Month: June 2019

Press Release: The National Association of Pro-life Nurses comments on recent AMA decision

nancyvalko assisted suicide, conscience rights, medical ethics, nursing, pro-life

The National Association of Pro-life Nurses comments on recent AMA decision

This month, the AMA House of Delegates overwhelmingly approved a strong report from AMA’s Council on Ethical and Judicial Affairs reaffirming current AMA policy on physician-assisted suicide stating that:

“permitting physicians to engage in assisted suicide would ultimately cause more harm than good. Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks. Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life.”

This happened despite the enormous pressure from assisted suicide supporters and groups like Compassion and Choices as well as some other professional associations to change its’ long standing opposition to physician-assisted suicide to “neutrality”.

But this is not just about doctors.

Earlier this year the American Nurses Association (ANA) wrote a draft position paper about also dropping its longstanding opposition to assisted suicide. The ANA draft paper also proposed changing the term “assisted suicide” to ““aid in dying”, requiring that nurses to be “non-judgmental when discussing end of life options with patients”, and that nurses who object to assisted suicide are still “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)

In other words, nurses must abandon their vital role in detecting and preventing suicide for some of their patients when the issue is assisted suicide. This kind of discrimination is not only lethal to the patient but also discourages dedicated, ethical people from entering or remaining in the healthcare professions.  The National Association of Pro-life Nurses strongly opposed the proposal due to conscience concerns raised by it.  The objections can be found on the NAPN website, www.nursesforlife.org.  No formal position has yet been taken.

Although most doctors and nurses are not members of the ANA or AMA, if such organizations capitulate to the pro-assisted suicide groups, legalized assisted suicide throughout the US may be inevitable.

Hopefully, the ANA will follow the AMA example of continued opposition to assisted suicide and begin to restore the public’s trust that we will never kill our patients or help them kill themselves.

Contact

Marianne Linane RN, MS, MA, National Association of Pro-Life Nurses Executive Director

📞  (202) 556-1240
✉  Director@nursesforlife.org

Great News: American Medical Association Votes to Continue Opposition to Physician-assisted Suicide. But Will the American Nurses Association Follow?

nancyvalko assisted suicide, Compassion & Choices, conscience rights, medical ethics, nursing

Over the last few years the American Medical Association (AMA) has been under enormous pressure from assisted suicide supporters and groups like Compassion and Choices as well as some other professional associations to change its’ long standing opposition to physician-assisted suicide to “neutrality”.

This month, the AMA House of Delegates decisively approved a strong report from AMA’s Council on Ethical and Judicial Affairs reaffirming current AMA policy on physician-assisted suicide stating that:

“permitting physicians to engage in assisted suicide would ultimately cause more harm than good. Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks. Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life.”

Dr. Shane Macaulay, MD, of Kirkland, Wash., speaking for the Washington delegation supported the report, stating that:

“Oregon legalized assisted suicide in 1997 with repeated assurances that it would stay contained and would not become euthanasia” (but) “Just last month, the Oregon state House of Representatives approved a bill to allow patient death by lethal injection, showing the inevitable progression from assisted suicide to euthanasia once physicians have accepted the idea that taking a patient’s life is permissible.”

Dr. David Grube, the national medical director of the pro-assisted suicide organization Compassion and Choices, countered that physician-assisted suicide is:

“a rarely-used request from patients, and yet it’s a response we can give to them when they’re suffering. The enemy is not death, but the enemy is terminal suffering; responding to that in ways that provide comfort is what matters the most.”

Ironically, physician-assisted suicide laws themselves do not require that pain or other suffering be present but rather death expected within six months.

In the Compassion and Choices article titled “AMA contradicts itself by passing resolution saying medical aid in dying is unethical, but ethical doctors can practice it”, Dr. Grube further criticizes the decision, saying:

“The report by the AMA Council on Ethical and Judicial Affairs (CEJA) reinterpreted the AMA’s Code of Medical Ethics (CEJA) by maintaining that ‘physician-assisted suicide’ (i.e., medical aid in dying) is ‘fundamentally incompatible with the physician’s role as healer,’ while paradoxically saying physicians can provide medical aid in dying ‘according to the dictates of their conscience without violating their professional obligations.’” (Emphasis added)

However, the report itself concluded that:

“Because Opinion E-5.7O   powerfully expresses the perspective of those who oppose physician-41 assisted suicide, and Opinion E-1.1.7   (on the exercise of conscience) articulates the thoughtful moral basis for those who support assisted suicide, the Council on Ethical and Judicial Affairs recommends that the Code of Medical Ethics not be amended, that Resolutions 15-A-16 and 14-A-17 (on neutrality) not be adopted, and that the remainder of the report be filed.”

As I wrote in my 2016 blog “Neutrality Kills”:

In 1997, 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 the latest physician-assisted suicide law after the California Medical Association changed its opposition to neutrality.

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

BUT THIS IS NOT JUST ABOUT DOCTORS

Earlier this year the American Nurses Association (ANA) wrote a draft position paper  about dropping its longstanding opposition to assisted suicide. The ANA draft paper also proposed changing the term “assisted suicide” to ““aid in dying”, requiring that nurses to be “non-judgmental when discussing end of life options with patients”, and that nurses who object to assisted suicide are still  “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)

In other words, nurses must abandon their vital role in detecting and preventing suicide for some of their patients when it comes to assisted suicide. This kind of discrimination is not only lethal to the patient but also discourages dedicated, ethical people from entering or remaining in the healthcare professions.

Although most doctors and nurses are NOT members of the ANA or AMA, if such organizations capitulate to the pro-assisted suicide groups, legalized assisted suicide throughout the US may be inevitable.

Hopefully, the ANA will follow the AMA example of continued opposition to assisted suicide and begin to restore the public’s trust that we will never kill our patients or help them kill themselves.

 

How Could This Happen? Ohio Doctor Accused of Murder in 25 Patient Overdose Deaths

nancyvalko assisted suicide, Compassion & Choices, euthanasia, medical ethics, palliative care

The shocking June 5, 2019 Associated Press headline read “Doctor accused of murder in 25 patient overdose deaths” and the details were alarming to read.

Dr. William Husel, a critical care physician, “was charged with murder Wednesday in the deaths of 25 hospital patients who, authorities say, were killed with deliberate overdoses of painkillers, many of them administered by other medical workers on his orders” at the Columbus-based Mount Carmel Health System in Ohio, a member of one of the largest Catholic health care delivery systems in the nation.

The Mount Carmel Health System found that Husel “ordered potentially fatal drug doses for 29 patients over several years, including five who may have been given that pain medication when there still was a chance to improve their conditions with treatment. The hospital system said six more patients got doses that were excessive but likely didn’t cause their deaths.”

According to the article “Many of the patients who died were on ventilators and receiving palliative care. The deaths occurred between 2015 and 2018.” Authorities decided not to prosecute the 48 nurses and pharmacists involved, although they were reported to their professional boards.

Dr. Husel pleaded not guilty and his lawyer said that Dr. Husel “was trying to provide ‘comfort care’ for dying patients. At no time did Dr. Husel ever intend to euthanize anyone — euthanize meaning speed up death.”

According to the article, none of the families of the victims who talked with investigators believed that what happened was “mercy treatment”.

In a related February Columbus Dispatch article  “Attorneys say former Mount Carmel doctor might have inappropriately deemed patients brain-dead”, it was also alleged by attorneys for the families that there were several instances where Dr. Husel would prescribe excessive dose of fentanyl shortly after telling family member their loved one was brain dead.

More than 2 dozen wrongful death lawsuits have now been filed against the doctor and  Mount Carmel.

Mount Carmel publicly apologized and said “it should have investigated and taken action sooner. It has acknowledged that the doctor was not removed from patient care for four weeks after the concerns were raised, and three patients died during that time.” (Emphasis added)

HOW COULD THIS HAPPEN?

When I started my career as a nurse in 1969, a situation like this was unthinkable, especially in a Catholic institution like Mount Carmel. But over the years, I saw ethics begin to change for the worse with the so-called “right to die” involving seriously brain-injured but non-dying people who needed feeding tubes. Eventually, the “right to die” became the “right to choose” legalized physician-assisted suicide by lethal overdose for people expected to die within 6 months with immunity granted to the prescribing doctor. Tragically, public and professional attitudes started to change.

Several years ago on a night shift in my intensive care unit, I was involved in a case similar to these 25 alleged murders when I was almost fired for refusing to increase a morphine drip “until he stops breathing” on a patient who continued to breathe after his ventilator was removed. The doctors presumed (mistakenly, as it turned out) that the patient had had a massive stroke and thus was irreparably brain-damaged.

I immediately reported this to the supervisor and a doctor but I was told that giving and increasing the morphine-even though the patient showed no discomfort-was merely “comfort care” that would “prevent pain”. But I knew it was euthanasia. No one supported me but I persisted trying to get a response from the patient after I stopped the morphine to hopefully give him a chance.

I was not surprised when I was later told that the doctor who gave the order wanted me fired. I defended myself and refused to be reprimanded or otherwise punished. I even threatened legal action.

I was relieved when I was not fired but other nurses heard about the incident and recognized the problem. Nurses on one unit began refusing to give what they now saw as lethal overdoses to terminally ill patients and eventually that practice stopped on that unit.

CAN SUCH CASES BE PREVENTED?

In another related March AP article ” 25 nurses cited over high doses for patients who died”, Attorney General Dave Yost, whose office represents the Ohio Board of Nursing in this matter, said that “Nurses who helped administer excessive and possibly fatal painkillers to dozens of Ohio hospital patients should have questioned an intensive-care doctor’s order for those high doses” and was quoted as saying:

“Nurses are professionals who have a duty to exercise their best judgment, and tens of thousands of them do, every single day. These nurses didn’t.”

But is this fair?

In Dr. Husel’s case, remember that Mount Carmel admitted it did not remove him for four weeks after concerns were raised and three more patients died.

I know how hard it is to report a problem with a doctor, especially when you realize that your own career may be at risk as a nurse. I’ve personally seen nurses fired or harassed until they quit when they reported a doctor or a serious problem. Tragically,  I have not yet seen our national or state nurses associations backing up such brave nurses. This is why I support not only strong conscience rights for all health care professionals but also whistle blower protection for the person reporting a problem so they will not lose their job.

It is said that sunlight is the best disinfectant and that is why I tell my story as well as similar stories other nurses have told me. The public has a right to know and be aware of potential problems that can occur when they or their loved ones face a life-threatening illness. They need to know the questions to ask and the actions to take if the answers are not acceptable.

Also, we need to fight against physician-assisted suicide laws and the seductive lie promoted by Compassion and Choices that killing can be “humane” in some circumstances. Terminal illness, disability, fear of being a burden, etc. are never reasons to end someone’s life, even when the person himself or herself asks for the lethal overdose.

Personally, I now always make sure the health care providers for myself or my loved ones share my values.

It’s a matter of safety and trust as well as ethics.