Final Federal Conscience Protection Rule Delayed Because of Lawsuits

Last year, I wrote about the new Conscience and Religious Freedom Division established by the Trump administration in the Office for Civil Rights to enforce already existing “federal laws that protect conscience and the free exercise of religion and prohibit coercion and discrimination in health and human services”. The division specifically mentioned “issues such as abortion and assisted suicide in HHS (Health and Human Services)-funded or conducted programs and activities”. The division also included a link to file a conscience or religious freedom complaint “if you feel a health care provider or government agency coerced or discriminated against you (or someone else) unlawfully”.

The rule mandates that institutions receiving federal money be certified that they comply with more than two dozen laws protecting conscience and religious freedom rights.

Despite fierce opposition by groups like Compassion and Choices and Planned Parenthood, HHS announced  on May 2, 2019 that the Final Conscience Rule Protecting Health Care Entities and Individuals  would go into effect July 22, 2019.

However, lawsuits were quickly filed by groups like Americans United for Separation of Church and State and the Center for Reproductive Rights, delaying implementation of the Final Conscience Rule until at least late November. The first lawsuit was filed by San Francisco within hours of the announcement of the Rule.

WHAT IS THE PROBLEM WITH CONSCIENCE RIGHTS?

While Roger Severino, the head of the HHS Office for Civil Rights has said that the Final Rule did not add any new laws but rather strengthened the enforcement of rules already on the books, the San Francisco lawsuit alleged that if San Francisco does not comply with the rule “”it risks losing nearly $1 billion in federal funds that support critical health care services and other vital functions.”

In a press release, San Francisco city attorney Dennis Herrera stated the Final Conscience Rule:

“would have allowed health care professionals to refuse to provide service to patients based on the staffer’s personal beliefs, threatening medical access for women, lesbian, gay, bisexual, and transgender people, and other medically or socially vulnerable populations.”

and that

“Hospitals are no place to put personal beliefs above patient care. Refusing treatment to vulnerable patients should not leave anyone with a clear conscience.”(All emphasis added)

Of course, ethical healthcare professionals respect all patients without bias. The problem is being forced to participate in actions that violate our consciences.

ARE CONSCIENCE AND RELIGIOUS RIGHTS NECESSARY?

Dr. Donna Harrison, director of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) makes the crucial point that:

 “Those who oppose the HHS Conscience Rule demonstrate their clear intention to squeeze out of the medical profession any doctor who still abides by the Hippocratic Oath, and to squelch any opposition to forcing doctors to kill human beings at the beginning and end of life.”

Those of us who are nurses have been especially vulnerable.

As I have written before, I was threatened with termination when I refused to cause a patient’s death by increasing a morphine drip “until he stops breathing”. I know many other nurses who have had similar experiences.

And in 2013, 12 New Jersey nurses who had a long-standing, in-writing agreement exempting them from participating in abortions apart from a medical emergency were nevertheless threatened with termination when the hospital initiated a new mandatory policy to participate in all abortions. These nurses were finally vindicated in court but litigation is time-consuming and expensive.

And even the liberal NPR recently noted the rise in conscience complaints for health care workers since the Division of Conscience and Religious Freedom was established.

Obviously, there is a great need for this conscience rights protection for all healthcare workers. Now there is a way to stand up  to bullying and discrimination so that we can properly care for our patients.

CONCLUSION

A few years ago, a worried student nurse asked if there was any area of nursing where her conscience rights would not be threatened. This was an important question because over the past several decades, new threats to conscience rights have widened from refusing to participate in abortions to other deliberate death decisions like withdrawal of feedings from people with serious brain injuries, VSED (voluntary stopping of eating and drinking), terminal sedation and physician-assisted suicide.

Most recently, the American Nurses Association wrote a draft position paper potentially changing its’ opposition to assisted suicide to neutrality and requiring that nurses must be nonjudgmental in discussing assisted suicide with a patient and even participate if no other willing nurse is available.

As assisted suicide and other such death decisions continue trying to expand, it is more necessary than ever to support ethical healthcare professionals both in law and in practice.

We all need the Conscience Rights Protection rule to ensure that ethical healthcare professionals can continue in their professions and help to restore trust in our healthcare system.

The Last Planned Parenthood Clinic in Missouri Again Evades Closure

My most vivid memory of prayerful witnessing at the Reproductive Health Services Planned Parenthood clinic in St. Louis happened in 1987. I joined a large pro-life group with signs not just decrying abortion but also offering help to women considering abortion.

At that time, I was pushing my 18 month old daughter in a stroller and obeying the instructions to stay on the sidewalk when my daughter suddenly bolted from the stroller and ran across the grass towards the clinic’s door.

I quickly grabbed her and put her back in her stroller, hoping no one from the clinic staff noticed. Even though I am opposed to abortion, I followed the rules.

32 years later, that daughter is firmly pro-life and expecting her second child while that same Planned Parenthood clinic-the last one in Missouri-is getting yet another court-ordered reprieve from closure after the Missouri Department of Health and Senior Services (DHSS) decided not to renew the facility’s license on May 31, 2019. The department cited dozens of serious health and safety violations.

Public records show numerous problems at the clinic including unreported failed abortions, life threatening complications, an illegal abortion at 21 weeks, insufficient supervision of medical residents (students) performing abortions and inaccurate medical records among the many other violations. According to an ABC News report, the DHSS director said “the decision to deny their health department license was based on the fact that of 30 deficiencies found in the department’s review of the clinic, only four have since been addressed by Planned Parenthood”.

Missouri is one of the most pro-life states in the US and Governor Parsons just signed one of the most protective pro-life laws in the nation but, as usual, abortion is usually more about politics than facts.

Planned Parenthood sued Missouri health officials several weeks ago over the licensing dispute and  a judge kept issuing temporary injunctions to keep the abortion clinic open until the judge sent the case to the Administrative Hearing Committee.  On June 28, 2019, that committee’s commissioner  granted Planned Parenthood’s motion for a stay that will allow abortions to continue at least until he hears the case later this year.

PROTECTING ABORTION, IGNORING SAFETY

In 2016 US Supreme Court case  Whole Women’s Health v Hellerstedt, the court overruled the requirements in Texas that abortionists have admitting privileges at a nearby hospital and that abortion clinics have facilities comparable to an ambulatory surgical center. The judges ruled 5-3 that these requirements constituted an undue burden on abortion access and were thus unconstitutional.

Ironically and just two years later , the true life movie “Gosnell: The Trial of America’s Biggest Serial Killer”  was released and opened many eyes. The movie is about the notorious Philadelphia abortionist who ran an outrageously filthy but politically protected abortion clinic and who eventually was convicted of murder. Dr. Gosnell executed late-term unborn babies who survived abortion by callously cutting their spinal cords. In addition, some of the women died, suffered serious complications or contracted diseases from dirty instruments during the 30 years he operated his clinic without penalty from the Pennsylvania Department of Health.

Of course Planned Parenthood is desperate to keep their last abortion clinic in Missouri open but public opinion is apparently turning on abortion “rights” in general, especially after at least 8 states have now stripped away all legal protections for unborn babies and allowing them to be aborted for basically any reason up to birth.

A recent Gallup poll now shows that 60% of Americans want all or most abortions made illegal and  9 state governors have recently signed laws giving even more protections to unborn babies. In addition, a federal appeals court just ruled that the Trump administration can defund Planned Parenthood of almost $60 million dollars in taxpayer funding.

While the well-funded and politically connected Planned Parenthood organization will continue to file lawsuits against even common sense health and safety requirements in states like Missouri, we all must never stop trying to protect both women and their unborn babies!

 

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

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?

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

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 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.

New Study on Progesterone to Prevent Miscarriage Supports Use in Abortion Reversal

Recently, I was talking to a young woman relative who had a miscarriage with her first pregnancy, a successful birth with the second and is now taking progesterone as soon as she found out she was pregnant with her third on the advice of her Natural Family Planning instructor and doctor.

I was a bit perplexed about this until I read the May 28, 2019 National Catholic Register article “New Study Supports Catholic Research on Progesterone in Pregnancy” .

Based on a recent study in the New England Journal of Medicine  titled  “A Randomized Trial of Progesterone in Women with Bleeding in Early Pregnancy”, it was found that those  women taking progesterone supplements during pregnancy had a 15% increase in live births.

This came as no surprise to Teresa Kenney, a women’s health nurse practitioner in Omaha at the Pope Paul VI Institute for the Study of Human Reproduction where being Catholic is not required for services.

Research there has shown progesterone to be “a significant factor in pregnancies who are at risk for miscarriage or premature labor.” She also noted that progesterone is routinely used during the in-vitro fertilization (IVF) process, a process that the Institute does not offer because of moral and ethical concerns.

Dr. Hilgers who founded and directs the Pope Paul VI Institute has been studying progesterone and pregnancy for decades and found that pregnancies that were not normal-for example, those ending in miscarriage, premature labor or other complications-often had lower than normal progesterone levels in the mother’s blood.

Not every miscarriage can be prevented with progesterone in the estimated  10%-25%  of pregnancies that end in miscarriage. Fifty percent of miscarriages happen because the baby has a chromosomal problem and there are other medical problems that can lead to miscarriage.

Dr. Kathleen Raviele, an OB-GYN and former president of the Catholic Medical Association, said that if a woman has undergone a miscarriage – particularly very early in pregnancy – she recommends that her progesterone levels be tested following ovulation during a normal cycle. If numbers are low, she recommends supplementing progesterone.

That is why my relative is now taking progesterone for her expected baby.

According to Nurse Kenney and Dr. Raviele, they use careful timing and only bioidentical progesterone perfectly matching the progesterone made by the woman’s body herself-not the synthetic versions.

ABORTION REVERSAL

As I wrote in my 2018 blog “What You Need to Know About Medical Abortion and Abortion Reversal” , medical 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)

Nurse Kenny replies that:

“It’s frustrating to me that these pro-abortion people are saying that this science is completely bogus, when we have studies like this [Birmingham study] that prove the absolute essential nature of progesterone to support and maintain pregnancy.”

CONCLUSION

I have long been a big supporter of Natural Family Planning and NaPro (Natural Procreative Technology) since I met Dr. Hilgers and visited the Pope Paul VI Institute decades ago.

I have told many women experiencing infertility or multiple miscarriages about these options. I believe it is essential for women to know all the options, risks and benefits when it comes to true reproductive health.

And thanks to this article, I am constantly learning more myself!

 

Missouri Legislature Passes both “Simon’s Law” and the “Missouri Stands for the Unborn Act”

I feel so fortunate to be living in a pro-life state like Missouri!

This month, the Missouri legislature passed both Simon’s Law and the Missouri Stands for the Unborn Act” . Both are expected to be signed soon by Governor Mike Parson.

SIMON’S LAW

When baby Simon Crosier was born with Trisomy 18  and a heart defect in 2010, his parents and brothers fell in love with him despite his life-threatening diagnosis and the medical community’s opinion that Trisomy 18 is “incompatible with life”.

However, just days before three month old Simon was scheduled to see a cardiac surgeon, his parents begged for help at the Catholic hospital treating Simon when his condition started to deteriorate. They were shocked when the staff did not intervene. They did not know that the hospital had made their baby a Do Not Resuscitate and that Simon was given only so-called “comfort feeds” due to a secret futility policy. They had to helplessly watch as Simon died in their arms.

Heartbroken and outraged but determined that this would not happen to another child, the Crosiers went to legislator Bill Kidd who formulated Simon’s Law. After five long years of frustration even getting the bill out of committee, Simon’s Law was finally and unanimously passed in the Missouri legislature and is awaiting Governor Mike Parson’s signature.

The law prohibits “any health care facility or health care professional from instituting a do-not-resuscitate or similar order without the written or oral consent of at least one parent or legal guardian of a non-emancipated minor patient or resident.”

Due to the Crosiers’ selfless efforts to protect children with disabilities like Simon’s by writing the book “I am Not a Syndrome-My Name is Simon” and speaking around the country, now Kansas, Arizona and South Dakota have also passed a Simon’s Law.

And stunningly, as I wrote in my blog “Parent Power”, even doctors have started to wake up: In 2016, Dr. John Lantos wrote an editorial in the Journal of the American Medical Association (JAMA) admitting that withholding life-sustaining treatment from babies with Trisomy 13 and 18 was really a value judgment rather than a medical judgment.

Simon’s Law is truly an act of love.

THE “MISSOURI STANDS FOR THE UNBORN ACT”

Also this month, the Missouri legislature passed the “Missouri Stands For the Unborn Act”., the strongest pro-life bill in Missouri history. Like Simon’s Law, it is also awaiting Governor Mike Parson’s signature.

According to Missouri Right to Life, the legislation will:

  • ban abortion at detection of a heartbeat at 8 weeks, if overturned
  • ban abortion at 14 weeks, if overturned
  • ban abortion at 18 weeks
  • ban abortion when the baby can feel pain
  • require 2nd custodial parent notification
  • require Missouri informed consent requirements for out-of-state abortion referrals
  • increase required malpractice insurance to 3 million dollars
  • increase to 70% of the donation, tax credits for donations to Pregnancy Resource Centers and lift the limit on the amount of the donation
  • ban abortion in Missouri when Roe v. Wade is overturned
  • ban abortion for race, gender and Down Syndrome diagnosis

Legal challenges from groups like Planned Parenthood are expected.

CONCLUSION

Both of these future laws are the result of decades of effort to protect life at all stages.

It’s been a long, difficult road but with the persistence of dedicated pro-life people, we can change not only laws but also hearts and even the culture of our society.

Abortionists and the American College of Obstetricians and Gynecologists (ACOG)

In an ironically titled May 4, 2019 MedPage article Panel: Abortion Providers Are People, Too,  a panel of  “abortion providers” claim that “Doctors (are) a lost voice in abortion political battle, media coverage”.

The panel was held at the American College of Obstetrics and Gynecologists (ACOG) annual meeting and maintained that “Abortion providers are fighting an uphill battle against a societal narrative that has attached so much stigma to the procedure, and trying to regain some of their humanity as people, not just abortion providers.” (Emphasis added)

These doctors cite the “incendiary” coverage of abortion and that the more than 300 pieces of abortion-related state legislation introduced in the first 3 months of 2019 has led to confusion about what they are and aren’t allowed to do.

One woman doctor who said she was once anti-abortion but now performs abortions claimed that she was “doxxed” (harassed when her personal information was revealed online) when she “came out” as an “abortion provider”. She complained that media stories about abortion rarely include references to “maternal care doctors, or physician specializing in maternal-fetal medicine-in other words, the doctors actually performing the procedures.”

Instead she says much of the media coverage is focused on the dangers to the doctors performing abortions and that as a result, “abortion is seen as inherently dangerous“.

Also cited was a recent online survey of 321 abortion providers showed that nearly all of the respondents were women and that 1/5 were not currently doing abortions. The respondents discussed a so-called “false dichotomy” between being pro-choice and pro-child that increases tension for the abortion provider since “59% of women who have an abortion already have children.”

One abortion provider claimed that becoming a parent “reinforced her commitment and passion for her profession” and helped her better bond with her patients, given the stigma of abortion.

“ACOG, PLANNED PARENTHOOD PROUD TO FIGHT FOR WOMEN’S HEALTHCARE”

A second article from the ACOG annual meeting titled “ACOG, Planned Parenthood Proud to Fight for Women’s Healthcare” had the subtitle “Organizations collaborated on Washington advocacy”. Cecile Richards, outgoing president of Planned Parenthood, gave a lecture on the History of Planned Parenthood.

Hal Lawrence, MD, ACOG executive vice president and chief executive officer, praised Planned Parenthood for providing, among other “services”, “300,000 mammograms per year”, even though Planned Parenthood does not do mammograms. Dr. Lawrence also spoke:

“about the hope for the future on a clinical level in the form of telemedicine for women’s healthcare, including medication abortion.

“It’s going to solve our access problem,” he said. “If we don’t use telemedicine, we’ll never solve the access problem because we don’t have enough providers.” (Emphasis added)

CONCLUSION

There are many reasons why there are not “enough” abortionists.

As a nurse, I left the American Nurses Association many years ago because of its’ support for even partial birth abortion, lack of support for real conscience rights and my ultimately futile attempts to change this. I am not alone. I also know many other doctors and nurses who left their national organizations over their support for legalized abortion. It’s an outrage that these national organizations claim to speak for nurses and doctors when just a fraction of us belong or agree with their positions.

Instead, many of us personally work to provide women and their babies the help and support they need regardless of their circumstances. Abortion is not the answer.

In addition, those doctors (and nurses) who perform abortions are also wounded by abortion and in need of our prayers, witness and compassionate outreach as Abby Johnson has shown in her book and movie “Unplanned”.

At the same time, all of us must also continue working tirelessly towards a world where every life is respected and abortion is unthinkable.

Strange Bedfellows: The Psychedelic Movement and Assisted Suicide

Kathryn Tucker is an influential lawyer and director of the pro-assisted suicide organization called the End of Life Liberty Project, described as “the leading advocacy organization using litigation as a tool to expand end-of-life liberty”. Back in January, 2017 I wrote about Ms. Tucker’s criticism of the so-called “safeguards” in assisted suicide laws as “burdens and restrictions”.

Now in a April 12, 2019 article for Chacruna Institute for Psychedelic Plant Medicines  titled “Can the Psychedelic Movement Learn from the Movement for End of Life Liberty?”, Ms. Tucker explains how the effort to legalize the psychedelic drug Psilocybin (better known as “magic mushrooms”) can learn from the techniques of the assisted suicide movement.

Currently, there is an effort in Oregon (the first state to legalize assisted suicide) for a “2020 ballot initiative to legalize psilocybin therapy and a Denver, Colorado (another assisted suicide state) initiative to decriminalize psilocybin use and possession by adults has just now narrowly passed.

WHAT IS PSILOCYBIN (“MAGIC MUSHROOMS”)?

According to the website drugs.com, so-called “magic mushrooms” contain chemical compounds obtained from certain types of dried or fresh mushrooms that are similar to LSD and “abused for their hallucinogenic and euphoric effects”.  Drugs.com also states that:

“The psychological reaction to psilocybin use include visual and auditory hallucinations and an inability to discern fantasy from reality. Panic reactions and psychosis also may occur, particularly if large doses of psilocybin are ingested.” (Emphasis added)

Because of special waivers from the US FDA (Food and Drug Administration), some small studies of cancer patients have shown benefits with small doses for anxiety and depression.

STRATEGIES

Ms. Tucker insists that the 1997 US Supreme Court case Vacco v Quill found a right  “of dying patients having access to as much pain medication as they need to get relief, even if it advances their time of death”.  (Emphasis added) However, Ms. Tucker neglects to mention that the Supreme Court ruled-unanimously-that there was no constitutional right to physician-assisted suicide.

She maintains that:

“Law and medicine already allow dying Oregonians access to controlled substances to eradicate consciousness (palliative sedation) and to advance the time of death (AID) (Aid in Dying, aka physician-assisted suicide). Surely law and medicine ought to allow access to controlled substances to alter and elevate consciousness.” (Emphasis added)

Tellingly Ms. Tucker writes about psychedelics:

“An authorization for medicinal use, allowing sick patients access to this medicine, appears the easiest first step in changing the law. Other medicinal uses are also compelling, including treatment of PTSD and depression. Focusing on medicinal use avoids attacks from those opposed to recreational or social drug use. It opens the door to societal familiarity with, and appreciation of, the benefits of psychedelics; this can lead to future expansion of access outside the medical realm.” (Emphasis added)

Because psychedelic drugs are not legal under current law and would need changes in the federal Controlled Substances Act, Ms. Tucker writes that various state efforts are instead emerging to change their state laws-just as Oregon did with assisted suicide after the 1997 Supreme Court case.

Ms. Tucker writes that one lesson the assisted suicide movement learned was that changing state laws can take multiple efforts. She writes that failed efforts to pass assisted suicide by ballot initiative in California and Washington state led to a tailoring of the text of such initiatives to get it passed by voters.

CHOOSE A STATE THAT ALREADY HAS PHYSICIAN-ASSISTED SUICIDE LAW

Ms Tucker says that using a state that already has an assisted suicide law would be strategic and would emphasize “the need to ensure that eligible patients would be provided with good palliative care to ensure that no patient would choose to precipitate death due to inadequate palliative care.” (Emphasis added)

She suggest that states like Hawaii might be the best test state because it has a unique provision to allow terminally ill patients to access undefined “remedial agents” as well as assisted suicide.

CONCLUSION

We often speak of the “slippery slope” of dangerous proposals that ultimately expand far beyond their initial enactment into law. We must recognize that this “slope” is planned and incremental, as Ms. Tucker makes clear.

With euthanasia, it started in 1938 with multiple failed legalization attempts by the Euthanasia Society of America. The concept finally gained traction after lawyer Luis Kutner’s 1969 law journal article “Due Process of Euthanasia: The Living Will, a Proposal”. After the well-publicized 1976 Karen Quinlan case, “living wills” and the “right to die” then were successfully sold to the public as the right of people to refuse extraordinary medical treatment when they are imminently dying or in a so-called “vegetative state”. Soon afterwards came the idea of legally removing feeding tubes from people who were also seriously brain-injured but not dying. This eventually led to several states legalizing physician-assisted suicide for the terminally ill expected to die within 6 months.

Now we are seeing, as in a (thankfully failed) recent bill in New Mexico,  further attempts to change the definition of terminal illness to expected death in the “forseeable future”,  non-physicians able to prescribe assisted suicide, inclusion of people with mental health disorders, approval by “telemedicine” and no state residency requirement.

As Ms Tucker makes clear in this article, the most important lesson for legalization of any formerly outrageous concept is to never give up.

But never giving up is also a strategy that we in the pro-life movement have already learned.

When Palliative Care goes Horribly Wrong

As I have written before,   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 mistakenly presumed he had a massive stroke and thus was irreparably brain-damaged. I was told at that time that giving and increasing the morphine even though the patient showed no discomfort was merely “comfort care” that would “prevent pain”. I knew it was euthanasia.

I remembered this terrible incident when I read the April 1, 2019 Federalist magazine article “This Belgian Nurse Watched Euthanasia Turn Pain Management Into A Death Prescription”

Belgium has had legalized euthanasia for many years, including organ donation euthanasia and now even minors and psychiatric patients. But Sophie Druenne, a palliative care nurse, reached her breaking point when she had to call a doctor had to come back to give another lethal injection when the patient didn’t die from the first injection. Sophie caught herself laughing at the absurdity of the situation at first but then realized the horror of the situation and began to question Belgium’s so-called social experiment with euthanasia.

What changed Sophie’s opinion was working in Belgium’s integrated palliative care (IPC) system. Palliative care is “medical aid that treats symptoms of a typically serious disease rather than the disease itself, which sometimes cannot be treated or not easily.” However Belgium’s euthanasia framework now includes integrated palliative care in the framework.

As the article states, palliative care used to be defined by the anti-euthanasia beliefs of its founder, Dame Cicely Saunders, a British nurse who developed holistic care for the dying in the 1940s. Dame Saunders believed that “that a patient’s request for euthanasia represented a failure to adequately care for the patient’s spiritual, emotional, and social needs.”

Although Belgium tried to reconcile Dame Cicely Saunders’ standard with its euthanasia laws, Sophie observed that the guiding intention to relieve suffering changed from “first, do no harm” to “first, relieve suffering”. This allowed euthanasia to become an “easy” solution that could effectively nullify even patient consent.

Sophie finally left Belgium to take a position in Paris at a hospital where terminally ill patients are treated with traditional palliative care

THE SITUATION IN THE US

Recently I was giving a talk on assisted suicide/euthanasia when I noticed that a woman in the audience was visibly upset. After I finished, I went over to her to ask if I said something that upset her. She responded that she was a nurse for 30 years and, when I related the story about the morphine overdose I refused to give, she said that she suddenly realized the truth of what was happening in her hospital. She started to cry while I held her hand. She was devastated just like the Belgian nurse.

Palliative care is a wonderful holistic approach to evaluating the patient’s needs beyond just the physical but it must not include causing death.

Unfortunately, a recent Delaware assisted suicide bill  actually tried to define assisted suicide as a palliative care option.

Currently, hospice/palliative care is held up as a good way to combat assisted suicide. However,  Compassion and Choices touts  that “(a) growing number of national and state medical organizations have endorsed or adopted a neutral position regarding medical aid in dying (physician-assisted suicide) as an end-of-life option for mentally capable, terminally ill adults.”

Barbara Coombs Lee, CEO of Compassion and Choices even issued a 2017 “Call to the Palliative Care Community for a Patient-Centered Response to Medical Aid in Dying (aka physician-assisted suicide)” stating that assisted suicide actually “could improve the image and acceptance of palliative care” by taking a position of  “engaged neutrality” that “indicates that it is a professional organization’s obligation to provide its members with the clinical guidelines, information, and tools they need if they choose to support their patients’ requests” for assisted suicide.” (Emphasis added)

Not surprisingly, Compassion and Choices had supported the 2016  “The Palliative Care and Hospice Education and Training Act” (reintroduced this year as HR 647) that would provide millions of dollars in grants or contracts to “increase the number of permanent faculty in palliative care at accredited allopathic and osteopathic medical schools, nursing schools, social work schools, and other programs, including physician assistant education programs, to promote education and research in palliative care and hospice, and to support the development of faculty careers in academic palliative medicine.” (Emphasis added)

Fortunately, a provision was added to forbid federal assistance to any health care item or service causing or assisting death such as assisted suicide. Since then, the Compassion and Choices website has been silent on the Act.

CONCLUSION

Over the years, the public has been told that assisted suicide is a humane answer to emotional and physical suffering at the end of life. But if doctors, nurses and their professional organizations come to agree with this, we all will lose the protection of truly ethical healthcare that rejects causing death as a solution. We must be able to trust that our healthcare system will  give us the care we need and deserve, especially at the end of our lives.

We cannot become like Belgium.