My Oral Submission to the New Zealand Health Committee Regarding Physician-assisted Suicide on March 5, 2017

As a nurse and legal consultant in the USA with 47 years of experience in the most challenging areas of medicine such as critical care, oncology, burn unit and hospice, I have seen many of the most challenging cases in medicine. I also have professional and personal experience with suicidal people, including my own 30 year old daughter Marie who died using an assisted suicide technique that she found searching the internet and after a 16 year struggle with drug addiction. I have worked with many suicidal people, including some with terminal illness. To my knowledge, my daughter was the only one lost to suicide.

I have previously submitted written testimony about physician-assisted suicide and I would like to follow up with two crucial issues that I feel must be addressed.

First I will discuss how physician-assisted suicide empowers doctors, not patients. Second, I’ll share a nurse’s perspective.

1. Physician-assisted suicide empowers doctors, not patients.

Society has long insisted that health care professionals adhere to the highest standards of ethics as a form of protection for society. The vulnerability of a sick person and the inability of society to monitor every health care decision or action are powerful motivators to enforce such standards.

However in physician-assisted suicide, unlike any other medical intervention, any licensed doctor of any experience or specialty is granted immunity from “civil or criminal liability or professional disciplinary action for participating in good faith compliance “with an assisted suicide law[1].  The doctor or doctors involved are the ones to decide whether or not the patient is eligible, not the patient.

All the doctor is required to do is fill out a prescription and state forms. The usual standards for caring for a suicidal person including  intensive management[2]  are changed in physician-assisted suicide to “If, in the opinion of the attending physician or the consulting physician, a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, either physician shall refer the patient for counseling.”[3] (Emphasis added). Not surprisingly, only 3.8% of people using physician-assisted suicide in Oregon were referred for psychiatric evaluation in 2016[4].

This is dangerous medical discrimination in treatment standards for suicidal people.

In addition, since the doctor is not required to be present or examine the patient after death, any complications or other problems must be self-reported by the doctor to the state. Even the death certificate must be falsified to report the death as from natural causes rather than the lethal overdose.[5]  This violates the standards set by the Centers for Disease Control which require accuracy because, among other issues, “The death certificate is the source for State and national mortality and is used to determine which medical conditions receive research and development funding, to set public health goals, and to measure health status at local, State, national, and international levels.”[6]

The  immunity protections and the secrecy of even the minimal self-reporting standards in US assisted suicide laws eliminates the possibility of future potential lawsuits or prosecutions and keeps the myth of “no problems, no abuses” alive.

2. A Nurse’s Perspective

The dangers of the legalization of physician-assisted suicide are especially acute for us nurses. Unlike doctors, we nurses cannot refuse to care for a patient in a situation like assisted suicide unless another willing nurse can be found which can be impossible. If we do refuse, that is considered abandonment and cause for discipline and even termination. And we are necessarily involved when the assisted suicide act occurs in home health, hospice or health care facility even though the prescribing doctor is not required to be there.

And these deaths are not guaranteed quick, painless or even possible in some circumstances. As a new December 21, 2016 Kaiser Health News article revealed, doctors are trying new drugs because the old drugs are becoming too expensive and taking too long to work. Unfortunately, some new alternative drugs have “turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain”.[7]

Like most nurses, I have worked over the years with a variety of doctors who are at various points on the spectrum on competency and integrity.

Years ago, I was threatened with termination after I refused to increase a morphine drip “until he stops breathing” on a man who would not stop breathing after his ventilator was removed and no other nurse was available to take over the patient. The patient was presumed to have had a stroke when he did not wake up from sedation after 24 hours. I reported the situation up the chain of command at my hospital but no one supported me. I loved my profession and at that time, I was the sole support of three young children but I knew that nothing was worth betraying the trust of my patients.

I escaped termination that time but I refused to back down. Soon after, every nurse on a medical division of nurses refused to give an overdose to a patient and told the doctor that he would have to give it himself. The doctor cancelled the order.

Legalizing physician-assisted suicide can force nurses like us to leave healthcare, leaving no reliable safe haven for people who don’t want to end their lives.

Does anyone really want to entrust our healthcare system just to people who are comfortable with ending lives? I don’t.

FOOTNOTES

[1] “Oregon Revised Statute. 127.885s.01. Online at: https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx

2 “Evaluation and Treatment of the Suicidal Patient” . American Family Physician. Online at http://www.aafp.org/afp/2012/0315/p602.html

3 “Evaluation and Treatment of the Suicidal Patient” .American Family Physician. Online at http://www.aafp.org/afp/2012/0315/p602.html

4 “Oregon Death with Dignity Act Date Summary” .Online at https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year19.pdf

5 : “Washington state “Death with Dignity Act”. Online at http://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct/DeathCertificateInstructions

6 CDC Medical Examiners’ and Coroners’ Handbook on Death Registration and Fetal Death Reporting”. CDC. Online at https://www.cdc.gov/nchs/data/misc/hb_me.pdf

7 “Docs  In Northwest Tweak Aid-In-Dying Drugs To Prevent Prolonged Deaths” by JoNel Aleccia. Kaiser Health News. February 21, 2017. Online at http://khn.org/news/docs-in-northwest-tweak-aid-in-dying-drugs-to-prevent-prolonged-deaths/

Reports of My Death are Greatly Exaggerated-Again

In 2009, I began to get emails and calls from people who had read reports about the death of Nancy Valko from physician-assisted suicide in Oregon. Even our ages were almost the same.

After assuring people that I was not only very much alive but just as committed to opposing assisted suicide, I did a google search and found the obituary and information about another Nancy Valko who had planned and publicized a kind of party around her suicide.

Now almost 8 years later, I received an email from a friend who just read an article about the assisted suicide of Nancy Valko. I thought she had just run across an old article but she sent me the article “I will be dancing once again-Nancy Valko’s controversial final act brought her life, but not her legacy, to an end” from the current April 2017 issue of Woman’s Day, a well-known and long-running women’s magazine often displayed at grocery store checkout lines.

The article painted quite a  picture that was”carefully planned” by this Nancy : sunlight streaming through fir trees, bouquets of spring flowers, a manicured backyard and a friend playing classical music on a harp.

She was surrounded by her children and her former husband when she swallowed the lethal mixture. According to the article, her family continued to talk to her for the last two hours of her life telling her they loved her and praising her as an amazing mom.

The article notes that this Nancy was following a healthy lifestyle before she started have mobility problems and was eventually diagnosed with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. In November 2008, she decided to move to Oregon to use its physician-assisted suicide law. The article states that she wanted to be around for her kids but she “knew that dying from ALS could be brutal-in late stages, sufferers typically remain mentally alert but lose the ability to move, swallow or breathe on their own.” She would eventually have to rely on family, friends or others.

By March when this Nancy started having more trouble talking and thus might not be able to swallow the drugs, she saw a doctor who determined that she was within 6 months of dying and able to swallow the lethal dose by herself. The article notes that “nearly everyone” in Nancy’s circle stood behind her decision to die and friends and family in other states “sent bubbles toward the sky” on April 19, 2009.

After Nancy’s assisted suicide, her older sister Marnie “was inspired” to fight for an assisted suicide law in Vermont that was signed into law in 2013.

The article ends with:

“Nancy wanted her life to matter,” says Marnie. “Because this legislation passed, it still does.”

A short section “The Case Against ‘Death with Dignity'” cites the American Medical Association’s opposition against assisted suicide but says that “it will revisit the issue”. The section also mentions that “some religions” like Catholicism and disability groups like Not Dead Yet also oppose assisted suicide but cite a recent Gallup poll showing that only around 40% of Americans now feel assisted suicide is “morally wrong”.

CONCLUSION

Why did Woman’s Day tell this story again after 8 years? It seems like a desperate attempt to show an assisted suicide as a happy party with friends and family celebrating while a loved one takes her life before, as the article states, there is a “loss of autonomy and dignity”.

I see this Nancy’s death as a sad tragedy of despair.

As a former hospice nurse myself, I felt privileged to be able to help people with life-threatening illnesses and their families achieve a peaceful and comfortable natural death. The traditional hospice philosophy of neither hastening nor prolonging dying allows a natural and truly dignified death that benefits both the patient and his or her family. Personally, these patients and their families inspired me with their devotion and love for each other. People should never feel that they are a burden to themselves, their families or to society.

Physician-assisted suicide is never the answer and I would never inflict it on my family and friends.

What You Need to Know Now That the District of Columbia Has Become the Seventh Jurisdiction in US to Legalize Assisted Suicide

Despite emails and other efforts to encourage the US Congress to exercise its legal authority to stop the Washington D.C. assisted suicide law, the expected congressional action was not completed within the 30 legislative days required.

However, there may be hope on the horizon according to a  February 18, 2017 Washington Times article that said “Congress can still neutralize the Death with Dignity Act by cutting off its funding through the appropriations process.”

What went wrong with the process of nullifying the assisted suicide law in time?  No one seems to know.

But one thing we do know is that Compassion and Choices, the well-funded assisted suicide activist organization, will continue its relentless fight over and over again in every state without an assisted suicide law and in the courts to make assisted suicide legal throughout the US. But even that is not the final goal.

Ominously, we are now seeing assisted suicide leaders like influential lawyer Kathryn Tucker even criticizing the so-called “safeguards” in assisted suicide laws  as “burdens and restrictions”. She now argues that  assisted suicide should be “normalized within the practice of medicine”.

WHAT WE NEED TO KNOW AND DO NOW

We cannot just depend on lobbying our politicians and legislatures to fight assisted suicide only when such bills are introduced in states legislatures or as public initiative votes. We must constantly reinforce our message that every life is worthy of respect and care, not medical termination.

But we must also understand that the assisted suicide/euthanasia movement has had decades of experience in shaping and publicizing its lethal message through carefully crafted steps to convince the public that physician-assisted suicide must be legalized to prevent or end suffering.

As I wrote in my 2013 article “Then and Now: The Descent of Ethics”, the assisted suicide/euthanasia movement has been very busy in the last several decades. I included a short history of the movement that people should know:

The 1970s brought the invention of “living wills” and the Euthanasia Society of America changed its name to the Society for the Right to Die. The so-called “right to die” movement received a real boost when the parents of Karen Quinlan, a 21-year-old woman considered “vegetative” after a probable drug overdose, “won” the right to remove her ventilator with the support of many prominent Catholic theologians. Karen continued to live 10 more years with a feeding tube, much to the surprise and dismay of some ethicists. Shortly after the Quinlan case, California passed the first “living will” law.

Originally, “living wills” only covered refusal of life-sustaining treatment for imminently dying people. There was some suspicion about this allegedly innocuous document and, here in Missouri, “living will” legislation only passed when “right to die” advocates agreed to a provision exempting food and water from the kinds of treatment to be refused.

But, it wasn’t long before the parents of Missouri’s Nancy Cruzan, who was also said to be in a “vegetative” state, “won” the right to withdraw her feeding tube despite her not being terminally ill or even having a “living will.” The case was appealed to the US Supreme Court, which upheld Missouri law requiring “clear and convincing evidence” that Nancy Cruzan would want her feeding tube removed, but, in the end, a local judge allowed the feeding tube to be removed. Shortly after Nancy’s slow death from dehydration, Senators John Danforth and Patrick Moynihan proposed the Patient Self-Determination Act (never voted upon but became law under budget reconciliation), which required all institutions to offer all patients information on “living wills” and other advance directives. Since then, such directives evolved to include not only the so-called “vegetative” state and feeding tubes but virtually any other condition a person specifies as worse than death and any medical care considered life-sustaining when that person is deemed unable to communicate.

But this “choice” is becoming an illusion. In 1999, Texas became the first state to pass a medical futility law to allow doctors and/or medical committees to  override advance directives and patient or family decisions to continue life-sustaining treatment on the basis that doctors and/or medical committees know best when to stop treatment.

In the 1990s, Jack Kevorkian went public with his self-built “suicide machines”  and the “right to die” debate took yet another direction. By the end of the decade, Oregon became the first state to allow physician-assisted suicide. At first, the law was portrayed as necessary for terminally ill people to die with allegedly unrelievable pain. Within a short time, though, it was reported that “according to their physicians, the patients requested assistance with suicide because of concern about loss of autonomy and control of bodily functions, not because of concern about inadequate control of pain or financial loss.”

Other states eventually followed Oregon but efforts to pass assisted suicide laws often failed in other states so Compassion and Choices (the former Hemlock Society) promoted palliative/terminal sedation and VSED (voluntary stopping of eating and drinking) as a legal alternative to assisted suicide in states without such laws.

Compassion and Choices has found much success in working with sympathetic news outlets and pollsters to encourage the public and even medical professionals to support assisted suicide.

Even TV’s popular Dr. Phil McGraw hosted a 2012 segment featuring a Canadian woman who wanted her adult disabled children to die by lethal injection. Ironically, the mother, along with former Kevorkian lawyer Geoffrey Feiger, argued that removing their feeding tubes was an “inhumane” way to end the lives of the adult children. Tragically, when the studio audience was polled, 90% were in favor of lethal injections for the disabled adults. Disability organizations protested after the show, writing that “By conveying social acceptance and approval of active euthanasia of individuals with disabilities by their family members, the segment threatens their very lives”.

Exploiting the natural fear of suffering most people have has also led to a growing acceptance of the premise that it can even be noble to choose death instead of becoming a burden on family members or a drain on society. It is up to us to combat this attitude of despair by  not only educating ourselves and others about the facts and dangers of assisted suicide but also by offering hope and support to those of us most at risk.

My Submission to the AMA Opposing Neutrality on Physician-Assisted Suicide

Amid conflicting reports about whether or not the American Medical Association was going to consider a position of neutrality on physician assisted suicide, I was informed that the AMA’s Council on Ethical and Judicial Affairs was collecting data, position statements, etc. for consideration of assisted suicide and other topics before the June AMA Annual meeting. The deadline for submissions was February 15.

The following is my submission titled “Neutrality on physician assisted suicide also hurts nurses”

Dear AMA,

I have been a registered nurse since 1969. After working in critical care, hospice, home health, oncology, dialysis and other specialties for 45 years, I am currently working as a legal nurse consultant and volunteer as well as spokesperson for the National Association of Pro-Life Nurses. Over the years, I have cared for many suicidal people as well as people who attempt suicide.

I have served on medical and nursing ethics committees, served on disability and nursing boards. I have written and spoken on medical ethics-especially end of life issues-since 1984.

The dangers of the legalization of physician-assisted suicide are especially acute for us nurses. Unlike doctors, we nurses cannot refuse to care for a patient  in a situation like assisted suicide unless another willing nurse can be found which can be impossible. If we do refuse, that is considered abandonment and cause for discipline and even termination. And we are necessarily involved when the assisted suicide act occurs in home health, hospice or health care facility even though the doctor is not required to be there.

marievalko

Marievalko Picture of Marie Valko 1979-2009

As a nurse and the mother of a suicide victim (see picture above), I am alarmed by reports that the AMA is considering a position of neutrality on physician-assisted suicide. I beg you to uphold the legal and ethical standard that medical professionals must not kill their patients or help them kill themselves. Suicide is a tragedy to be prevented if possible, not a civil right.

MY DAUGHTER KILLED HERSELF USING AN ASSISTED SUICIDE TECHNIQUE

In 2009, I lost a beautiful, physically well 30-year-old daughter, Marie, to suicide after a 16-year battle with substance abuse and other issues. Her suicide was like an atom bomb dropped on our family, friends and even her therapists.

Despite all of our efforts to save her, my Marie told me that she learned how to kill herself from visiting suicide/assisted suicide websites and reading Derek Humphry’s book Final Exit. The medical examiner called Marie’s suicide technique “textbook final exit” but her death was neither dignified nor peaceful.

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

SUICIDE CONTAGION

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

STUDY SHOWS LEGALIZING PHYSICIAN-ASSISTED SUICIDE IS ASSOCIATED WITH AN INCREASE RATE OF TOTAL SUICIDES

A 2015 article in the Southern Medical Journal titled “How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?” came to these conclusions:

“Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides. This suggests either that PAS does not inhibit (nor acts as an alternative to) nonassisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals.”

THE HEALTH AND ECONOMIC COSTS OF SUICIDE

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

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

BRITTANY MAYNARD

There was a media frenzy in October 2014 when Brittany Maynard, a young newlywed woman with a brain tumor, announced plans to commit physician-assisted suicide on November 1 and raise money to have physician-assisted suicide legalized in all US states. There was an immediate and unprecedented media frenzy surrounding Ms. Maynard’s tragic story that routinely portrayed her pending assisted suicide as “heroic” and even counting down the days to her suicide. Personally, I thought this looked like a crowd on the street shouting for a suicidal person on a window ledge to jump.

In the end, Brittany hesitated for a day before she went through with her pledge to take the lethal overdose.

Now, assisted suicide supporters even deny that physician-assisted suicide is suicide, insisting that media stories use euphemisms like “aid-in-dying” and “death with dignity” in cases like Ms. Maynard’s to make assisted suicide more palatable to the public. However, this defies common sense when the definition of suicide is the intentional taking of one’s own life.

PHYSICIAN-ASSISTED SUICIDE AND MEDICAL DISCRIMINATION

I have been a registered nurse for 47 years, working in intensive care, oncology, hospice and home health among other specialties. Personally and professionally, I have cared for many people who attempt or consider killing themselves.

Some of these people were old, chronically ill or had disabilities. Some were young and physically healthy. A few were terminally ill. I cared for all of them to the best of my ability without discrimination as to their condition, age, socioeconomic status, race or gender. I will do anything to help my patients — except kill them or help them kill themselves.

Suicide prevention and treatment works, and the standards must not be changed just because some people insist their desire for physician-assisted suicide is rational and even a civil right.

Are Mail Order Abortions Coming?

Abortion clinics have been closing at a record pace. Since 2011, at least 162 abortion clinic have shut or stopped offering the procedure while just 21 have opened. Five states now have just one abortion clinic still open.

New pro-life laws regulating safety and standards are part of the reason but as feminist Madeleine Schwartz writes, even in liberal states “the combination of the economic difficulties of operating a clinic, a generally hostile atmosphere and declining demand means that many clinics are shutting down.

It should be no surprise that telemedicine medical abortion has also become appealing to Planned Parenthood because it reduces the cost burden of the clinics.

Not to mention that abortion has also become increasingly concentrated among the poor with 49% of aborted women patients having a family income below the federal poverty level.

MEDICAL ABORTION AND TELEMEDICINE

Although abortion was legalized in 1973, it wasn’t until 2000 that the U.S. Food and Drug Administration (FDA) approved the first oral abortion drug mifepristone (also known as RU-486) for medical abortions within 7 weeks of pregnancy (In March 2016, the FDA changed its guideline to allow medical abortion up to 10 weeks into pregnancy.)

Back in 2000, the “early abortion” procedure involved 3 clinic visits. The first session was with a doctor and taking the mifepristone dose to stop the progesterone necessary to establish and maintain the attachment of the unborn baby and placenta to the womb.  Two days later and if still pregnant, the expectant mother had to return to the clinic for the dose of misoprostol to cause expulsion of the preborn baby. Two weeks after the first clinic visit, the mother must return to the clinic to confirm that the pregnancy was ended.

In 2008, a Planned Parenthood affiliate in Iowa initiated the first formal telemedicine abortion program in the U.S. for abortion clinics not regularly staffed by a physician. In this situation, a physician in another location reviews prior labs and imaging to estimate the length of pregnancy and potential contraindications before speaking by a webcam to the pregnant woman.

The doctor is never physically present. Instead, he consults with the pregnant woman via the webcam about her medical history and tests, explains the procedure and then remotely activates a drawer that opens to dispense the abortion pills.

Now rates of medical abortions rival surgical abortions in the U.S.

However by citing safety concerns, 37 states currently require clinicians who perform medication abortions to be licensed physicians and 19 states require that the clinician providing a medication abortion be physically present during the procedure, thereby prohibiting the use of telemedicine to prescribe medication for abortion remotely.

NOW MEDICAL ABORTIONS BY MAIL?

A new study has been started in 4 states (Hawaii, New York, Oregon and Washington) to allow women to terminate a pregnancy by telemedicine and mail-order drugs.

Although the telemedicine medical abortions by email are touted as especially a boon for women in rural areas without a close abortion clinic, the process does not allow women to avoid the doctor’s office entirely. Using a video hookup on a home computer, a woman first consults a physician (or other clinician such as a nurse practitioner) at one of three participating abortion clinics who evaluates her medical history, explains how to take the abortion pills and what to expect. The woman then must get medical tests including ultrasound and blood work at a medical facility.

The study is being conducted by Gynuity Health Projects in the hope that good results will encourage the FDA to stop restrictions on mifepristone in pharmacies.

IS MEDICAL ABORTION EVEN PHYSICALLY SAFE?

The list of contraindications for medical abortion include ectopic pregnancy, chronic adrenal failure, chronic corticosteroid use and blood clotting problems. If tests do not reveal such problems or if a pregnant woman does not know or tell the doctor about certain conditions, the results could be deadly.

Complications of medical abortions include infection, heavy or prolonged bleeding in an estimated 1% of women and in an estimated 2% to 5% of medical abortions, the unborn baby is not completely expelled from the womb. When the unborn baby is not completely expelled, a surgical abortion is done to prevent infection or other problems

In December 2014, the University of California-San Francisco (UCSF) released an extensive study on Medicaid abortions in California. While its press release was titled “Major Complication rate after Abortion is Extremely Low”, Stanford University Ph.D. Michael New and his team found something quite different when they analyzed the data. They found that the study confirmed the finding that telemedicine abortions have “four times more risk of complications”.

A NURSE’S PERSPECTIVE

Although Planned Parenthood calls medical abortion “similar to a miscarriage”, it’s not.

Years ago, I had a miscarriage at 10 weeks with complications. I had a doctor who knew my medical history before he gently told me that my baby had died in my womb. When I had complications at home during my miscarriage, he met me in the emergency room and took care of the problem. It was my doctor who reassured me when I was hospitalized overnight. That kind of physical and emotional support is not possible with a medical abortion from a clinic.

Now imagine a young woman afraid to tell anyone she is pregnant and who visits an abortion clinic to get the abortion pills. Will anyone be with her or even know when she goes home and experiences what Planned Parenthood says is “kind of like having a really heavy, crampy period” with large clots and that “(a)ny chills, fevers, or nausea you have should go away pretty quickly”? Will she recognize the signs of a complication? Will anyone follow up if she doesn’t return to the clinic to be checked after the abortion?

There is a big difference between medical abortion and miscarriage physically, emotionally and spiritually because abortion is NOT health care.

My Trip to Georgetown University: The Inspiration of a New Generation

I was honored to be asked to give a talk at the annual Cardinal O’Connor Conference On Life at Georgetown University in Washington D.C. on January 28, 2017, the day after the annual March for Life. To be honest, I believe that I received more from the conference and students than I could ever contribute!

The title of my talk was “Killing or Caring? A Nurse’s Professional and Personal Journey”. I spoke about the progression of the Culture of Death through 4 professional and personal stories from abortion through assisted suicide. My stories included my 1982 fight to save the life of my newborn daughter with Down Syndrome and a severe heart defect against some lethal medical discrimination based on her disability. The second story was about how a young man in a car accident in the early 1970s “miraculously” recovered when we nurses refused to give up after the doctor initially predicted that the young man would at best be a so-called “vegetable” if he lived. The third story was about my daughter who died by suicide in 2009 at the age of 30 using an assisted suicide technique she read about and the tragedy of suicide contagion when assisted suicide is normalized and even glamorized. My last story was how I was almost fired from my ICU unit when I refused to participate in a withdrawal of treatment/terminal sedation euthanasia.

I was so moved by the enthusiastic response of the students to the message that the Culture of Death cannot be ignored or tolerated because evil will always expand until we stop it by demanding the recognition that every life is valuable and worthy of protection. I also loved getting a chance to talk to so many of the students after the talk. They inspired me!

Even on my trips to and from Georgetown University, I met two other inspiring young people. One was a lovely young African-American woman seated next to me on the flight to Washington, D.C. She told me about her career as a police officer patrolling the toughest area in Oakland, California. She also spoke about her passion to help the community and how she embraced the challenges of her choice. Who could not be inspired by that?

The Uber driver who drove me to the airport after my talk was similarly inspiring. It turned out that he was a young nurse who emigrated here from Ethiopia last year and was now studying for his national nursing exam to practice in the U.S. His story was fascinating and when he learned I was a veteran nurse, we had a wonderful discussion about nursing as a great career.

CONCLUSION

We sometimes hear the pessimistic opinion that our next generation is self-absorbed and only interested in money and the next cultural fad.

Based on my experiences in Georgetown, I think that our next generation may prove to be one of the best!

Emergency re-post: Write to Your Legislators in Congress Now!

On January 21, I wrote the following post (see below) to encourage all assisted suicide opponents to contact their own state’s legislators with instructions on how to find your state’s legislators and how to contact them.

There are only 30 legislative days (not calendar days but rather official working days for Congress which are impossible to predict) to contact your own state’s legislators to support a house and senate resolution bill disapproving the D.C. assisted suicide law before it automatically takes effect. The bills are S.J.Res. 4 for the Senate and H.J.Res.27 for the House and both are titled “Nullify District of Columbia Assisted Suicide Law”. You can also find and contact your legislators at those links.

It does not matter if your state has already approved assisted suicide or not. This is a way to let your legislator know you oppose it and this can educate him or her on what a constituent actually wants.

If you can, tell your story about why you oppose legalizing assisted suicide. Speak from your heart. It could be as simple as “I am a senior citizen and I fear giving doctors the right to kill”. Shorter messages are actually more likely to be read.

Thank you.

Nancy Valko RN ALNC

Urgent: Will Congress Stop the Washington D.C. Assisted Suicide Law in Time? Write Now!

January 21, 2017 nancyvalko assisted suicide, Compassion & Choices, law, medical ethics,

Washington D.C. Mayor Muriel Bowser  quietly signed an assisted suicide bill into law on December 19, 2016 after a majority of the city council voted for it.

Under the U.S. Constitution, the Congress has exclusive legislative authority over the District of Columbia. Congress has just 30 legislative days to review a law of the District of Columbia once it is passed by the city government. Resolutions of disapproval must be passed by both houses and be signed by the president to block a D.C. law.

In a race against time, the first step  to block the assisted suicide law was taken January 12, 2017 by Sen. James Lankford (R-Okla.) who introduced introducing a resolution in the Senate that opposes D.C.’s  “Death With Dignity Act”.

A companion resolution was introduced in the House by Rep. Brad Wenstrup (R-Ohio) and Rep. Jason Chaffetz (R-Utah) also said that he would push to block the law.

COMPASSION AND CHOICES HAS ALREADY STARTED A LETTER WRITING CAMPAIGN TO LEGALIZE ASSISTED SUICIDE IN WASHINGTON, D.C.

In a message to assisted suicide supporters, Compassion and Choices claims that “more than 2400 supporters” have “sent more than 7,000 messages to members of Congress”.  The organization also emphasizes “the importance of including your personal testimony” as “often the most effective way to change the minds of lawmakers”.

HOW TO CONTACT YOUR CONGRESSMAN OR CONGRESSWOMAN TO OPPOSE  ASSISTED SUICIDE IN WASHINGTON, D.C.

The National Right to Life Committee has a website link   to “Nullify District of Columbia Assisted Suicide Law” to contact your Senators and a separate link to contact your House representative(s). Enter your zip code in the box provided and you will be taken to a list of your congresspersons and a form you fill out to send an email to those representatives or senators with your comments.

HOW TO WRITE COMMENTS

Keep your comments respectful  and address the points that most move you. If you have a personal story about why you are against assisted suicide, write it as clearly and concisely as possible.

PROBLEMS WITH THE ASSISTED SUICIDE BILL

While many legislators (as well as the public) are persuaded by the “safeguards” to support assisted suicide laws, the Washington D.C. bill has many of the same problems with “safeguards” that other assisted suicide bills have. (For example, see my blogs “The slippery Slope-Tactics in the Assisted Suicide Movement” and “Pain and ‘Choice’“.)

In the D.C. assisted suicide law, such problems include:

1.The extraordinary immunity protections against civil, criminal liability or professional  disciplinary actions for doctors who participate in “good faith compliance” with the law.

  1. Protection from life or annuity insurance problems due to suicide (“Neither may a qualified patient’s at of ingesting a covered medication have an effect upon a life, health, accident, insurance, or annuity policy”)
  2. Minimal reporting requirements and secrecy in public records (“The Department will generate and make available to the public an annual statistical record of information collected”) Emphasis added.
  3. Require mental health evaluation only for the purpose of determining if the person is mentally capable to make the decision to end his or her life. (“‘Counseling’ means one or more consultations as necessary between a state licensed psychiatrist or psychologist  and a patient for the purpose of determining that the patient is capable and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.”)

CONCLUSION

There are many reasons to oppose legalizing assisted suicide including risk for elder abuse, discrimination against people with disabilities and/or terminal or chronic conditions, the destruction of the most basic rule of medical ethics to not kill patients or help them kill themselves, suicide contagion, etc.

Assisted suicide, legalized and approved by society, is a manifestation of despair and abandonment-not empowerment. We cannot afford to be bystanders while others like Compassion and Choices continue to demand that we all accept legalized assisted suicide as a constitutional and civil right.

 

 

Dr. Anne Bannon, Hero For Life

anne-reading

Dr. Anne Bannon “reading” her old pro-life insert. June 2016.

My friend and hero, Dr. Anne Bannon, died at the age of 89 on January 30, 2017.

Dr. Anne Bannon became a pediatrician decades ago at a time when women were usually discouraged from entering the almost exclusively men’s profession of medicine. But feisty and stubborn, Dr. Anne persevered to become a great doctor and the Chief of Pediatrics at City Hospital in St. Louis.

When the 1973 Roe v. Wade Supreme Court decision to legalize abortion came down, Dr. Anne was surprised and horrified. She went on to found Doctors for Life here in St. Louis.

One of her biggest projects was yearly producing and paying for a multi-page insert into the St. Louis Post-Dispatch (see picture), a newspaper that strongly supports legalized abortion and now assisted suicide.

Dr. Anne’s insert was full of facts but perhaps most importantly, it also listed the names of doctors against abortion. Every year, she would personally call every doctor she could and ask them if they opposed abortion and would agree to be listed in the insert. Despite the effort involved, Anne refused any help in contacting these doctors.

Every year, the list of doctors was long and it took courage for these doctors to agree to be listed. My own obstetrician-gynecologist told me that he received calls from other doctors who told him that they would never refer another patient to him if he continued to be listed in the insert. My doctor refused to be intimidated and he told me that publicly standing up for life was more important than possibly hurting his practice. In the end, his practice wound up even stronger.

DR. ANNE AND I

I was introduced to Dr. Anne in 1982 when my daughter Karen was born with Down Syndrome and a severe heart defect. I told her about several doctors who tried to undermine our decision to have our daughter medically treated exactly the same as any other child with a heart condition.

Of course, Dr. Anne was supportive and in 1983, even introduced me to Dr. C. Everett Koop, then Surgeon General under President Ronald Reagan, so that I could tell him my story and advocate for a national hotline that parents of newborns with any disability  could call to find resources to help their children.

Dr. Anne recognized that legalized abortion was leading to increasing acceptance of deliberate death decisions for born people, especially the disabled. Never married with no family nearby, she asked me to be her durable power of attorney for health care because she wanted truly ethical health care in case she became unable to speak for herself.

Several years ago, Dr. Anne developed dementia, probably Alzheimer’s, and was in a nursing home on Medicaid. By the time she died, she was in the late stages and unable to walk or even speak clearly  most of the time. But she was excited and delighted when we, her friends, visited her in the nursing home even when she could not remember our names. We were her St. Louis family and we loved her.

Dr. Anne fractured her hip last Saturday night and needed surgery. She did well in surgery but suddenly became critically ill at the end of the surgery . But, to the doctors’ surprise and just when they were ready to give up, Anne suddenly got better. She was taken to intensive care on a ventilator and unconscious but stable. Anne’s famous fighting Irish spirit came out one last time and we were proud of her.

Dr. Anne was in critical but stable condition and apparently in a coma when we called a wonderful local priest to give her the Catholic Sacrament of the Anointing of the Sick, previously known as Last Rites or Extreme Unction. According to one friend and the doctor attending, her face seemed to soften during the sacrament and she even blinked and put her tongue out. That in itself was amazing.

After the sacrament, her vital signs immediately started to drop and despite an increase in her medications, Dr. Anne died peacefully and in no distress a few hours later. We knew she wanted the sacrament and I believe that she hung on until she received it.

As a former hospice nurse, I have often seen this kind of hanging on by dying patients until an important matter was resolved.

So, to the end, Dr. Anne was still teaching about the value of all life.

Rest in peace, Dr. Anne Bannon!

Urgent: Will Congress Stop the Washington D.C. Assisted Suicide Law in Time? Write Now!

Washington D.C. Mayor Muriel Bowser  quietly signed an assisted suicide bill into law on December 19, 2016 after a majority of the city council voted for it.

Under the U.S. Constitution, the Congress has exclusive legislative authority over the District of Columbia. Congress has just 30 legislative days to review a law of the District of Columbia once it is passed by the city government. Resolutions of disapproval must be passed by both houses and be signed by the president to block a D.C. law.

In a race against time, the first step  to block the assisted suicide law was taken January 12, 2017 by Sen. James Lankford (R-Okla.) who introduced introducing a resolution in the Senate that opposes D.C.’s  “Death With Dignity Act”.

A companion resolution was introduced in the House by Rep. Brad Wenstrup (R-Ohio) and Rep. Jason Chaffetz (R-Utah) also said that he would push to block the law.

COMPASSION AND CHOICES HAS ALREADY STARTED A LETTER WRITING CAMPAIGN TO LEGALIZE ASSISTED SUICIDE IN WASHINGTON, D.C.

In a message to assisted suicide supporters, Compassion and Choices claims that “more than 2400 supporters” have “sent more than 7,000 messages to members of Congress”.  The organization also emphasizes “the importance of including your personal testimony” as “often the most effective way to change the minds of lawmakers”.

HOW TO CONTACT YOUR CONGRESSMAN OR CONGRESSWOMAN TO OPPOSE  ASSISTED SUICIDE IN WASHINGTON, D.C.

The National Right to Life Committee has a website link   to “Nullify District of Columbia Assisted Suicide Law” to contact your Senators and a separate link to contact your House representative(s). Enter your zip code in the box provided and you will be taken to a list of your congresspersons and a form you fill out to send an email to those representatives or senators with your comments.

HOW TO WRITE COMMENTS

Keep your comments respectful  and address the points that most move you. If you have a personal story about why you are against assisted suicide, write it as clearly and concisely as possible.

PROBLEMS WITH THE ASSISTED SUICIDE BILL

While many legislators (as well as the public) are persuaded by the “safeguards” to support assisted suicide laws, the Washington D.C. bill has many of the same problems with “safeguards” that other assisted suicide bills have. (For example, see my blogs “The slippery Slope-Tactics in the Assisted Suicide Movement” and “Pain and ‘Choice’“.)

In the D.C. assisted suicide law, such problems include:

1.The extraordinary immunity protections against civil, criminal liability or professional  disciplinary actions for doctors who participate in “good faith compliance” with the law.

2. Protection from life or annuity insurance problems due to suicide (“Neither may a qualified patient’s at of ingesting a covered medication have an effect upon a life, health, accident, insurance, or annuity policy”)

3. Minimal reporting requirements and secrecy in public records (“The Department will generate and make available to the public an annual statistical record of information collected”) Emphasis added.

4. Require mental health evaluation only for the purpose of determining if the person is mentally capable to make the decision to end his or her life. (“‘Counseling’ means one or more consultations as necessary between a state licensed psychiatrist or psychologist  and a patient for the purpose of determining that the patient is capable and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.”)

CONCLUSION

There are many reasons to oppose legalizing assisted suicide including risk for elder abuse, discrimination against people with disabilities and/or terminal or chronic conditions, the destruction of the most basic rule of medical ethics to not kill patients or help them kill themselves, suicide contagion, etc.

Assisted suicide, legalized and approved by society, is a manifestation of despair and abandonment-not empowerment. We cannot afford to be bystanders while others like Compassion and Choices continue to demand that we all accept legalized assisted suicide as a constitutional and civil right.

Could St. Louis Become a Sanctuary City for Abortion?

The St. Louis Planned Parenthood became the last abortion clinic in Missouri in November, 2015 after an abortionist lost her “refer and follow” hospital admitting privileges in Columbia, Mo.

Now two St. Louis aldermen in partnership with NARAL Pro-Choice Missouri started an effort  in December 2016 to “make the city a sanctuary for reproductive rights, i.e. abortion, by adding “reproductive health decisions” to the city’s anti-discrimination ordinance.

Their new bill, BB 203, adds “reproductive health decisions”, defined as “any decision related to the use or intended use of a particular drug, device, or medical service, including the use or intended use of contraception or fertility control or the planned or intended initiation or termination of a pregnancy” to the already protected categories of race, color, religion, sex, age, disability, marital status, familial status, sexual orientation, gender identity or expression, national origin or ancestry, or legal source of income.

Penalties under the current Civil Rights Enforcement Agency ordinance include up to $500 in fines and up to 90 days in jail but already a veteran pro-life activist was arrested on New Year’s Eve morning at the clinic and charged with alleged “domestic terrorism”.

In addition, as Samuel Lee of Campaign Life Missouri points out about BB 203: “There are no exemptions for churches, religious organization or for any person with a conscientious objection.”

Furthermore, he lists some possible acts that could be considered unlawful “discrimination” if BB 203 becomes law:

  • A Catholic hospital refusing to lease medical office space to a doctor who wants to perform abortions.
  • A doctors’ medical group rejecting as an employee, a physician who wants to prescribe abortion pills to his or her patients.
  • A property owner declining to lease office space to the CEO of Planned Parenthood.
  • The Archdiocese of St. Louis or Catholic Charities (at least as applied to their City of St. Louis employees), failing to include in their employees’ health benefit plans, coverage for abortion (at any time for any reason throughout pregnancy), contraception, sterilization or artificial reproduction.
  • A pastor in a pro-life church demoting or reassigning the youth minister because he encouraged and paid for his girlfriend’s abortion, because that is an “adverse employment action” (as defined in the bill) against the employee.
  • A maternity home, pregnancy resource center, Catholic Charities agency, etc., firing a counselor or social worker who referred a client for an abortion.
  • A mom or dad to denying parental consent for their minor daughter to get an abortion, because the parent would be “interfer[ing] with any person in the exercise or enjoyment of, or on account of his having exercised or enjoyed, rights granted and protected by this ordinance.”

Perhaps not surprisingly, Planned Parenthood’s new efforts to pass such an ordinance come after much bad publicity for the St. Louis Planned Parenthood clinic, including multiple safety violations discovered by Operation Rescue and 60 ambulance responses to the Planned Parenthood clinic since 2009 and observed by pro-life activists at the clinic.

.Archbishop Robert J. Carlson of St. Louis is also speaking out against BB 203 and states that  “the Archdiocese of St. Louis cannot and will not comply with any ordinance like Board Bill 203 that attempts to force the Church and others to become unwilling participants in the abortion business. There is no room for compromise on such a matter.”

Instead, Archbishop Carlson proposes that “St. Louis should be a sanctuary for life and compassion, especially compassion for mothers and their developing children.”

We must continue to challenge Planned Parenthood’s desperate efforts to shield its abortion business whenever and wherever such efforts occur.