Year: 2023

Pro-Life and Other Resources for Help and Information to Protect Human Life

nancyvalko abortion, adoption, assisted suicide, bereavement, culture, disability, education, futility, grief, law, medical, medical ethics, nursing, pro-life, ventilators/life support

There are many pro-life organizations that can help you or someone you are trying to help find information, referrals and/or other help with crucial decisions about vulnerable lives from conception to death. Here are many of them.

I am personally on the board of two of these organizations: HALO (Healthcare Advocacy and Leadership Organization) and National Association of Pro-life Nurses (NAPN) and have personally worked with many of the organizations on this list.

NATIONAL PRO-LIFE ORGANIZATIONS

The National Right to Life (NRLC) was formed in 1968 and is the largest and oldest pro-life organization in the United States. The mission of NRLC is “to protect and defend the most fundamental right of humankind, the right to life of every innocent human being from the beginning of life to natural death.” They have over 3,000 local chapters, which can be found in all 50 states.

American United for Life -“We strive for the day when all are welcomed throughout life and protected in law.”

American Life League-“Building a Culture of Life”

Charlotte Lozier Institute-“America’s #1 source for science, data, and medical research on the value of human life.”

Students for Life– “Impacting Campuses & Communities”

PRO-LIFE SITE TO HELP BOTH PATIENTS AND FAMILIES NAVIGATE THE HEALTHCARE SYSTEM

HALO (Healthcare Advocacy and Leadership Organization) -“Defending the lives and safety of persons facing the grave consequences of healthcare rationing and unethical practices, especially those at risk of euthanasia and assisted suicide.”

Please visit the Resources section that includes crucial information about “living wills”, ventilators, etc. and “is designed to help YOU navigate the complicated and sometimes perilous healthcare system. “

PRENANCY RESOURCE CENTERS

Carenet-“Acknowledging that every human life begins at conception and is worthy of protection, Care Net offers compassion, hope, and help to anyone considering abortion by presenting them with realistic alternatives and Christ-centered support through our life-affirming network of pregnancy centers, churches, organizations, and individuals. “

Birthright-“Birthright is a non-profit charitable organization that has been providing love and support for over 50 years to women facing unplanned pregnancies” and offers “free non-judgmental support 24/7

Abortion Pill Reversal-“Have you taken the first dose of the abortion pill? Do you regret your decision and wish you could reverse the effects of the abortion pill? We’re here for you!” ” Call our 24/7 Helpline: 1-877-558-0333″

Perinatal Hospice & Palliative Care-Continuing Your Pregnancy -“When Your Baby’s Life Is Expected to Be Brief “

PRO-LIFE MEDICAL AND NURSING ORGANIZATIONS

American Association of Pro-Life Obstetricians and Gynecologists  ~   Its membership is 85% OB/GYNS, about 15% Family Medicine, ER and other physicians who deal with reproductive health. It includes midwives, nurse practitioners, etc. who also deal with reproductive health, including pregnancy care center organizations. Membership helps to keep them abreast of what is happening in reproductive health.

American College of Pediatricians  –  “Pediatricians and Family Medicine physicians who deal in pediatrics, as well as other medical professionals who work in pediatrics.”

Association of American Physicians and Surgeons  -“Physicians of all specialties.”

“Christian Medical and Dental Society  -“Christian physicians of any denomination, and Advanced Practice Clinicians of all specialties.”

National Association of Pro-life Nurses (NAPN)-We care for all lives from conception to the end of life. I encourage all nurses to join and every pro-life person to also visit our Facebook page for more news.

PRO-LIFE GROUPS FOR HELP AFTER ABORTION

Project Rachel – “It’s normal to grieve a pregnancy loss, including the loss of a child by abortion. It can form a hole in one’s heart, a hole so deep that sometimes it seems nothing can fill the emptiness. You are not alone.”

Project Joseph (St. Louis)-“Project Joseph – “a men’s only program through our Abortion Healing Ministry, provides healing and hope to men wounded by abortion.”      

 Elliott Institute was founded in 1988 by Dr. David Reardon, who conducts scientific, evidence-based research on abortion’s effects on women, men, families, and societies. They invest in research, education, and outreach. They are also dedicated to advocacy for women traumatized by abortion and how to provide healing support.

In addition, the Elliott Institute raises awareness about the injustices of coerced and forced abortions, referring to abortion as the “unchoice.”

HELP FOR PEOPLE CONSIDERING SUICIDE

988 Suicide & Crisis Lifeline-“The 988 Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States. We’re committed to improving crisis services and advancing suicide prevention by empowering individuals, advancing professional best practices, and building awareness.”

PRO-LIFE LEGAL GROUPS:

“Center Against Forced Abortions – The Justice Foundation
The Justice Foundation’s “Center Against Forced Abortions” or “CAFA”- “was created to provide educational resources to empower women who are being forced, unduly pressured, or coerced into an unwanted abortion.”

Life Legal Defense Foundation-“Our mission is to give innocent and helpless human beings of any age, particularly babies in the womb, a trained and committed defense against the threat of death, and to support their advocates in the nation’s courtrooms.”

The Alliance Defending Freedom– “ADF is the world’s largest legal organization committed to protecting religious freedom, free speech, the sanctity of life, marriage and family, and parental rights.”

Thomas More Society – “For decades, we’ve passionately championed the causes of everyday individuals confronting remarkable injustices, from the sidewalks and town squares to the Supreme Court.”

American Center for Law and Justice-“Led by Chief Counsel Jay Sekulow, the ACLJ focuses on constitutional and human rights law worldwide. Based in Washington, D.C., with affiliated offices in Israel, Russia, Kenya, France, Pakistan, and Zimbabwe, the ACLJ is pro-life and dedicated to the ideal that religious freedom and freedom of speech are inalienable, God-given rights for all people. The ACLJ engages legal, legislative, and cultural issues by implementing an effective strategy of advocacy, education, and litigation that includes representing clients before the Supreme Court of the United States and international tribunals around the globe.”

DISABILITY GROUPS (some not formally against abortion)

The National Down Syndrome Congress on abortion-“National Down Syndrome Congress (NDSC) has long held that abortion for the sole reason that a fetus has Down syndrome borders on eugenics...We believe a better approach is to require healthcare providers to provide their patients with accurate, up-to-date information about the
realities of having Down syndrome in contemporary America; and, to promote full, meaningful inclusion of all people – with and without disabilities – in every aspect of society.” (Emphasis added)

National Down Syndrome Adoption Network-“Our mission is to ensure that every child born with Down syndrome has the opportunity to grow up in a loving family.”

Prenatal Partners for Life-“We are a group of concerned parents, medical professionals, legal professionals and clergy whose aim is to support, inform and encourage expectant or new parents with a special needs child.”

Simon’s Law -“Simon’s Law says, “NO! No child’s medical chart should have a do not resuscitate order (DNR) and/or the withholding of life sustaining treatments without parental knowledge or consent…No child should be denied life sustaining treatment withheld by a medical professional or insurance provider. Our intent is to make each state a “Simon State” by stopping secret do not resuscitate (DNR) orders!”

Not dead Yet -“is “a national, grassroots disability rights group that opposes legalization of assisted suicide and euthanasia as deadly forms of discrimination.” (Emphasis added)

The Frightening Deterioration of Professional Medical Ethics Regarding Abortion and Assisted Suicide at the AMA and ANA

nancyvalko abortion, assisted suicide, Compassion & Choices, conscience rights, culture, end-of-life, law, medical ethics, nursing, pro-life

ABORTION AND THE AMERICAN MEDICAL ASSOCIATION

When I went to nursing school in 1967, abortion was illegal in the US and so-called “back alley” abortions were universally condemned.

According to a Hopkins Bloomberg Public Health article titled “A Brief History of Abortion in the U.S.”:

“America’s first anti-abortion movement wasn’t driven primarily by moral or religious concerns like it is today. Instead, abortion’s first major foe in the U.S. was physicians on a mission to regulate medicine.” and “Most providers were midwives, many of whom made a good living selling abortifacient plants.” (Emphasis added)

The American Medical Association was established in 1847 and the “AMA was keen to be taken seriously as a gatekeeper of the medical profession, and abortion services made midwives and other irregular practitioners—so-called quacks—an easy target.”

“In 1857, the AMA took aim at unregulated abortion providers with a letter-writing campaign pushing state lawmakers to ban the practice. To make their case, they asserted that there was a medical consensus that life begins at conception, rather than at quickening.“

The campaign succeeded. At least 40 anti-abortion laws went on the books between 1860 and 1880.” (All emphasis added)

And abortion eventually became illegal throughout the US until the 1973 Roe v. Wade Supreme Court decision that legalized most abortions in the US.

FAST FORWARD TO TODAY

In a June 13, 2023 article on Medpage titled “AMA Delegates Make Short Work of Proposals on Abortion” at AMA Delegates Make Short Work of Proposals on Abortion | MedPage Today, Dr Thomas Eppes Jr, MD from Virginia introduced a resolution that asked the AMA to:

 “advocate for availability of the highest standard of neonatal care to [an] aborted fetus born alive at a gestational age of viability,” which occurs at approximately 22 weeks’ gestation. “This position is not to argue the woman’s right to choose … The decision to abort is still between the patient and the physician,” Eppes said. “It does not imply the woman’s responsibility for the fetal life, but this resolution places the burden of care on the physician, who now has to care for two patients once the fetus is viable.” (Emphasis added)

The resolution was opposed by Kavita Arora, MD, of Chapel Hill, North Carolina, a delegate from the American College of Obstetricians and Gynecologists (ACOG) who was speaking on behalf of the ACOG section council and the Specialty and Service societies who said that:

“Our policy should be based on science, it should be based on fact, and it should be based on the best available evidence that honors and upholds the value of the patient-physician relationship and the nuance and complexity of medical care,” and that “It is not a one-size-fits-all approach and should not be based on misinformation or disinformation. I strongly urge you to oppose.” (Emphasis added)

The Dr. Eppes’ resolution was voted down 476-106 and the council moved on to reimbursement matters.

ASSISTED SUICIDE AND THE AMA

A May 1, 2023, article by Dallas R. Lawry, DNP, FNP-C, AOCNP® from the University of California, San Diego in the Journal of the Advanced Practitioner in Oncology titled “Rethinking Medical Aid in Dying: What Does It Mean to ‘Do No Harm?’” at Rethinking Medical Aid in Dying: What Does It Mean to ‘Do No Harm?’ – PMC (nih.gov) reveals that:

“Until 2019, the American Medical Association (AMA) maintained that MAID (medical aid in dying aka assisted suicide) was incompatible with their code of ethics and a physician’s responsibility to heal (AMA, 2022)“.

 But now, the AMA Medical Code of Ethics now has two provisions that support both positions on MAID, including: “Physicians who participate in MAID are adhering to their professional, ethical obligations as are physicians who decline to participate” (AMA, 2019, 2022; Compassion & Choices, 2022) (Emphasis added)

ABORTION AND THE ANA (American Nurses Association)

When I graduated nursing school in 1969, abortion was still a criminal act and no one expected the 1973 Roe v. Wade decision legalizing most abortions.

In 2022, the ANA publish a position statement fully supporting “respect for a person’s reproductive choices; sex education; access to contraception; access to abortion care; ensuring equity in reproductive health, access, and care delivery; and matters of conscience for nurses in SRH (sexual and reproductive health)”.

So it was not surprising that several national nursing associations condemned the US Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision overturning the 1973 Roe v Wade decision and returning regulating abortion to the states and the ANA wrote in its  official statement that:

“the “U.S. Supreme Court’s decision to overturn Roe vs. Wade is a serious setback for reproductive health and human rights” and that “”(n)urses have an ethical obligation to safeguard the right to privacy for individuals, families, and communities, allowing for decision making that is based on full information without coercion.” (All emphasis added)

ASSISTED SUICIDE AND THE ANA

In 1995, the American Nurses Association stated:

“The American Nurses Association (ANA) believes that the nurse should not participate in assisted suicide. Such an act is in violation of the Code for Nurses with Interpretive Statements (Code for Nurses) and the ethical traditions of the profession. “ (Emphasis added)

In 2017, the ANA revised in position on VSED (voluntary stopping of eating and drinking) “with the intention of hastening death”.

In 2019, the American Nurses Association revised their position on assisted suicide titled “The Nurse’s Role When a Patient Requests Medical Aid in Dying”, stating that nurses:

“• Remain objective when discussing end-of-life options with patients who are exploring medical aid in dying.

• Have an ethical duty to be knowledgeable about this evolving issue.

• Be aware of their personal values regarding medical aid in dying and how these values might affect the patient-nurse relationship.

• Have the right to conscientiously object to being involved in the aid in dying process. (But “Conscience-based refusals to participate exclude personal preference, prejudice, bias, convenience, or arbitrariness”)

• Never “abandon or refuse to provide comfort and safety measures to the patient” who has chosen medical aid in dying (Ersek, 2004, p. 55). Nurses who work in jurisdictions where medical aid in dying is legal have an obligation to inform their employers that they would predictively exercise a conscience-based objection so that appropriate assignments could be made” (All emphasis added)

But while the ANA is states that “It is a strict legal and ethical prohibition that a nurse may not administer the medication that causes the patient’s death“, it is silent when some states with assisted suicide laws like Washington state’s where Governor Jay Inslee signed a new expansion to the law in April 2023 to “allow physician assistants and advanced nurse practitioners to be one of the medical providers who sign off on the procedure”, “eliminates a two-day waiting period for prescribing the drugs” and “allow the necessary drugs to be mailed to patients instead of picked up in person”. (Emphasis added) https://www.axios.com/2023/04/24/washington-death-with-dignity-law

Most recently on June 2, 2023 in Hawaii, Gov. Josh Green (D), a physician, signed a bill that “allows qualified advanced practice registered nurses (APRNs) the authority as attending and consulting healthcare providers to evaluate and confirm a patient’s eligibility and to prescribe medical aid in dying medications.“ (Emphasis added)

CONCLUSION

Because there are now many state and national medical professional organizations that support assisted suicide, , abortion and other problematic ethical issues, the discouraging effect on idealistic people considering or remaining in a health care career may be devastating to our most vulnerable people and indeed to our healthcare system itself.

But, as I will write in a future blog, there is hope, alternatives and resources that everyone needs to know to protect themselves and their loved ones as well as other vulnerable lives.

What are QALYS and Why Should We Care?

nancyvalko assisted suicide, culture, dementia, end-of-life, euthanasia, family, food and water, futility, hospice, law, medical ethics, VSED

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Planned Parenthood Sues Kansas to Challenge a New State Law Requiring Abortion Reversal Information to be Provided Before Abortion

nancyvalko abortion, culture, education, law, medical ethics, nursing

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Statement of the National Association Of Pro-Life Nurses against the Potential Revision of the Uniform Determination of Death Act (UDDA)

nancyvalko brain death, conscience rights, end-of-life, law, medical ethics, nursing

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Journal of Neurotrauma Paper on Withdrawal of Treatment in Severe Traumatic Brain Injury

nancyvalko advance directives, brain injury, disability, futility, Living wills, medical ethics, pro-life, Simon's Law, ventilators/life support

Just before Drs. Jennet and Plum invented the term “persistent vegetative state” in 1972,  I started working with many comatose patients as a young ICU nurse. Despite the skepticism of my colleagues, I talked to these patients as if they were awake because I believed it was worth doing, especially if it is true that hearing is the last sense to go. And why not do it to respect the patient as a person?

Then one day a 17 year old young man I will call “Mike” was admitted to our ICU in a coma and on a ventilator after a horrific car accident. The neurosurgeon who examined him predicted he would be dead by morning or become a “vegetable.” The doctor recommended that he not be resuscitated if his heart stopped.

But “Mike” didn’t die and almost 2 years later returned to our ICU fully recovered and told us that he would only respond to me at first and refused to respond to the doctor because he was angry when heard the doctor call him a “vegetable” when the doctor assumed ‘Mike” was comatose!

After that, every nurse was told to treat all our coma patients as if they were fully awake. We were rewarded when several other coma patients later woke up.

Over the years, I’ve written about several other patients like “Jack”, “Katie” and “Chris” in comas or “persistent vegetative states” who regained full or some consciousness with verbal and physical stimulation. I have also recommended Jane Hoyt’s wonderful 1994 pamphlet “A Gentle Approach-Interacting with a Person who is Semi-Conscious  or Presumed in Coma” to help families and others stimulate consciousness. Personally, I have only seen one person who did not improve from the so-called “vegetative” state during the approximately two years I saw him

Since then, I have written several blogs on unexpected recoveries from severe brain injuries, most recently the 2018 blog “Medical Experts Now Agree that Severely Brain-injured Patients are Often Misdiagnosed and May Recover” and my 2020 blog “Surprising New Test for Predicting Recovery after Coma

However, there is now a new article in the Journal of Neurotrauma titled “Prognostication and Goals of Care Decisions in Severe Traumatic Brain Injury: A Survey of The Seattle International Severe Traumatic Brain Injury Consensus Conference Working Group” about a panel of 42 physicians and surgeons recognized for their expertise of traumatic brain injury that states:

“Overall, panelists felt that it would be beneficial for physicians to improve consensus on what constitutes an acceptable neurological outcome and what chance of achieving that outcome is acceptable. “Over 50% of panelists felt that if it was certain to be enduring, a vegetative state or lower severe disability would justify a withdrawal of care decision.” (Emphasis added)

In addition:

“92.7% of respondents somewhat or strongly agreed that there is a lack of consensus among physicians as to what constitutes a good or bad neurological outcome (Fig. 3A). Similarly, 95.1% of respondents somewhat or strongly agreed that there is a lack of consensus among physicians as to what constitutes an acceptable chance of achieving a good neurological outcome.” (All emphasis added)

RESPONSIBILITY FOR WITHDRAWAL OF CARE DECISIONS

As the article states:

“Although many would report that decision making following devastating TBI is the responsibility of well-informed substitute decision makers familiar with the wishes of a patient,12,25 our survey confirms that the relationship between clinicians and decision makers is complex. As our panelists recognize the marked influence that physicians have on aggressiveness of care, it would seem that in many cases physicians are actually the decision makers and that substitute decision makers are limited by the perceptions (communicated to them. (Emphasis added)

CONCLUSION

Legally, the issue of who makes the decision when treatment or care can be withdrawn as “medically futile” varies.

Often ethics committees are called in to review a situation. Sometimes, as in the Simon Crosier case, families can be unaware that treatment is being withdrawn.

For years, Texas has had a controversial “futile care” law that allows treatment to be withdrawn with the patient or family having only 10 days to find another facility willing to provide care. This was challenged in court and was successful in the Baby Tinslee Lewis’ case . Tinslee eventually went home.

Now a new bill H B3162 has passed in the Texas legislature and is headed to the Governor to be signed and Texas Right to Life states that:

“HB 3162 modifies several aspects of the Texas Advance Directives Act, including the 10-Day Rule. The bill by Representative Klick offers more protections to patients, such as:

  • Requiring the hospital to perform a procedure necessary to facilitate a transfer before the countdown may begin, 
  • Specifying that the process cannot be imposed on competent patients, 
  • Prohibiting decisions from being based on perceived “quality of life” judgments, and 
  • Giving the family more notice of the ethics committee meeting and more days to secure a transfer.”

Every state should consider having such protections for vulnerable patients and their families.

Is Donation after Circulatory Death a “Game Changer” for Heart Transplant?

nancyvalko assisted suicide, brain death, brain injury, culture, disability, end-of-life, euthanasia, futility, law, medical ethics, organ donation, suicide, ventilators/life support

In 2002, I wrote a paper titled “Ethical Implications of Non-Heart-Beating Organ Donation” (NHBD) and presented it at Trinity College at a medical ethics conference. At that time, brain death organ donation was well-known, but NHBD was virtually unknown to the public although it comprised about 2% of organ donations at that time.

As I wrote then:

“It is now apparent that the number of organs from people declared brain dead will never be enough to treat all patients who need new organs. ” and “doctors and ethicists have turned to a new source of organs — patients who are not brain dead but who are on ventilators and considered “hopeless”. In these patients, the ventilator is withdrawn and organs are quickly taken when cardiac death (DCD) rather than brain death is pronounced.”

Now, the term “Donation after Circulatory Death” (DCD) is used instead and means:

“Circulatory death occurs when the heart has irreversibly stopped beating and when circulation and oxygenation to the tissues irreversibly stops.” (Emphasis added)

However, with heart transplantation, the heart will be restarted as explained in a March 24, 2023 Medscape article “A ‘Game Changer’ for Heart Transplant: Donation After Circulatory Death Explained”.

In the article, Adam D. DeVore, MD, MHS is interviewed by Ileana L. Piña, MD, MPH and explains how this works and why he is excited:

“Adam D. DeVore, MD, MHS: In the field of heart transplant, DCD or donation after circulatory death is really a game changer. For decades now, we’ve been doing heart transplants from donors who die or have been declared brain dead.

There’s a whole population of potential donors who have very similar neurologic injuries — they’re just not technically declared brain dead — whose organs the family would like to donate. We didn’t have a way before.”

“There are two mechanisms. The family would withdraw care. Somebody affiliated with the hospital would declare that the donor has died. There’s usually a standoff period. That is a little variable, but it’s around 5 minutes.” (All emphasis added)

and added that then:

“…There are then two ways where that heart could be resuscitated or revived, outside the body on the organ care system. Or it could remain in the body through normothermic regional perfusion (NRP), or they’ll go on cardiopulmonary bypass and re-perfuse the heart in the room, and then look at the heart and try to evaluate it before donation. The rest of that donation looks just like every other brain-dead donation.”

…I remember when we were first starting this, I was thinking of how we would explain this to potential recipients and what would this look like. It turns out that something terrible has happened, and families that want to donate organs are relatively enthusiastic and less focused on the details.” (All emphasis added)

ETHICAL CONCERNS

In another March 23, 2023 Medscape article titled “Does New Heart Transplant Method Challenge Definition of Death?, Sue Hughes, a journalist on Medscape Neurology, writes:

“The difficulty with this approach, however, is that because the heart has been stopped, it has been deprived of oxygen, potentially causing injury. While DCD has been practiced for several years to retrieve organs such as the kidney, liver, lungs, and pancreas, the heart is more difficult as it is more susceptible to oxygen deprivation. And for the heart to be assessed for transplant suitability, it should ideally be beating, so it has to be reperfused and restarted quickly after death has been declared.” (Emphasis added)

When the NRP technique was first used in the US, these ethical questions were raised by several groups, including the American College of Physicians (ACP).

“The difficulty with this approach, however, is that because the heart has been stopped, it has been deprived of oxygen, potentially causing injury. While DCD has been practiced for several years to retrieve organs such as the kidney, liver, lungs, and pancreas, the heart is more difficult as it is more susceptible to oxygen deprivation. And for the heart to be assessed for transplant suitability, it should ideally be beating, so it has to be reperfused and restarted quickly after death has been declared.” (Emphasis added)

Harry Peled, MD, Providence St Jude Medical Center, Fullerton, California, co-author of a recent Viewpoint on the issue said that:

“There are two ethical problems with NRP, he said. The first is whether by restarting the circulation, the NRP process violates the US definition of death, and retrieval of organs would therefore violate the dead donor rule.

“American law states that death is the irreversible cessation of brain function or of circulatory function. But with NRP, the circulation is artificially restored, so the cessation of circulatory function is not irreversible,” Peled points out.

The second ethical problem with NRP is concern about whether, during the process, there would be any circulation to the brain, and if so, would this be enough to restore some brain function? Before NRP is started, the main arch vessel arteries to the head are clamped to prevent flow to the brain, but there are worries that some blood flow may still be possible through small collateral vessels.” (Emphasis added)

Nader Moazami, MD, professor of cardiovascular surgery, NYU Langone Health, New York City, is one of the more vocal proponents of NRP, stating that:

“”Our position is that death has already been declared based on the lack of circulatory function for over 5 minutes and this has been with the full agreement of the family, knowing that the patient has no chance of a meaningful life. No one is thinking of trying to resuscitate the patient. It has already been established that any future efforts to resuscitate are futile. In this case, we are not resuscitating the patient by restarting the circulation. It is just regional perfusion of the organs.” and “We are arguing that the patient has already been declared dead as they have a circulatory death. You cannot die twice.” (Emphasis added)

CONCLUSION

Ms. Hughes also wrote in her article that:

“Heart transplantation after circulatory death has now become a routine part of the transplant program in many countries, including the United States, Spain, Belgium, the Netherlands, and Austria.”

And in the US, “348 DCD heart transplants were performed in 2022, with numbers expected to reach 700 to 800 this year as more centers come online.” And “It is expected that most countries with heart transplant programs will follow suit and the number of donor hearts will increase by up to 30% worldwide because of DCD. ”

So how important is it to have strict medical ethics standards in organ donations?

In a February 9, 2023 Transplant International article titled “Organ Donation After Euthanasia in Patients Suffering From Psychiatric Disorders: 10-Years of Preliminary Experiences in the Netherlands“, it was reported that:

“Over the ten-year study period 2012–2021 59,546 patients underwent euthanasia of whom 58,912 suffered from a somatic (physical) disorder. The number of patients that underwent euthanasia for an underlying psychiatric disorder was 634 (1.1%). An estimated 10% (5955) of patients who undergo euthanasia in general are medically eligible to donate one or more organs (11).” (Emphasis added)

Organ transplants can be wonderful and lifesaving, but we must know all the facts, be able to trust our healthcare providers, and especially not allow the “slippery slope” of legalized assisted suicide/euthanasia to get any steeper.

Potentially Lethal Problems with the Uniform Determination of Death (UDDA) and Its Proposed Revision

nancyvalko brain death, law, medical ethics, organ donation, ventilators/life support

In a December, 2022 Wall Street Journal article “Doctors and Lawyers Debate Meaning of Death as Families Challenge Practices-Changing the determination of brain death potentially affects organ donation”, law and ethics Professor Thaddeus Pope stated that:

“Without brain death, most of the U.S. organ transplant system goes away,” (Emphasis added)

Ironically and on March 16, 2023, the Wilkes Journal-Patriot newspaper in North Carolina published an article “‘Clinically dead’ pastor recovering about Ryan Marlow, a father of three young children who was pronounced *“clinically deceased” and brain dead” after “a severe case of Listeriosis impacted Ryan’s neurological system, causing abscesses on his brain stem and leaving him in a deep coma” in August, 2022. 

“The hospital recorded his time of death but he remained on life support to keep his organs live before removing them since he was an organ donor.” The wife insisted on further testing and that showed he had blood flow to his brain.

According to the news article, “On Oct. 6, 2022, he awoke from a coma by indicating yes to a simple question from a therapist”,  Ryan is now home and making more progress with rehab.

MY JOURNEY TO DISCOVER THE FACTS ABOUT BRAIN DEATH

Back in the early 1970s when I was a young intensive care unit nurse, no one questioned the new innovation of brain death organ transplantation. We trusted the experts.

However, as the doctors diagnosed brain death in our unit and I cared for these patients until their organs were harvested, I started to ask questions. For example, doctors assured us that these patients would die anyway within two weeks even if the ventilator to support breathing was continued, but no studies were cited. I also asked if we were making a brain-injured patient worse by removing the ventilator for several minutes for the apnea test to see if he or she would breathe since we knew that brain cells start to die when breathing stops for more than a few minutes.

I was told not to worry because greater minds than mine had it all figured out.

It was years before I realized that these doctors did not have the answers to my concerns either. After more investigation, I found that my questions were valid.

I also discovered that some mothers declared “brain dead” were able to gestate their babies for weeks or months to a successful delivery and that there were cases of “brain dead” people who lived for months or years.

In my 2021 blog “Rethinking Brain Death and Organ Donation“, I wrote:

“I have been writing for many years about the implications of brain death, the lesser known “donation after cardiac/circulatory death”, diagnosed brain death cases like the supposedly “impossible” prolonged survival and maturation of Jahi McMath, and the unexpected recoveries like Zack Dunlap’s.

Last August, I wrote about the World Brain Death Project and the effort to establish a worldwide consensus on brain death criteria and testing to develop the “minimum clinical standards for determination of brain death”. (Emphasis added)

I also wrote about the current effort “to revise the (US) Uniform Determination of Death Act (UDDA) to assure a consistent nationwide approach to consent for brain death testing” that could otherwise lead to a situation where ”a patient might be legally dead in Nevada, New York, or Virginia (where consent is not required). But that same patient might not be legally dead in California, Kansas, or Montana (where consent is required and might be refused)”. (All emphasis added)”

In 2021, 107 experts in medicine, bioethics, philosophy, and law, are challenging the proposed revisions to the UDDA. While they admit that they “do not necessarily agree with each other on all aspects of the brain-death debate or on fundamental ethical principles”, they do object to three aspects of the revision to:

“(1) specify the Guidelines (the adult and pediatric diagnostic guidelines) as the legally recognized “medical standard,” (2) to exclude hypothalamic function from the category of “brain function,” and (3) to authorize physicians to conduct an apnea test without consent and even over a proxy’s objection.” (All emphasis added)

These experts’ objections to those proposed revisions are that:

” (1) the Guidelines have a non-negligible risk of false-positive error, (2) hypothalamic function (a small but essential part of the brain helps control the pituitary gland and regulates many body functions) is more relevant to the organism as a whole than any brainstem reflex, and (3) the apnea test carries a risk of precipitating BD (brain death) in a non-BD patient….provides no benefit to the patient, does not reliably accomplish its intended purpose”… and “should at the very least require informed consent, as do many procedures that are much more beneficial and less risky.” (All emphasis added)

And these experts further state that:

“People have a right to not have a concept of death that experts vigorously debate imposed upon them against their judgment and conscience; any revision of the UDDA should therefore contain an opt-out clause for those who accept only a circulatory-respiratory criterion.”

AUTOMATED ORGAN DONOR REFERRAL

In the January 2023 United Network for Organ Sharing (UNOS) document “Actions to strengthen the U.S. organ donation and transplant system” has several suggestions such as:

“Seek authorization for the OPTN (Organ Procurement and Transplantation Network) to collect or receive data on ICU deaths for patients under age 70 for faster and more accurate monitoring of organ procurement organization (OPO) performance”

and

“The OPTN will continue to advocate for a national investment in the automation of donor referral” that “would ensure every
potential donor is referred every time. Every hospital with the ability to ventilate patients would need to participate, a requirement that is beyond the authority of UNOS or the OPTN. Automated donor referral would be a significant innovation. Our nation has the technology to automate this important step, but it will not occur without a national commitment.” (All emphasis added)

CONCLUSION

Many years ago, I served on a hospital ethics committee when a doctor complained that he could not arrange an organ transplantation from an elderly woman in a coma caused by a stroke because she “failed” one of the hospital’s mandated tests for brain death. He said he felt like he was “burying two good kidneys”.

Although I already knew that the medical criteria used to determine brain death vary — often widely — from one hospital to another, one young doctor checked our area hospitals and came back elated after he found a hospital that did not include the test the elderly woman “failed”. He suggested that our hospital adopt the other hospital’s criteria to allow more organ donations.

When I pointed out that the public could lose trust in the ethics of organ donations if they knew we would change our rules just to get more organ transplants, I was told that I being hard-hearted to people who desperately needed such organs.

Unfortunately, now some countries’ healthcare ethics have degenerated to the point where euthanasia by organ donation is legally allowed.

Personally, I am all for the ethical donation of organs and tissues. Years ago, I volunteered to donate a kidney to a friend and one of our grandsons was saved in 2013 by an adult stem cell transplant.

But I do not have an organ donor card nor encourage others to sign one because I believe that standard organ donor cards give too little information for truly informed consent. Instead, my family knows that I am willing to donate tissues like corneas, skin and bones that can be ethically donated after natural death and will only agree to that donation.

The bottom line is that what we don’t know-or allowed to know-can indeed hurt us, especially when it comes to organ donation. We need to demand transparency and accurate information for truly informed consent as well as conscience rights because good medical ethics are the foundation of a trustworthy healthcare system.

A New Medically Assisted Suicide Organization Arises

nancyvalko assisted suicide, Canada, end-of-life, hospice, law, medical ethics, nursing, palliative care

In my June, 2016 blog “Tolerating Evil” at , I wrote:

“(A) few days after California’s new assisted suicide law took effect,  one doctor immediately opened up a dedicated assisted suicide clinic in San Francisco.

Dr. Lonnie Shavelson, 64 and a long-time supporter of physician-assisted suicide, was an emergency room doctor for 29 year and then spend 7 years at an Oakland clinic for immigrants and refugees before taking a 2 year break.

His new assisted suicide business could be quite lucrative. Although Medicare will not pay for assisted suicide costs, Shavelson says he will charge $200 for an initial patient evaluation. If the patient is deemed qualified under California law, Shavelson said he would charge another $1800 for more visits, evaluations and legal forms. (Emphasis added)

Shavelson defends his business by claiming that “..the demand (for assisted suicide) is so high, that the only compassionate thing to do would be to bring it above ground and regulate it.”

Now, a new medical group called American Clinicians Academy on Medical Aid in Dying  has been formed with a Board of Directors and Advisors and chaired by the same Dr. Lonnie Shavelson.

The board of this organization includes a Nursing Coordinator, Director of End-of-Life Doula Education, a Volunteer Systems Advisor, as well as Hospice and Palliative Care Advisors including chaplains, nurses and social workers. There is also an “Aid in Dying Ethics Consultation Service”, ethicist, lawyer and pharmacists. An Investigations and Data Collection group is also included as well as State Liaisons in various states.

Also included is Resident Training and Education, Patient Liaisons and Volunteers, Chaplains and End-of-Life  Spiritual Advisors, a legal advisor/ethicist, and a member of the San Francisco/Marin Medical Society with a Master’s in Public Health degree.

The American Clinicians Academy on Medical Aid along with the older Death with Dignity organization just had their second conference February 17-18 in Portland Oregon and provided “13 continuing education units for doctors and nurses” and 10 for social workers.

The conference included presentations like “ Some Myths about Aid in Dying”, “State Differences — Present and Future Legal Considerations”, “Hospices and Aid in Dying — A land of many journeys”, “Prognostic Dilemmas in Aid in Dying”, “Medical Aid in Dying for ALS: Navigating Complexities from Prognosis to Ingestion” and “Clinician Attendance on the Aid-in-Dying day — Doctors, nurses, volunteers, end-of-life doulas, hospice staff” and “Socially-Challenging Settings and Circumstances — homeless and impoverished; family conflicts; skilled nursing and long-term care facilities” and “Medically Challenging Cases: Complex gut function; Self-administration by oral, rectal, PEG and ostomy routes” presented by Dr. Shavelson himself. (All emphasis added)

The first National Clinicians Conference on Medical Aid in Dying occurred in 2020 at UC Berkley in California. It was sponsored   by groups like UC Davis Health,  Mission Hospice and Home Care, the San Francisco Marin Medical Society and the Center for Bioethics and Humanities at the University of Colorado that promotes “Research at the Intersection of Bioethics and Policy for Persons with Disability” (emphasis added) among other groups.

Apparently, Compassion and Choice  now has some competition in the relentless campaign to legalize and normalize medically assisted suicide in every US state.

COMPASSION AND CHOICES

Now, Compassion and Choices has a new “Federal Advocacy and Policy-Bringing the voice of the terminally ill to Capitol Hill“ that:

“advances federal legislation and regulatory change focused on:

  • Strengthening and expanding the full spectrum of end-of-life care such as advance care planning, hospice care, and palliative care, while protecting end-of-life options and patient autonomy from federal efforts to weaken or overturn federal and state laws.
  • Addressing disparities in end-of-life care for historically disadvantaged populations and advancing healthcare equity at life’s end.
  • Expanding professional end-of-life care education, training and development for all healthcare professionals.
  • Preventing healthcare entities from disregarding patient values and preferences by refusing care due to their ethical directives and policy-based restrictions. (All emphasis added)”

Compassion and Choices strongly opposes the “Assisted Suicide Funding Restrictions Act (ASFRA) (seeking repeal)” that:

“Prohibits the use of federal funds to provide or pay for any healthcare item or service or health benefit coverage for the purpose of causing, or assisting to cause, the death of any individual.” as well as “Seeking to permanently vacate the proposed rule, “Protecting Statutory Conscience Rights In Health Care (83 FR 3880),” from the U.S. Department of Health and Human Services, which attempted to allow medical providers expanded exemptions from critical healthcare services beyond what the law currently allows.”

Compassion also supports effort to “Establish Comprehensive Telehealth Reform” and also ominously, the Palliative Care and Hospice Education Act (PCHETA)

CONCLUSION

In 2018, I wrote the blog “Beware the New Palliative Care and Hospice Education and Training Act” (PCHETA)” about Senate Bill 693. 

A similar bill had already passed in the House and this Senate bill was also expected.

As I wrote then:

“As an RN with decades of nursing experience in hospice, oncology (cancer) and critical care, I have been involved with many end-of-life situations. I am an enthusiastic supporter of ethical palliative and hospice care which is indeed wonderful for patients of any age and their families.

Unfortunately, there is a growing trend towards calling unethical practices ‘palliative’ or ‘hospice’ care.”

And we certainly should not be allocating federal dollars for this.

But, despite the enormous push for the PCHETA, it never passed.

There was great opposition by American Association of Physicians and Surgeons, the National Association of Pro-life Nurses  , Sara Buscher, a retired attorney and CPA on the board of the Euthanasia Prevention Coalition – USA. who advocates for the elderly and disabled , the Healthcare Advocacy and Leadership Organization (HALO) and others.

Now, Compassion and Choices is working hard again to get PCHETA passed to “ increase the number of faculty at accredited healthcare programs” and “promote increased education and research in Palliative Care and Hospice care.” (All emphasis added)

If groups promoting medically assisted suicide throughout the US are successful in taking over the ethics education of our health care professionals, eliminating conscience rights for healthcare providers and institutions, continue to dismantle so-called legal safeguards called “obstacles” and allow the same poor oversight and documentation found in Oregon, the first state to legalize assisted suicide, we will see the inevitable and inexorable expansion of medically assisted suicide  that we are now seeing in Canada.

We need to demand the highest ethical standards in healthcare to protect ourselves, our healthcare institutions and the most vulnerable among us who need hope and help-not medically assisted suicide.

 

 

“Safer Than Tylenol” is Deliberate Medical Abortion Disinformation

nancyvalko Uncategorized

February 26, 2023 nancyvalko abortion, culture, medical ethics, Planned Parenthood, pro-life

February 23, 2023, the Attorney General of Connecticut issued a press release “Attorney General Tong Sues FDA Over Unlawful, Unnecessary Restrictions on Medication Abortion Drug”, stating that:

“Attorney General William Tong today joined a multistate federal lawsuit against the U.S. Food & Drug Administration (FDA) accusing it of singling out one of the two drugs used for medication abortions for excessively burdensome regulation, despite ample evidence that the drug is safer than Tylenol.” (Emphasis added)

In April, 2021, the Federal Drug Administration (FDA) lifted a requirement for women to have in-person visits with their doctors before receiving medication abortions. and a February 17, 2022 Bloomberg article titled “The Abortion Pill Is Safer Than Tylenol and Almost Impossible to Get” argued for medication abortion pills by mail.

As Dr. Christina Francis, a board-certified OB/GYN and chair of the board of the American Association of Pro-life Obstetricians and Gynecologists (AAPLOG), wrote in a 5/21/2021 article titled “The government’s abortion pill policy puts mothers’ lives at risk-As an OB-GYN, I know that allowing women to access abortion drugs through telemedicine is the wrong move“, stating:

“The medication regime for these abortions has real risks. When Mifepristone,
the first-stage medication in a chemical abortion, was first approved in 2000, it was
only approved with safety regulations in place (later known as REMS) that would
minimize the significant risk of hemorrhage, retained fetal tissue and infection.
These REMS were then relaxed in 2016 by the FDA absent any further safety testing
and despite mounting evidence of significant adverse events and maternal deaths….

For unknown reasons, however, the FDA also made the decision in 2016 to stop
collecting data on nonfatal adverse events related to Mifepristone, instead only
collecting data on maternal fatalities related to the drug. This change ignores the
women who may show up to their local emergency rooms with severe complications
potentially caused by the drug — women whose lives are typically saved not by their
abortionist, but by an on-call physician at the hospital. (Emphasis added)”

And:

One of the most significant reasons why an in-person visit has been required is for
proper medical oversight as well as a physical exam and ultrasound. These visits are
meant to accurately assess the gestational age of a woman’s pregnancy, as well as rule
out ectopic pregnancy, which is life threatening. The difference in size of an 8-weekold and 12-week-old preborn child is significant”

Mifepristone abortions are only approved for use up to 10 weeks gestation because the complication rates increase significantly beyond this stage.

IS THIS JUST PRO-LIFE PROPAGANDA?

The Cleveland Clinic, a respected healthcare institution and NOT pro-life, has a section:

“Who should NOT get a medical abortion?

Medical abortion is not a safe option for those who:

  • Are too far along in the pregnancy.
  • Have a pregnancy outside of the uterus (ectopic pregnancy).
  • Have a blood clotting disorder or significant anemia.
  • Have chronic adrenal failure.
  • Use long-term corticosteroids.
  • Have an intrauterine device (IUD).
  • Have an allergy to the medications used.
  • Do not have access to emergency care.
  • Can’t return for a follow-up visit.

It is important to discuss your medical history with your healthcare provider before a medical abortion procedure.” (Emphasis added)

So, how can abortion pills by mail be safe?

It is also disturbing that now CVS and Walgreens Plan to Offer Abortion Pills Where Abortion Is Legal”. The two chains said they would begin the certification process under a new FDA regulation that will allow retail pharmacies to dispense the prescription pills for the first time.

It is also disturbing that now the two chains said they would begin the certification process under a new FDA regulation that will allow retail pharmacies to dispense the prescription pills for the fist time.

Even worse, the American Pharmacists Association said in a statement that it had urged the FDA “to level the playing field by permitting any pharmacy that chooses to dispense this product to becomes certified.” (Emphasis added)

CONCLUSION

Not surprisingly, unmentioned in these articles is informing the woman about the abortion reversal option that I wrote about in my 3/20/2018 blog titled “What You Need to Know About Medical Abortion and Abortion Reversal”

However, the pro-abortion ACOG (the American College of Obstetricians and Gynecologists) condemns abortion reversal, claiming that “Facts Are Important: Medication Abortion “Reversal” Is Not Supported by Science”, stating that “”So-called abortion “reversal” procedures are unproven and unethical“. They maintain this despite citing a “A 2012 case series reported on six women who took mifepristone and were then administered varying progesterone doses. Four continued their pregnancies. This is not scientific evidence that progesterone resulted in the continuation of those pregnancies.” And the article admits that “A 2020 study intending to evaluate medication abortion reversal in a controlled, IRB-approved setting was ended early due to safety concerns among the participants.” (Emphasis added).

As I wrote in my May, 2019 blog “New Study on Progesterone to Prevent Miscarriage Supports Use in Abortion Reversal“:

“(M)edical abortions can often be reversed by taking progesterone if the mother changes her mind after the first abortion pill to block progesterone is given but she hasn’t yet taken the second pill to expel the baby. There is now a website at www.abortionpillreversal.com for information on abortion reversal that includes a hotline phone number at 1-877-558-0333.

But according to Planned Parenthood :

 “…(only) a handful of states require doctors and nurses to tell their patients about (abortion reversal treatment) before they can provide abortion care. But these claims haven’t been proven in reliable medical studies — nor have they been tested for safety, effectiveness, or the likelihood of side effects — so experts like the American College of Obstetricians and Gynecologists reject these untested supposed treatments.” (Emphasis added)

Why don’t we all deserve to know all the facts and all the options like crisis pregnancy centers and abortion reversal when it comes to abortion instead of relying on a mostly biased media, Planned Parenthood and wealthy, pro-abortion healthcare provider organizations?

As a society, we can’t afford not to know!