

nancyvalko assisted suicide, euthanasia, medical ethics

In February 2015, the Canadian Supreme Court unanimously voted to legalize physician-assisted suicide.  In September 2015, it was revealed that Canada’s Quebec province was preparing euthanasia kits with lethal injections for distribution to doctors for assisted suicide.

In December, Canada’s National Post published an article titled “‘We can definitely help’: What vets can teach doctors about assisted dying“ that reports:

Before every euthanasia, Dr. Amy Wilson prays things will go smoothly — that her patient will sedate well, that she’ll hit the vein with the catheter on the first try, that there will be no sudden, involuntary spasms or grunts for breath that can be agonizing for owners.
Wilson, like all veterinarians, is trained to put suffering animals to death as humanely as possible. She does it more often than she wishes she had to, but she does it well. Now, as Canada continues to debate the way forward on assisted dying, she and other vets say there is much they can teach doctors about a different kind of animal — humans

One argument long promulgated by assisted suicide/euthanasia proponents is that we should put people out of their misery just as we do for our pets.

However, pets become at risk for many reasons:

According to the American Humane Association, the most common reasons why people relinquish or give away their dogs is because their place of residence does not allow pets (29%), not enough time, divorce/death and behavior issues (10% each). The most common reasons for cats are that they were not allowed in the residence (21%) and allergies (11%).

Many are then taken to animal shelters. About twice as many animals enter shelters as strays compared to the number that are relinquished by their owners but nevertheless about 1/3 each year, approximately 2.7 million animals, are euthanized.

According to the website Petful, pets in animal shelters in the United States are euthanized every year for three major reasons: illness, aggression and overpopulation.

Regarding illness, the website states:

Because most shelters operate on tight budgets, the cost of treating every animal’s illness is impossibly high.Many shelters have veterinarians to prescribe medications and perform exams for sick animals, but the decision to euthanize must still be made sometimes after considering several factors:
•The severity of the illness
•The chance of recovery
•How infectious the disease is
•The cost of treatment
•The length of treatment
•The adoptability of the pet

Do we really want to adopt a veterinary standard that makes it acceptable to euthanize people as well as pets when illnesses are too expensive or  personalities are too difficult or simply when there are too many of them around?

Effects of Euthanasia on Veterinarians

Although the National Post article is generally supportive of veterinarians teaching doctors to perform euthanasia, it does document the emotional distress that can affect even veterinarians who perform euthanasia:

Studies suggest people whose jobs require them to kill animals are at risk of a phenomenon known as PITS – perpetration-induced traumatic stress. Euthanasia was one of the reasons Rothenburger (a veterinarian) chose to leave practice; she now specializes in pathology. When she used to perform euthanasia, “I put this filter on: This was ending suffering. That was the role I had to play. But it often wasn’t easy, and it’s hard to keep your professional persona on when you’re trying not to shake while you’re injecting the medication, or not cry with the owners until you’ve done your job.”

Studies have documented a higher suicide risk among vets than the general population. A 2010 survey by the Canadian Veterinary Medical Association found 19 per cent of those who responded had seriously thought about suicide, half reported experiencing burnout and 27 per cent were taking anti-depressants. Rothenburger belongs to a closed Facebook page called Not One More Vet. “It’s a safe place for vets to talk about things they need to get off their chest,” she says, “like compassion fatigue, and maybe that tough euthanasia.” (Emphasis added)

Many years ago, my adult children and I had to have our beloved cat Callie euthanized because of an inoperable cancer. We decided to stay with Callie throughout the procedure because we wanted to surround her with love until the end. However, the procedure had some unexpected difficulties and we all found the process stressful and incredibly sad.

When we left, I told my children that if anyone ever tried to euthanize me for any reason, they had better stop them.

People are not animals and they must not be treated like animals.

Do We Know Enough About Brain Death?

nancyvalko brain death, medical ethics, organ donation

Just last month, there were two major developments reported on the controversial issue of brain death. One was an article about a lawsuit to revoke the death certificate of Jahi McMath, a California teenager who was declared brain dead 2 years ago but is still alive and apparently showing some signs of improvement.

The other was a December 30, 2015 article in Medscape, a website for medical professionals that requires subscription, titled “Not All Hospital Brain Death Policies Comply With Guidelines” . The article reports on a medical journal study titled “Variability of Brain Death Policies in the United States.”

Jahi McMath

Jahi McMath, a 13-year-old girl, underwent a routine surgery for sleep apnea in December 2013 at a California children’s hospital. That night she started bleeding and eventually her heart stopped. Her heart was restarted and she was placed on a ventilator to stabilize her condition, but soon the doctors declared her brain dead and prepared to remove the ventilator. However, the family insisted that the ventilator be continued, hoping that Jahi might eventually get better.

The doctors disagreed, insisting that Jahi was legally dead by brain death criteria. The parents went to court to keep the doctors from removing her ventilator but after a series of legal battles lasting weeks, a judge eventually gave Jahi’s family permission to transfer her to another facility that would continue the ventilator.

Virtually all the ethicists and other experts contacted by most media outlets condemned the family’s actions as denying the reality of brain death. In a January 10, 2014 USA Today article, ethicist Arthur Caplan, head of the bioethics division at New York University’s Langone Medical Center, criticized the judge’s decision for Jahi’s family, declaring that Jahi’s new doctors are “trying to ventilate and otherwise treat a corpse,” Caplan said. “She is going to start to decompose.”

Now, 2 years after Jahi was declared brain dead, her family is in federal court suing to revoke her death certificate because as their experts contend

“At this time, Jahi does not fulfill California’s statutory definition of death, which requires the irreversible absence of all brain function, because she exhibits hypothalamic function and intermittent responsiveness to verbal commands.”

A future ruling revoking Ms. McMath’s death certificate would be groundbreaking.

“Variability of Brain Death Policies in the United States.”

In this December 28, 2013 Journal of the American Medical Association Neurology article, a study was done of 508 US hospital policies on brain death determination.

Alarmingly, the article states that hospital brain death criteria requirements “are not 100% compliant” even with updated 2010 guidelines by the American Academy of Neurology which require only one examination to determine brain death.

And of the total 508 hospitals, the article states that only

“about a third of policies (33.1%) required specialist expertise in neurology or neurosurgery, but 150 policies had no mention of who could perform the determination. Many policies still allow for more junior physicians to determine brain death, the authors noted.” (Emphasis added)

Also disturbing, the article noted that some policies didn’t require testing of lower brainstem function (required for a finding of irreversible loss of all brain functions) with less than 80% of the policies requiring the absence of a cough reflex. Only 57.2% of hospital brain death policies required that oxygen be given to maintain oxygenation during the critical apnea test to determine if a patient can take breaths off a ventilator, even though low a low oxygen level can lead to more brain damage.

In an effort to reassure, Gene Sung, MD, past-president, Neurocritical Care Society, and director, Division of Neurocritical Care and Stroke at UCLA claims that he

agreed that there have there have been no documented reports of regaining function after a declaration of brain death. “But still, we don’t know for sure; maybe mistakes happened and they weren’t reported,” he said. (Emphasis added)

Actually, there have been multiple reported cases of people regaining at least some function after a brain death declaration such as Zach Dunlap (who fully recovered) as well as Jahi McMath.

If as Dr Greer, the lead author of the study, states “This is one of those diagnoses where we need to be correct 100% of the time”, must we not rigorously examine such cases to determine if or why there was a misdiagnosis to ensure that current brain death guidelines really hold up to scrutiny?

Besides the potential premature loss of lives, our medical integrity is at stake and we medical professionals must prove worthy of the trust society gives us.