What about Ventilators and “Pulling the Plug”?

When I first became a registered nurse in 1969, ICUs (intensive care units) were still new. The first one I worked was set up in the former visitors’ lounge and we learned how to read EKGs (heart tracings) by using a book.

By the early 1970s, I worked in a surgical/trauma ICU where we used sophisticated ventilators like the MA-1. We were able to get almost all our patients off ventilators by weaning, the process of gradually lowering ventilator support until the patient can breathe on his or her own.

But in 1976, I was shocked by the Karen Quinlan case that changed everything.

Karen was a 21 year old woman who suffered brain damage after apparently taking drugs at a party. She was hospitalized and placed on a ventilator. When she was thought to be in a “persistent vegetative state”, her adoptive parents asked that her ventilator be removed. The doctors disagreed and they case eventually went to the New Jersey Supreme court that allowed the removal of the ventilator on the grounds of an individual’s right to privacy.  Shortly afterward, California passed the first “living will” to refuse “life support” if or when the signer is incapacitated.

Ironically, Karen lived 10 more years because, as some ethicists criticized, she was weaned off the ventilator instead of just abruptly stopping the ventilator.

My experience with ventilators became personal in 1983 when my baby daughter Karen died on a ventilator before she could get open-heart surgery. Unfortunately, one young doctor earlier offered to take her off the ventilator to “get this over with”. I reported him to the chief of cardiology who was furious with the young doctor.

In the 1990s, I returned to working in an ICU and was shocked by the development of the “terminal wean” for some patients on ventilators. Often the families were told that there was no hope of a “meaningful” life. The terminal wean involved abruptly disconnecting the ventilator and “allowing” the patient to die. I brought up at least trying regular, gradual weaning and oxygen as we did for the other patients on ventilators but I was ignored.

After I retired from bedside nursing, I was asked to be with an elderly man on a ventilator who had had a massive stroke and the family was told that he would never have any quality of life and would die soon anyway. I tried to bring up weaning but some members of the family were adamant.

When the ventilator was stopped. I held the man’s hand and prayed while he gasped for air and turned blue. I asked the nurse to at least giving him oxygen for comfort but she ignored me. Instead, she gave frequent doses of morphine intravenously until the man’s heart finally stopped after 20 minutes.

I am still haunted by this man’s death.

INFORMED CONSENT?

The medical definition of informed consent requires understanding “the purpose, benefits, and potential risks of a medical or surgical intervention…”.

But most people seem to have a vague understanding of ventilators when they sign a “living will” or other advance directives and thus have very little information about this often life-saving medical intervention.

As a nurse, I found that most people-especially the elderly-tend to automatically check off ventilators without understanding that a sudden problem with breathing can come from a number of treatable conditions that don’t require long-term use of a ventilator such as  asthma, drug overdoses, pneumonia and some brain injuries.

In some circumstances such as certain spinal cord injuries and late-stage neurodegenerative diseases like amyotrophic lateral sclerosis, the ventilator is  necessary long-term to live. But even then, people like Christopher Reeve and Stephen Hawking have used portable ventilators to continue with their lives. Some people with disabilities use small ventilators only at night.

It is important to know that ventilators move air in and out of the lungs but do not cause respiration-the exchange of oxygen and carbon dioxide that occurs in lungs and body tissues. Respiration can occur only when the body’s respiratory and circulatory systems are otherwise intact. A ventilator cannot keep a corpse alive.

It’s also important to know that not all machines that assist breathing require the insertion of a tube into the windpipe. Non-invasive positive-pressure ventilation like the BiPap successfully used for my elderly friend Melissa allowed her to use a face mask to assist her breathing until antibiotics cured her pneumonia.

WEANING FROM A VENTILATOR

Many patients are easy to wean from a ventilator but some patients are more difficult.

Years ago, I cared for an elderly woman with Alzheimer’s who needed a ventilator when she developed pneumonia. She had made her son and daughter her medical decision makers in her advance directive.

However, the doctors found it very difficult to try to wean the ventilator after the woman improved. They spoke to the family about removing the ventilator and letting her die. The daughter agreed but the son was adamantly against this.

The woman was totally awake after the sedation to keep her comfortable on the ventilator was stopped. She was cooperative and made no effort to pull out the tube in her windpipe. She just smiled when asked if she wanted the ventilator stopped.

Having known of some great respiratory therapists in the past who were able to successfully wean difficult patients from ventilators, I suggested that she be transferred. She was transferred and a week later we were told that she was successfully weaned from her ventilator.

About a year later, I encountered the woman again when she was recuperating after a routine surgery. Although her Alzheimer’s disease was unchanged, she was doing well in an assisted living residence.

CONCLUSION

As a student nurse, I was as initially intimidated by ventilators as anyone else. But as I learned how to use them and saw the constant improvements not only in the technology but also in our care of patients on ventilators, I came to see ventilators as a great blessing when needed.

And while we are never required to accept treatment that is medically futile or excessively burdensome to us, sometimes this can be hard to determine-especially in a crisis situation. Most of my patients on ventilators recovered but some could not be saved. We were surprised and humbled when some patients with a poor prognosis recovered while others who seemed to have a better chance died unexpectedly. There are no guarantees in life or death.

That is why my husband and I wrote our advance directives that designate each other as our decision maker with the right to have all current options, risk and benefits of treatment fully explained.

We don’t want an advance directive that could be hazardous to our health!

 

Dying Well?

I discovered that former San Francisco Chronicle reporter Katy Butler is now publishing yet another book on dying well (her first book “Knocking on Heaven’s Door” was a best seller) when I read her lead essay in the February 8, 2019 Wall Street Journal article titled “Preparing for a Good End of Life”.

However, I recognized her name from reading her 2014 interview with Compassion and Choices , the well-funded former Hemlock Society that promotes physician-assisted suicide .

In that interview, she urged people to back the 2014 “Better Care. Lower Cost Act” sponsored by Senator Ron Wyden of Oregon “to improve appropriate medical support for people with chronic illness” and to “advocate to reduce payments to doctors who perform futile ‘Hail Mary’ surgeries, tests and treatments near the end of life”. Ms Butler also added that “we have an epidemic of unnecessary suffering at the end of life, and what’s more, it’s expensive!” (All emphasis added)

In that interview, Ms. Butler also talked about how her mother was “exhausted from nonstop caregiving” and how they fought doctors to have her father’s pacemaker turned off after he developed dementia, couldn’t walk to the neighborhood pool, became deaf and “too blind to read the New York Times-his last remaining pleasure”. Ms. Butler said she was glad to learn “from Judith Schwartz at Compassion and Choices that we each have a constitutional right to refuse any medical treatment or ask for its withdrawal.” (Compassion and Choices also promotes VSED, the voluntary stopping of eating and drinking, as well as terminal sedation as two legal options to hasten death in states without physician-assisted suicide laws.)

SCARE TACTICS?

In the Wall Street Journal article, Ms. Butler flatly states-without a source-that “Pain is a major barrier to a peaceful death, and nearly half of dying Americans suffer from uncontrolled pain.” (Emphasis added)

However, in an article “Pain Control at the End of Life” , June Dahl, PhD, a professor of pharmacology at the University of Wisconsin at Madison, and a founder of the American Alliance of Cancer Pain Initiatives states that:

“Thanks to recent advances in pain treatments, roughly 90 to 95 percent of all dying patients should be able to experience substantial relief from pain.”

Although Ms. Butler doesn’t mention physician-assisted suicide specifically, she does strongly advocate taking control of how we die, especially as we get older, because “Advanced medicine is replete with treatments (ventilator, dialysis, defibrillators, feeding tubes, to name a few) that postpone death and prolong misery without restoring health“. (Emphasis added)

She writes that “The best way to achieve a peaceful death is by planning ahead and enlisting the help of loved ones.”

In the Wall Street Journal article, she approvingly writes:

“When Liz Salmi’s mentor lay unconscious on a ventilator in a dark, windowless ICU room, attended by a cacophony of hisses and electronic bloops, she and other close friends lobbied for a better setup. All monitors but one were silenced, a doctor removed the breathing tube, and nurses and aides gurneyed her dying friend quickly into the ICU’s “best room”—a sunny spot, with windows opening to the outdoors.” (Emphasis added)

In this instance, note that the friends-apparently not the family or a “living will”- lobbied  the doctor to remove (not try to wean off) the ventilator. I am not surprised since I have personally heard some doctors say that, if in doubt, it might be legally safer not to treat rather than treat a patient because of the risk of a future lawsuit.

These kinds of articles and books are being used as “end-of-life education” for both the public and professionals. Can this be dangerous?

CAN WHAT YOU SAY POTENTIALLY BE USED AGAINST YOU?

My own mother often told me “I never want to be a burden on you children”. Then she developed Alzheimer’s and a terminal thyroid cancer. I was asked if the family wanted her fed if she got worse. “Of course, if she needs it”, I responded. My mother should die from her condition, not from starvation and dehydration. I  never told the doctors her comment about not wanting to be a burden because she wasn’t a burden. Mom died shortly after she went to a nursing home for safety reasons and we spoon-fed her at the end. She had no pain, thanks to a short course of radiation and chemo that she tolerated. My last memory of my mother was her smiling and enjoying the attention of her family before she died in her sleep.

In 1990, 2 years after my mother’s death, Nancy Cruzan died after 12 long days without a feeding tube, even after the US Supreme Court ruled that Missouri could require “clear and convincing evidence” that she would not want a feeding tube if she was in a “vegetative state.” At the time of the decision, there was no evidence of this.

However, Nancy’s parents later returned to a Missouri court with some of Nancy’s former co-workers who testified that they recalled her saying she would never want to live ‘like a vegetable’.

Three years later in a letter published in the Journal of the American Medical Association by Dr. Ezekiel Emanuel, one of the future architects of Obamacare, acknowledged that this “proof” of Nancy Cruzan’s alleged statement rested only on “fairly vague and insubstantial comments to other people”.

However and most disturbing, he also wrote that:

“…increasingly it will be our collective determination as to what lives are worth living that will decide how incompetent patients are treated. We need to begin to articulate and justify these collective determinations.” (Emphasis added.) Source: The American Journal of Medicine January 1993 Volume 94 p. 115

CONCLUSION

As a hospice and critical care nurse, I strove to make sure dying patients and their families had a good death, either in a hospital or other institution or at home.

Personally, my husband and I also made a careful durable power of attorney document that only designates each other as our decision maker with the right to make decisions about our care rather than signing a “living will” to refuse potential future treatments or set possible future conditions like dementia where we would want treatment stopped or withheld. Instead, we want all current options, risks and benefits of treatment fully explained to the decision maker based on the current condition.

I also encourage people to check out information sites like the Healthcare Advocacy and Leadership organization (I am an advisor) and magazines like “Informed-A Guide for Critical Medical Decisions”  which has sections explaining ventilators, CPR (cardiopulmonary resuscitation), feeding tubes, use and misuse of opioids and sedatives as well as other end of life considerations.

Death is a journey we all will take someday. Especially in today’s world, we should protect ourselves and our loved ones by trying to ensure a truly good death.

The Most Important Thing I Told a Maryland Legislator

I just recently returned from a trip to Maryland where Jack Ames of Defend Life asked me to speak to various groups, hopefully including legislators, about opposing a current physician-assisted suicide bill in the Maryland legislature. The Maryland “End of Life Options” bill was, as usual, based on the first physician-assisted suicide law passed in Oregon with a few additional loopholes.

I was able to speak to many groups during my trip but unfortunately, I could not be scheduled to speak at the legislature’s committee meeting where people from both sides of the issue were able to speak.

However, one of the Defend Life people and I went to the statehouse to see if we could get in to talk to some legislators personally. We were only able to get to speak to one legislator and he was considered to be on the side of passing such a bill. We were told we only had 5 minutes to talk to him.

We were there for much longer.

We talked about our personal experiences, especially about my 30 year old, physically healthy daughter Marie who killed herself after a 16-year struggle with substance abuse using an assisted suicide technique she learned after reading pro-assisted suicide advocate Derek Humphry’s book Final Exit.

I told him about Marie’s death which was horrific instead of peaceful and that was like an atom bomb dropped on our family. I talked about the reality of suicide contagion which led two people close to Marie became suicidal but who were able to be saved. We talked about the increasing epidemic of suicides we have now  and how seductive is the message that killing ourselves can solve problems like not wanting to be a burden on our families. That is what my daughter told me and one of the biggest reasons given by people who have resorted to physician-assisted suicide.

I also told him about at least six problems with physician-assisted suicide laws that most legislators-and the public-don’t know but that are inherent in physician-assisted laws. These include such problems as the total immunity for doctors and the secrecy involved, mandatory falsification of physician-assisted suicide death certificates and the obvious medical discrimination between treating suicidal people who are physically healthy and suicidal people who are considered terminally ill and seeking physician-assisted suicide.

I also told him about my experiences as a nurse with suicidal people-some of whom were terminally ill-and how (except for my daughter) they all changed their minds with listening, support and referral to a mental health specialist. I also told him about a UCLA project started when California legalized physician-assisted suicide. The project offered an intensive intake process for patient requesting physician-assisted suicide conducted by trained psychotherapists and social workers instead of physicians and offering help and support for any needs the patient might have. Not only did the project show that “most of what patients needed was to discuss their feelings about their approaching death and process their grief and sense of loss”, but also that “only” 25% of patients went on to commit physician-assisted suicide.

When you combine this with the fact that an admitted 1/3 of terminally ill Oregon patients who obtain the lethal overdose for assisted suicide never take it and with no follow-up as to whether the diagnosis was wrong, people changed their minds or even what happened to the dangerous lethal medication in the home etc., it is obvious that lethal mistakes are being made.

THE MOST IMPORTANT THING I TOLD THE LEGISLATOR

However, what seemed to be the most important point that stunned the legislator was telling him that if he voted for the physician-assisted suicide bill, he would have to personally shoulder the responsibility for the lives subsequently lost that obviously could have been saved.

I told him that like other ethical medical professionals, my most profound fear was harming or worst of all killing a patient, however inadvertently. I told him that despite my decades of nursing, I always knew I would have to leave my profession if such a tragedy happened because I would be devastated and lose my confidence in my abilities.

I told him that now with the facts we gave him, it was up to him to vote responsibly and hopefully share our information with others.

CONCLUSION

Most people assume that legislators are always lawyers who carefully read and understand legislation before voting. Wrong!

And most people don’t understand that most legislators rely on lobbyists for their information. Well-funded groups like Compassion and Choices are able to afford lobbyists, activists, access to sympathetic media outlets, etc. that promote their physician-assisted suicide agenda while other groups like pro-life groups and disability advocates have to rely on passionate volunteers.

Years ago, a legislator here in my home state of Missouri said he felt his constituents were against a certain piece of legislation. Why? Because he said he had received 4 letters!

This was before the internet has made it easier to contact our representatives but this shows how powerful our individual efforts can be.

We need everyone to speak out and speak up, especially when it comes to dangerous legislative bills like physician-assisted suicide.

 

 

 

Why Can’t We Protect Babies who Survive Abortion?

I still remember my shock when nurse Jill Stanek came forward to describe how she discovered a baby with Down Syndrome born alive after a late-term abortion who was left in a dirty utility room to die at Christ Hospital in Oak Lawn, Illinois in 1999. She found that these second or even third trimester babies were sometimes born alive after an induced labor abortion. At great risk both professionally and personally, Jill Stanek fought this barbaric practice publicly and testified in Congress. This resulted in the passage of the Born-Alive Infants Protection Act of 2002.

Just a year later, Congress was finally able to pass The Partial Birth Abortion Ban Act of 2003  many years after it was discovered that abortionists could ensure the death of the baby by delivering the baby feet first except for the head and then suctioning out the baby’s brain.

But in October 2003, abortionist Warren Hern wrote an article explaining how he got around the new law:

“I reassured her (a patient) that I do not perform the “partial-birth” procedure and that there is no likelihood that the ban’s passage would close my office and keep me from seeing her. The fetus cannot be delivered “alive” in my procedure—as the ban stipulates in defining prohibited procedures—because I begin by giving the fetus an injection that stops its heart immediately.” (Emphasis added)

And just last year, the US House passed the Born-Alive Abortion Survivors Protection Act (H.R. 4712) that:

  • Requires health care practitioners present at the time a child is born alive during an abortion or attempted abortion to exercise the same degree of care to preserve the life and health of the child as any health care practitioner would provide to a child born alive at the same gestational age;

  • Requires that children born alive during an abortion or attempted abortion be transported and admitted to a hospital immediately following the administration of emergency care;

However and just days ago, this Act was blocked from unanimous consent in the US Senate by Democrats .

This happened despite the controversial on-air comments by Democrat Governor Northam of Virginia defending a bill allowing abortions up to birth. When asked what would happen if the baby was born after the abortion, Gov. Northam said that “the infant would be resuscitated if that’s what the mother and the family desired, and then a discussion would ensue between the physicians and the mother.” (Emphasis added)

In other words, the same infanticide by neglect that nurse Jill Stanek discovered in 1999.

The Virginia abortion bill thankfully died in committee but there is now a frenzy among abortion supporters to pass radical pro-abortion laws like New York’s in other states like Rhode Island  and Vermont that allow abortions up to birth, allow non-doctors to perform abortions and to prohibit any effort to “deny, regulate or restrict” abortion.

The most recent and extreme bill just passed the House in New Mexico. This bill redefines abortion as merely “health care” and even removes conscience rights for medical professionals who refuse to participate. Governor Michelle Lujan Grisham has promised to sign the bill into law if it passes the New Mexico Senate.

CONCLUSION

In my home town of St. Louis, Missouri, the US Supreme Court voted 7-2 in the infamous 1857  Dred Scott v Sandford decision about slavery which held that black people were an “inferior class of beings”  and thus ” had no rights or privileges but such as those who held the power and the Government might choose to grant them”.

It took a civil war and the Emancipation Proclamation to end this travesty. The Dred Scott decision is now remembered as a turning point that ignited a political firestorm.

Will these current outrageous efforts to also make unborn babies an “inferior class of beings” with “no rights or privileges” prick the conscience of the American people and become a turning point in the fight to restore respect for the lives of preborn human beings?

We must never give up trying!

Is Abortion Really the Best We Can do for Women?

As a nurse and a mother myself, it was awful to read about the newest and most radical abortion law voted in and just signed by New York governor Andrew Cuomo. The vote on this law was even met with a standing ovation in the New York legislature.

This bill would not only legalize abortions UP TO BIRTH but also revokes the requirement for medical care that must be provided afterwards if the baby survives an abortion attempt. Now, Rhode Island is poised to do the same thing.

The “right to abortion” is a central tenet of the “Women’s Rights” movement and most mainstream media complies by constantly insisting that women want and need abortion. Planned Parenthood and even Oprah Winfrey promote women to “Shout Your Abortion” to show that abortion is empowering and even necessary to women’s success.

But is this true?

“EMPOWERING WOMEN AND DEFENDING LIFE: AN INSEPARABLE CALL TO ACTION”

This is the title of a powerful article by a woman who started working at a crisis pregnancy center after she had received help there in the past when she was pregnant and money was tight.

As the anonymous author writes in FemCatholic:

“What I hadn’t realized was that, in situations of unplanned, crisis, or unwanted pregnancies, the staff set out not only to save the life of an unborn child or give women access to free pregnancy tests and resources (as important as those things are); the counselors want to give women hope, confidence, and the ability to look within and see their own strength. In short, they want to empower every woman they encounter.

My interviewer described to me the approach that counselors took in that initial appointment. She stressed that the goal of the appointment is never to convince the woman one way or another. Instead, counselors provide each woman with information regarding all options, and work to help her realize that she has the strength to do hard things, to be courageous in the face of this difficult situation, and to assure her that there are people ready to love and support her. If the woman chooses to she can continue meeting with a counselor regularly throughout her pregnancy for support, resources, and caring community.” (Extra emphasis added)

The author also writes about her other experiences:

“I have worked at two different maternity homes, and have seen firsthand the freedom that women experience when they discover and engage their strength, gifts, passions, and sheer willpower. It is incredible to watch these empowered women getting and staying sober or clean, finishing or going back to school, applying for jobs, dreaming about their futures with hope rather than despair. Women are capable of amazing things! I honestly believe one of our greatest feminine gifts is the ability to carry on in the face of even seemingly impossible situations.” (Emphasis added)

Her message is both simple and profound:

How can we, women who are passionate about empowering other women, begin to change the conversation, to advance true liberation for women in unplanned pregnancies?”

 

WHAT ABOUT THE “WORST CASE” SCENARIO WHEN THE UNBORN BABY IS DOOMED TO DIE?

In the latest Gallup poll on abortion, 67% of the people polled approve abortion “When the child would be born with a life-threatening illness”. (Of course, sometimes that diagnosis proves to be wrong.)

But is abortion really the best answer for these distressed parents?

The answer is no, according to a recent article in The Public Discourse titled “Do Women Regret Giving Birth When the Baby is Doomed to Die? by Professor Christopher Kaczor of Loyola Marymount University.

Professor Kaczor cites a 2018 article from the Journal of Clinical Ethics titled “‘I Would Do It All Over Again’: Cherishing Time and the Absence of Regret in Continuing a Pregnancy after a Life-Limiting Diagnosis that found:

“Absence of regret was articulated in 97.5 percent of participants. Parents valued the baby as a part of their family and had opportunities to love, hold, meet, and cherish their child. Participants treasured the time together before and after the birth. Although emotionally difficult, parents articulated an empowering, transformative experience that lingers over time.” (Emphasis added)

He also cites another study titled “We want what’s best for our baby: Prenatal Parenting of Babies with Lethal Conditions” from the Journal of Prenatal and Perinatal Psychology and Health that found:

“After the birth, and at the time of the baby’s death, parents expressed thankfulness that they were able to spend as much time with their baby as possible.”

In contrast, Professor Kaczor cites a meta-analysis (a statistical analysis that combines the results of multiple scientific studies) in a Journal of Obstetric, Gynecologic and Neonatal Nursing titled “The Travesty of Choosing after Positive Prenatal Diagnosis” as well as another study to state that:

“Couples experienced selective termination as traumatic, regardless of the prenatal test revealing the fetal impairment or stage in pregnancy in which the termination occurred.”

Professor Kaczor concludes from this:

“Women who receive a lethal fetal diagnosis deserve our compassion and support. Fortunately, organizations such as Caring to Term and Perinatal Hospice & Palliative Care provide information and support for these tremendously difficult situations. Unfortunately, doctors sometimes pressure women into getting abortions and do not share with them the information that is necessary to make an informed choice. Those who receive a lethal diagnosis deserve to know the truth that 97.5 percent of women who continue pregnancies when the baby is doomed to die have no regrets about doing so—and that abortion does not have similar outcomes. Numerous studies have come to the same conclusion: giving life rather than aborting is likely to lead to greater psychological benefit for women whose baby is doomed to die.

CONCLUSION

Many  years ago with my last child, I had abortion recommended to me by two different doctors but not because the baby had an adverse prenatal diagnosis. In my case, abortion was suggested  because, due to my first husband’s severe psychosis, I would most likely wind up supporting my children alone.

The doctors’ prediction about my husband’s prognosis proved to be correct. But I was outraged that these doctors could even think about encouraging an abortion and adding more trauma to a difficult situation. And I was also outraged that they thought I was too powerless to raise 3 children on my own. I wasn’t.

Because of that experience, I now know the power of the simple phrase “I am here for you” and I have said it myself to other mothers, especially ones who were given an adverse prenatal diagnosis.

I know that choosing life is the ultimate victory!

Roe v. Wade’s Disastrous Impact on Medical Ethics

This was published in the National Right to Life News January 2019 issue “The Consequences of Roe v Wade” on page 8.

Most people volunteer for the pro-life movement. I consider myself a draftee. For me, there was no “choice.” I became a conscript because of personal and professional experiences that followed in the wake of the Roe v Wade decision.

I was a young intensive care unit nurse when the Roe v. Wade decision came down in 1973. Like most people I knew, I was shocked when abortion was legalized. As a medical professional, I couldn’t imagine good doctors and nurses condoning — much less participating in — such a brutal act.

However, I quickly found that my medical colleagues were split on the issue. In a foreshadowing of what was to come, those supporting what was then said to be “only” early abortions were the most vocal and insistent.. Our formerly cohesive unit began to fray.

However, I was professionally offended by the pro-life argument that legalizing abortion would lead to the legalization of infanticide and euthanasia. It was one thing to deny the truth with an early and unobserved unborn baby but it was quite another to imagine any doctor or nurse looking a born human being in the eye and killing him or her.

How wrong I was!

INFANTICIDE AND MEDICAL DISCRIMINATION AGAINST PEOPLE WITH DISABILITIES

My eyes were opened with the 1982 Baby Doe case in Indiana. Baby Doe was a newborn baby boy with an easily correctable hole between his esophagus (food pipe) and trachea (windpipe). He was denied this lifesaving surgery by his parents and a judge because he also had Down Syndrome. He also was not fed. Six days later, Baby Doe starved and dehydrated to death while his case was being appealed to the Supreme Court.

When we read the story, my husband and I wanted to adopt Baby Doe. But all offers of adoption were refused.

When our daughter Karen was born a few months after Baby Doe, we were stunned that she had both Down Syndrome and a severe heart defect but I was determined that she would not become another Baby Doe.

The cardiologist told us that Karen had an 80-90% chance of survival with one open-heart surgery by age 6 months. He also gave us a “choice”- to let Karen die. I was outraged that he could even consider not treating my daughter like any other baby with the same heart defect.

Even worse, when my daughter was hospitalized with pneumonia at 4 months, I was tipped off that my trusted pediatrician had made her a “do not resuscitate” without my knowledge or consent because “Nancy is too emotionally involved with that retarded baby”. I then realized that “choice” was just an empty slogan that had infected medical ethics.

Although Karen survived that incident, she unfortunately died at age 5 1/2 months just before her scheduled surgery.

At last I finally joined the disability rights and the pro-life movements.

THE “RIGHT TO DIE” MOVEMENT

A few years after Karen, I was shocked by the so-called “right to die” movement that pushed “living wills” to refuse even food and water by tube if or when a person became incapacitated. I became involved in both the Nancy Cruzan and Terri Schiavo cases.

Both involved seriously brain-injured, non-dying young women declared “vegetative”, a dehumanizing term invented in 1972. I wrote an op-ed for my local paper predicting that the potential pool of victims would expand if death by starvation and dehydration was allowed.

I was thinking about my own mother who had Alzheimer’s and cancer and indeed I was asked at one point if our family was going to feed her. I replied that my mother would die naturally from her condition, not starvation and dehydration.

How far we have descended! Now,  prominent doctors and the American Nurses Association are promoting what Compassion and Choices calls voluntary stopping of eating and drinking by mouth (VSED) as a legal option to  “speed up dying” for competent people with serious illnesses. “Living wills” to prevent even spoon feeding for people with dementia are also being developed.

PHYSICIAN-ASSISTED SUICIDE

The “right to die” movement ultimately did expand into the Compassion and Choices organization, the well-funded former Hemlock Society that promotes physician-assisted suicide by lethal overdose. In the late 1990s, Oregon became the first state to legalize assisted suicide. Now a handful of states and the District of Columbia have followed Oregon but the relentless effort to legalize physician-assisted suicide continues in the other US states.

Over the years, I had cared for many suicidal people and I saw the seductive effect of people like Jack Kevorkian, the infamous “Dr. Death” on them. As a nurse, I knew how dangerous it was to portray suicide as a “solution” to many at-risk people.

But it became personal when my 30 year old daughter Marie killed herself using an assisted suicide technique that she learned reading the pro-assisted suicide book “Final Exit”. My Marie had struggled with drug addiction for 16 years and despite our best efforts and those of her therapists, she finally succumbed to despair. She was the only suicidal person I ever lost.

I was not surprised when two people close to Marie became suicidal after her death. Fortunately, they were saved.

Suicide contagion is not a figment of someone’s imagination but a real phenomenon. It is no coincidence that the US suicide rate has skyrocketed since Oregon first legalized physician-assisted suicide.

EUTHANASIA

I also discovered that it’s only a short step from “I wouldn’t want to live like that” for assisted suicide to “No one should have to live like that” for euthanasia.

In 2003, Dr. Lloyd Thompson, then head of the Vermont Medical Society, escaped prosecution for intentionally giving a paralyzing, “life ending drug” to an elderly woman with terminal cancer whose breathing machine had been removed. The family had opposed prosecuting the doctor.

 Ironically and around the same time, I was threatened with the loss of my job after I refused to increase a morphine drip “until he stops breathing” on an older man who did not stop breathing as expected after his ventilator was removed. 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 escaped termination that time but I refused to back down.

An autopsy later showed that the man had no lethal condition or brain injury.

CONCLUSION

As the late Fr. Richard John Neuhaus wisely said  ” I believe in the slippery slope the same way I believe in the Hudson River. It’s there.”

But until and unless we are ready to recognize what we unlock when we legalize “just a little bit” of medical killing, we may find that the slippery slope has no bottom and that no one is safe.

And I saw it all start with the Roe v Wade decision legalizing abortion.

An Amazing Video of a Living, First Trimester Unborn Baby

Recently, I saw an amazing video in a post on the Nurses&Midwives4Life Ireland Facebook page showing a living, first trimester baby on a surgical field. The baby was moving its’ tiny head and limbs remarkably like a newborn baby. The image was both beautiful and heartbreaking since this little one could not survive.

The Speak Life video is covered with a warning that “This video may be sensitive to some people” and posted by Jonathan Van Maren, communications director for the Canadian Centre for Bio-Ethical Reform, with the caption ”This 8-second video of a first-trimester baby tells you everything you need to know about how wrong abortion is.”

I investigated further and it seems that the that the unborn baby was about 8 weeks old and that he or she had been removed after an ectopic pregnancy in which the unborn baby develops outside the womb.

Ectopic pregnancies can be life-threatening to both mother and child when the unborn baby develops in one of the Fallopian tubes leading to the womb, although there have been some rare cases where a baby develops in the abdomen and survives. Several years ago, I had an elderly patient who told me how her unborn baby survived decades ago when the doctors did not know that the baby was in the abdomen during her uneventful pregnancy until labor began. That is unlikely today since ultrasound images are routine during pregnancy.

A PICTURE IS WORTH A THOUSAND WORDS

Although the baby in the video could not survive after he or she was removed, the video itself is powerful evidence that abortion takes the life of a real human person even in the first trimester.

Most abortions are performed in the first trimester when women and the public are often told by organizations like Planned Parenthood that the unborn baby is just a “clump of cells”.  In the first trimester, most babies are aborted by either vacuum suction which destroys the little person or by  medical abortion using pills to first disrupt the attachment of the unborn baby to the mother and then expel the baby. However, abortion reversal is possible after the first set of pills.

Women who have abortions rarely see their baby after a first trimester abortion but it has happened, especially with medical abortion. This can be very traumatic to the woman. Contrast the look of the deceased first trimester unborn baby in the article titled “She took the abortion pill, then saw her 7-week-old baby” with the living first trimester unborn baby in the video.

CONCLUSION

Years ago, my late daughter Marie became unexpectedly pregnant and found out that the unborn baby was growing in one of her Fallopian tubes rather than her womb. She had to have emergency surgery when the tube ruptured.

Afterwards, the surgeon showed me the picture he had taken (unasked) during the surgery to remove the then deceased baby, my grandchild. The picture was personally so sad to see but I was comforted that the surgeon cared enough to take a picture of this tiny person.

After so many years and so many experiences as a nurse and volunteer in the pro-life movement, I believe that all women should be given the opportunity to know the truth about their unborn baby’s humanity as part of informed consent before abortion.

And I believe the rest of us should also have the opportunity to learn the same truth before we support legalized abortion.

This video of a living, first trimester unborn baby speaks louder than mere words.

“Life is Worth Living, Even if It is Painful and Short”

I was greatly moved by a December 21, 2018 op-ed in the Wall Street Journal by Gayle Somers titled “Life Is Worth Living, Even if It Is Painful and Short” with the subtitle “My son’s addiction caused great suffering and ended with a fatal overdose. I’ve never regretted his birth”

In this op-ed, Ms. Somers told the story of her son’s birth and eventual death 33 years later from an accidental overdose after a 14 year battle with drug addiction. That resonated with me since I lost my 30 year old daughter Marie to suicide using an assisted suicide technique after a 16 year battle with addiction.

But it was Ms. Somers’ wonderful statement “I’ve never regretted his birth” that caused me to write a letter to the editor that was published today:

“As someone who has lost a daughter to suicide and has also lost another daughter and a grandson to medical conditions, I really appreciate and agree with Gayle Somers’ op-ed “Life is Worth Living, Even if it is Painful and Short” (Dec. 22). My first daughter died at 30 after struggling with substance abuse for 16 years.

As a nurse and friend of bereaved parents, I also have never met a parent or grandparent who regretted the birth of his or her lost child.

I once was asked for advice by a bereaved mother after her 2-year-old son with Down Syndrome died unexpectedly. She wanted to know what might help her accept her son’s death with a hopeful outlook. From my own personal experience, I told her that solace comes when a lost child’s life rather than his death becomes the most important fact about him. The love itself never dies.

Nancy Valko

St. Louis

CELEBRATING LIFE

Ms. Somers also wrote in her op-ed that:

“These days pregnant women can take prenatal tests to learn about genetic defects their babies may have. Sometimes I’m grateful that no test allows you to see how a child’s life will unfold. All parents instinctively shrink from the excruciating expectation of a child’s suffering and, inevitably, their own suffering.

Some parents are so frightened at the prospect of raising a child with a genetic abnormality that they end the child’s life in the womb. While I understand this temptation—to spare the child the struggle, to spare yourself the pain—reflecting on the time I spent with my son convinced me that life is worth it despite the suffering.”

This also resonated with me since I lost my 5 1/2 month old daughter Karen who had Down Syndrome and a severe heart defect just before her scheduled surgery in 1983.

Two years later, I was pregnant again and the doctor strongly urged me to have an amniocentesis to test for Down Syndrome. I refused not only because of the unnecessary risk to the baby but also because I knew I would love this baby regardless of any condition or lifespan. Because of Karen, I was not afraid to welcome this baby.

Happily, my daughter Joy was born healthy and now has a baby daughter of her own to share with us.

CONCLUSION

Over the years, I’ve been inspired by many parents who have lost children of all ages. Some of these children died of natural causes and some from medical malpractice, tragic accidents, suicide and even murder.

The pain of losing a child is naturally devastating, especially at first. However, I have seen those same parents also rise up and honor those children’s lives by helping others or fighting injustices.

I consider Ms. Somers one of those inspiring parents, especially how she ended her op-ed by writing:

“Even knowing what we know now about how our children’s lives would end, all of us would choose life, no matter how short, no matter how painful. We welcomed our children into our families. We gave them names, and then, one day, we began to learn how to do what all parents must do—love without limits, comfort during the pain, not shrink from the suffering, give thanks for the gifts our children are to us.”

 

 

The Trouble with Planned Parenthood

In a stunning December 20, 2018 New York Times article  titled “Planned Parenthood Is Accused of Mistreating Pregnant Employees”, former employees of the $1.5 billion dollar ($543.7 million in government grants and reimbursements) organization assert that they were discriminated against because of their pregnancies.

The New York Times has long been one of the staunchest supports of Planned Parenthood as a great champion of “reproductive choice” through abortion, so it is ironic that their article paints a terrible picture of how the organization treats its own employees when they make the reproductive choice to have a child.

The New York Times interviewed several current and former employees of Planned Parenthood who described discrimination that violated state or federal laws against pregnancy discrimination by declining to hire pregnant job candidates, refusing requests by expecting mothers to take breaks and in some cases pushing women out of their jobs after they gave birth.

Perhaps the most heartbreaking story was that of  Ta’Lisa Hairston, an employee who became pregnant but later started battling high blood pressure that threatened her pregnancy. However, her multiple medical orders stating she needed frequent breaks  were ignored by management. Her hands swelled so much that she couldn’t wear the required plastic gloves and her doctor ordered bedrest. When she returned with orders not to work over 6 hours, she worked a much longer shift and few days later had to have an emergency C-section at 34 weeks. She resigned after repeated calls urging her to return to work before her guaranteed 3 months under the Family and Medical Leave Act was up.

Dr. Leana Wen, the new head of Planned Parenthood, says that the organization is looking into the allegations and will be “conducting a review to determine the cost of providing paid maternity leave to nearly 12,000 employees nationwide.”

While the New York Times article admits that “most Planned Parenthood offices do not provide paid maternity leave”, it counters that “(d)iscrimination against pregnant women and new mothers remains widespread in the American workplace.” The Times also blames “conservative lawmakers (who) routinely threaten to kill” Planned Parenthood’s taxpayer funding, making the organization’s financing “precarious”.

THE REAL TROUBLE WITH PLANNED PARENTHOOD

Planned Parenthood tries to downplay its’ role as the largest provider of abortion in the US by touting  services like breast cancer screening (without mammograms), birth control pills and devices, pregnancy tests, etc. to low-income women even though the reality is that there are many more places, such as federally qualified community health centers (which do not provide abortions) that provide more comprehensive health care services than those offered by Planned Parenthood.

But the larger problem is that it is hard to reconcile two completely opposite philosophies: an unborn child is nothing more than tissue that can be removed by abortion if a woman so chooses vs an unborn child is a living human being deserving of protection. Planned Parenthood is firmly on the side of the first philosophy.

Thus, as Live Action found when it contacted 97 facilities at 41 Planned Parenthood affiliates, it is almost impossible to find a Planned Parenthood clinic that offers prenatal care as well as abortion, not to mention Planned Parenthood’s current campaign to encourage women to “Shout Out Your Abortion”.

So it perhaps it should not be a surprise that a pregnant employee who wants her unborn baby might pose a challenge in a Planned Parenthood abortion clinic.

 

 

Why is the US Supreme Court Ducking the Issue of States Defunding Planned Parenthood?

As a nurse, I have always known that medical ethics and the law are very much entwined. But when the US Supreme Court unexpectedly legalized abortion in the 1973 Roe v Wade decision, I started really studying the legal system and how it impacts medical practice beyond just the medical malpractice cases that I knew about.

When I studied the actual Roe v Wade decision itself, the dissenting opinions, commentaries, amicus briefs, etc., I was appalled to find that the decision was basically political and not based on established science and facts.

That sad knowledge has insulated me from hopelessness with many subsequent US Supreme Court decisions involving abortion and other life issues. I have always felt that the truth about human lives-born and unborn-will eventually win.

But I have to admit that I was surprised that the majority of the current Supreme Court justices ruled against even hearing the Gee v Planned Parenthood of Gulf Coast case involving conflicting federal court cases decisions about states defunding Planned Parenthood in their Medicaid programs.

The Gee v Planned Parenthood case involved the issue of whether patients may sue states in federal court for restricting or removing providers from their Medicaid programs. The case does not directly involve abortion since the federal Hyde amendment prohibits Medicaid funding for abortion, a prohibition that Planned Parenthood itself insists “hurts women on Medicaid” and wants eliminated. Planned Parenthood also admits that:

Most of Planned Parenthood’s federal funding is from Medicaid reimbursements for preventive care, and some is from Title X. At least 60% of Planned Parenthood patients rely on public health programs like Medicaid and Title X for preventive and primary care.” (Emphasis added)

According to a Lozier Institute Report, in its latest report 2016-2017, Planned Parenthood received “$543.7 million in funds from all levels of government in that fiscal year…primarily from the Medicaid program”.

Several state laws have already excluded Planned Parenthood as Medicaid providers, especially after the reports of illegal harvesting of organs from aborted unborn babies and fraudulent billing. Federal law does give states substantial leeway to administer their Medicaid programs but does not define the term “qualified” for providers and states can exclude providers “for any reason…authorized by state law”. The law does allow for an appeal and judicial review for excluded providers.

According to the Wall Street Journal:

“But Planned Parenthood has leapfrogged state adjudication by recruiting plaintiffs to sue in federal court to vindicate their putative right to their preferred provider. Five appellate courts including the Fifth, Sixth, Seventh, Ninth and Tenth Circuits have recognized a private right of action while the Eighth has not.” (Emphasis added)

This split in court decisions needed to be resolved by the Supreme Court because it involves basic questions about the state-federal relationship.

Only four Supreme Court judges were necessary to vote to hear the case but 6 judges voted not to hear the case, surprisingly two of whom were considered conservative.

Justice Thomas who voted to hear the case was scathing in his rebuke of the 6 judges who voted not to even hear the case saying:

“So what explains the Court’s refusal to do its job here? I suspect it has something to do with the fact that some respondents in these cases are named ‘Planned Parenthood.’ That makes the Court’s decision particularly troubling, as the question presented has nothing to do with abortion.

Some tenuous connection to a politically fraught issue does not justify abdicating our judicial duty. If anything, neutrally applying the law is all the more important when political issues are in the background…The Framers gave us lifetime tenure to promote ‘that independent spirit in the judges which must be essential to the faithful performance’ of the courts’ role as ‘bulwarks of a limited Constitution,’ unaffected by fleeting ‘mischiefs.’” (Emphasis added)

The Supreme Court’s refusal to even hear the case is more than disappointing. Continuing the legal confusion about states’ rights will almost certainly lead to more litigation against states that pass laws excluding Planned Parenthood from Medicaid programs. As the Wall Street editorial states, “If the Justices duck every case remotely implicating gender politics, substantive constitutional issues will go unresolved and individual rights may be impaired.”

CONCLUSION

Ironically, although the brief by Planned Parenthood of Gulf Coast  to the Supreme Court insisted that their clinics “..provide essential medical care to thousands of low-income Louisiana residents through Medicaid” and “offer a range of services, including annual physical exams, screenings for breast cancer and cervical cancer, contraception, pregnancy testing and counseling, and other preventative health services”, the reality is that there are many more places, such as federally qualified community health centers (which do not provide abortions) that provide more comprehensive health care services than those offered by Planned Parenthood.

On a personal note, several years ago my late daughter Marie secretly went to a Planned Parenthood clinic for a possible sexually transmitted disease. She finally admitted this to me when her symptoms grew worse. I immediately took her to my own gynecologist who had to perform surgery to remove part of her cervix to deal with the damage.

Planned Parenthood had missed the diagnosis.