assisted suicide

New Dementia Directive Developed to Avoid Late-Stage Dementia

nancyvalko advance directives, Alzheimer's, assisted suicide, Cancer, culture, dementia, end-of-life, euthanasia, food and water, law, medical, medical ethics

In the September 25, 2025, issue of the Journal of Law, Medicine and Ethics, there is a shocking article titled “New VSED Advance Directive: Improved Documentation to Avoid Late-Stage Dementia.” VSED means voluntary stopping of eating and drinking.

The authors state:

“People use advance directives to express preferences that direct their future care when they lack decision-making capacity. One form of advance directive, a “dementia directive,” records preferences about living in various stages of dementia. This is important because many Americans want to avoid living with advanced progressive dementia. Unfortunately, traditional advance directives cannot dependably achieve this goal. In contrast, some dementia directives can achieve this goal by directing cessation of manually assisted feeding and drinking. (Emphasis added)

We proceed in six stages. First, we review the prevalence of advanced dementia. Second, we identify the disadvantages of another option for accomplishing the goal of not living into advanced dementia, preemptive VSED. Third, we distinguish notable court cases where dementia directives were unsuccessful. Fourth, we review nine prominent dementia directives, noting how the Northwest Justice Project’s Advance Directive for VSED remedies those shortcomings. Fifth, we review this directive’s legal status. Sixth, we articulate its ethical justification.”

CONCLUSION

I have had a lot of experience caring for people with Alzheimer’s, both personally and professionally. I have written several blogs over the years, such as “Five Things my Mother (and Daughter) Taught Me about Caring for People with Dementia” (2016), Marketing Death and Alzheimer’s Disease (2019), and Alzheimer’s Association Ends Agreement with Compassion and Choices, Marketing Death and Alzheimer’s Disease (2023). In 1988, I wrote an op-ed published in the St. Louis Post-Dispatch titled “FEEDING IS NOT EXTRAORDINARY CARE– DECISION IN THE NANCY CRUZAN CASE ADDS TO THE LIST OF EXPENDABLE PEOPLE“

I remember when my mother was first diagnosed with Alzheimer’s and thyroid cancer. She needed a tracheostomy (a tube in her windpipe), but was able to eat by mouth.

I was shocked when one doctor asked if we wanted her fed, and I responded angrily, “She gets up and eats ice cream out of the refrigerator! Do you want me to tackle her?!”

Of course, I knew what he meant, but he got the message.

Eventually, my mother died peacefully in her sleep at a nursing home after enjoying a meal and laughter with the whole family. It was the kind of death she told me she wanted.

Unfortunately, my younger brother developed Alzheimer’s and diabetes and was critically injured in a fall down the stairs last October. I was able to calm him and carefully feed him.

The doctor recommended a feeding tube to ensure he was getting adequate nutrition, especially for his diabetes.

However, a palliative care team was called in and disagreed with the doctor, telling my sister-in-law that my brother was not going to get better anyway.

I explained to the family that a small feeding tube was available and comfortable, but the family rejected that option.

It took several long days for him to die.

No wonder assisted suicide is being considered for Alzheimer’s patients!

New York Times: A PUSH FOR MORE ORGAN TRANSPLANTS IS PUTTING DONORS AT RISK

nancyvalko advance directives, assisted suicide, brain death, brain injury, civil rights, euthanasia, law, media, medical ethics, organ donation

A bombshell article in the July 20, 2025, New York Times titled “A Push forA Push for More Organ Transplants Is Putting Donors at Risk More Organ Transplants Is Putting Donors at Risk” states:

“People across the United States have endured rushed or premature attempts to remove their organs. Some were gasping, crying or showing other signs of life.” (Emphasis added).

and:

“Organ transplantation had another record year in 2024. That’s great news for all the recipient patients. But there is increasing scrutiny on the costs of the regulatory incentives pushing this success. An alarming number of donors were still alive as transplantation began. “ (Emphasis added)

The next day, the US HHS (Health and Human Services) published a report, “HHS Finds Systemic Disregard for Sanctity of Life in Organ Transplant System,” that reported:

“The U.S. Department of Health and Human Services (HHS) under the leadership of Secretary Robert F. Kennedy, Jr., today announced a major initiative to begin reforming the organ transplant system following an investigation by its Health Resources and Services Administration (HRSA) that revealed disturbing practices by a major organ procurement organization.

Our findings show that hospitals allowed the organ procurement process to begin when patients showed signs of life, and this is horrifying,” Secretary Kennedy said. “The organ procurement organizations that coordinate access to transplants will be held accountable. The entire system must be fixed to ensure that every potential donor’s life is treated with the sanctity it deserves.” (Emphasis added)

HRSA directed the Organ Procurement and Transplantation Network (OPTN) to reopen a disturbing case involving potentially preventable harm to a neurologically injured patient by the federally-funded organ procurement organization (OPO) serving Kentucky, southwest Ohio, and part of West Virginia. Under the Biden administration, the OPTN’s Membership and Professional Standards Committee closed the same case without action.

Under Secretary Kennedy’s leadership, HRSA demanded a thorough, independent review of the OPO’s conduct and the treatment of vulnerable patients under its care. HRSA’s independent investigation revealed clear negligence after the previous OPTN Board of Directors claimed to find no major concerns in their internal review.

HRSA examined 351 cases where organ donation was authorized, but ultimately not completed. It found:

  • 103 cases (29.3%) showed concerning features, including 73 patients with neurological signs incompatible with organ donation.
  • At least 28 patients may not have been deceased at the time organ procurement was initiated—raising serious ethical and legal questions.
  • Evidence pointed to poor neurologic assessments, lack of coordination with medical teams, questionable consent practices, and misclassification of causes of death, particularly in overdose cases. (All emphasis added)

Vulnerabilities were highest in smaller and rural hospitals, indicating systemic gaps in oversight and accountability. In response to these findings, HRSA has mandated strict corrective actions for the OPO and system-level changes to safeguard potential organ donors nationally. The OPO must conduct a full root cause analysis of its failure to follow internal protocols—including noncompliance with the five-minute observation rule after the patient’s death—and develop clear, enforceable policies to define donor eligibility criteria. Additionally, it must adopt a formal procedure allowing any staff member to halt a donation process if patient safety concerns arise.

Secretary Kennedy will decertify the OPO if it fails to comply with these corrective action requirements [PDF].

HRSA also took action to make sure that patients across the country will be safer when donating organs by directing the OPTN to improve safeguards and monitoring at the national level. Under HRSA’s directive, data about any safety-related stoppages of organ donation called for by families, hospitals, or OPO staff must be reported to regulators and the OPTN must update policies to strengthen organ procurement safety and provide accurate, complete information about the donation process to families and hospitals.

These findings from HHS confirm what the Trump administration has long warned: entrenched bureaucracies, outdated systems, and reckless disregard for human life have failed to protect our most vulnerable citizens. Under Secretary Kennedy’s leadership, HHS is restoring integrity and transparency to organ procurement and transplant policy by putting patients’ lives first. These reforms are essential to restoring trust, ensuring informed consent, and protecting the rights and dignity of prospective donors and their families.

HHS recognizes House Committee on Energy and Commerce Chairman Brett Guthrie’s (KY-02) bipartisan work to improve the organ transplant system and looks forward to working with him and other issue-area champions in Congress to deliver reforms.” (All emphasis added)”

CONCLUSION

As I wrote in my October 18, 2022, blog “PLEASE READ BEFORE YOU AGREE TO BE AN ORGAN DONOR”:

“But are ethical lines being crossed in the zeal to obtain organs to transplant?

While most people presume that organs can be removed and transplanted only after “all efforts to save your life have been exhausted” and brain death has been determined, that presumption is no longer necessarily true. (Emphasis added)

Now, organ donation can occur with a person who is in a coma and considered close to death but who does not meet the criteria for brain death. In those cases, an organ donor card or relatives who have agreed to withdraw a ventilator (a machine that supports or maintains breathing) and have the person’s organs removed for transplant if or when the heartbeat stops. This was called DCD or donation after cardiac death until some doctors found that the stopped heart could be successfully restarted it in the patient receiving the transplant!

Now, that ethically questionable procedure is called donation after circulatory death (also DCD) since circulation stops when the heart stops.

If circulation does not stop within 60 minutes, the organs are deemed to be too damaged for transplant and the patient dies without donating organs.

IT GETS WORSE

A September 29, 2022, article in Medpage titled “No Brain Death? No Problem. New Organ Transplant Protocol Stirs Debate-Is it ethical to pull the plug in patients who aren’t brain dead, then restart their hearts?” reported on a new procedure to get more organs:

“With little attention or debate, transplant surgeons across the country are experimenting with a kind of partial resurrection: They’re allowing terminal patients to die, then restarting their hearts while clamping off blood flow to their brains. The procedure allows the surgeons to inspect and remove organs from warm bodies with heartbeats.” (Emphasis added)

The article also said that this new procedure is being criticized by doctors like Dr. Wes Ely and the American College of Physicians, who warned that the procedure raises “profound ethical questions regarding determination of death, respect for patients, and the ethical obligation to do what is best.”

and

“PRESUMED CONSENT AND LAW

Another problem is “presumed consent,” which is the assumption that everyone is willing to donate his/her organs unless there is evidence that they would not want to donate. Illinois narrowly avoided a “presumed consent” statute a few years ago in which people who didn’t want to donate had to file an opt-out document with the Secretary of State. (Emphasis added)

Some countries already have “presumed consent” laws, most recently in England, which states:

“it will be considered that you agree to become an organ donor when you die, if:

  • you are over 18;
  • you have not opted out;
  • you are not in an excluded group”

Even more horrifying, there have also been proposals to link organ donation and assisted suicide as “a potential solution to the organ scarcity problem”. Countries like Belgium and the Netherlands already allow this.

CONCLUSION

Organ donation can truly be “the gift of life”, and innovations such as adult stem cells. The donation of a kidney or part of a liver by a living person generally poses no ethical problems and holds much promise to increasingly meet the needs of people with failing organs. I have a grandson whose life was saved by a stem cell transplant, and another relative who has had 2 kidney transplants.

Personally, I have offered to be a living donor for friends, and my family knows that I am willing to donate tissues, such as bone, corneas, and skin, that can be used after natural death.

Everyone can make his or her own decision about organ donation, but we all must have the necessary information to make an informed decision. (Emphasis added)

“Suicide Helpline” in Canada Suggested Euthanasia for a Person with Disabilities

nancyvalko assisted suicide, Compassion & Choices, culture, drug addiction, education, euthanasia, law, medical ethics, mental health, nursing

In a stunning article on Ales Schadenberg’s May 31, 202 blog titled “Suicide helpline suggested euthanasia for my disabled friend”, Meghan Schrader, a disability justice advocate and scholar, warns that “it is best to nip the USA assisted suicide movement in the bud and not let that movement get its foot in the door” and tells the story of her Canadian friend “Amy”. (Emphasis added)

Ms. Schrader writes that Amy reached out to her for help after Canada legalized euthanasia for disabled people in 2021.

“Amy had endured child abuse, which left Amy with PTSD and physical injuries that caused severe chronic pain. As an indigent disabled person Amy was unable to access thorough medical treatment for these disabilities, so even though Amy wanted to live and was deeply offended by Canada’s decision to expand euthanasia to people with disabilities, Amy’s suffering was so great that Amy thought constantly of dying by “MAiD” (Medical Aid in Dying).”

“However, when Amy called a mental health and suicide crisis support hotline for poor people and asked the operator for help fighting against these thoughts, the operator said, “Well, MAiD is a legit and legal option. Maybe it’s something you should consider. The medical system seems to be failing you. And you are never going to get the opiate pain medication that you think you need.” (Emphasis added)”

“With help from about ten different people, including the Euthanasia Prevention Coalition, Amy was eventually able to take a train four hours away from home and show up in the emergency room of a hospital that opposes “MAiD” and specializes in chronic pain and mental illness. Amy finally received excellent care. Although Amy sometimes still has symptoms of chronic pain and PTSD and life is still often quite a struggle, Amy’s symptoms are manageable and Amy is not planning to die by “MAiD.” It was my honor to attend Amy’s Zoom birthday party recently.

But thanks to Compassion and Choice’s friends in Canada and the systemic ableism that is enabling their cause, the Canadian medical system would have killed Amy before providing adequate medical treatment or support.”

She ends by stating:

“I’ve read statements from proponents of recent assisted suicide bill’s saying that their supporters are “real people with grief and loss, not hypothetical scenarios.” Well, Amy and Rachel are not hypothetical scenarios, they are my friends. I’ve read statements describing myself and other disability rights movement opponents of assisted suicide as “abusive, bullying and cruel.” (Emphasis added)

But I can think of few things more abusive, bullying and cruel than for a suicide prevention hotline operator to tell a caller to go ahead and be killed. I don’t want to live in that world, and like others in the disability justice movement, I won’t be quiet while the proponents lay the scaffolding for that to happen.

I’m sorry if that makes me cruel.”

CONCLUSION

As I wrote in 2015:

“In 2009, I lost my 30 year old daughter Marie to assisted suicide after using an assisted suicide technique after a 16 year battle with addiction.

Marie’s suicide hit our family, her friends, and her therapists like an atom bomb. We had all tried for years to help her, with periods of success. Suicide was always our greatest fear, and we made sure she was armed with crisis helpline numbers and our cell phone numbers at all times. I trust in an all-merciful God Who loves my daughter as much as I do, and I don’t regret one minute of those 16 years of trying to save her.

Both personally and professionally, as a nurse, I’ve cared for many suicidal people whose lives were saved. It’s a myth that suicidal people are destined to commit suicide eventually, and studies have shown that only 10 percent (or less, according to some studies) complete a suicide.1 I’m still determined to save vulnerable people from suicide, regardless of their age, socioeconomic status, or condition. Giving up hope is not an option.

Not surprisingly, since suicide contagion is a recognized risk factor for suicide, one of Marie’s close friends became suicidal on the first anniversary of her suicide but was saved. Is it really just a coincidence that Oregon, which doesn’t include assisted suicide in its suicide statistics, now reports a suicide rate that’s 41 percent above the national average?4“

But the “assisted suicide/ euthanasia” machine still rolls on in the US.

The Patients Rights Action organization keeps track of states with bills to legalize assisted suicide and those states that defeated assisted suicide. (see state status updated 5/29/2025)

Please check the status in your state and take the necessary action.

We cannot become like Canada!

FEEDING IS NOT EXTRAORDINARY CARE– DECISION IN THE NANCY CRUZAN CASE ADDS TO THE LIST OF EXPENDABLE PEOPLE

nancyvalko assisted suicide, brain injury, conscience rights, disability, education, end-of-life, euthanasia, food and water, futility, law, Living wills, medical, medical ethics, nursing, pro-life

Before the famous Terri Schiavo food and water case gained national attention 20 years ago, Dr. Harvath and I wrote this Op-Ed in the St. Louis Post-Dispatch (no longer online) about the Nancy Cruzan casw, an earlier case of withdrawing food and water from a “so-called “vegetative state”‘ My family was furious when it was pusblished and told me that I was being “mean” to the family.

Unfortunately, such removal has become common and even recently, has resulted in a brother’s death.

Not surprisingly, so-called “assisted suicide” is now allowed in many states and countries

Nancy Valko, RN

Here is our op-ed:
Friday, August 12, 1988
FEEDING IS NOT EXTRAORDINARY CARE– DECISION IN THE NANCY CRUZAN CASE ADDS TO THE LIST OF EXPENDABLE PEOPLE

By Susan Harvath and Nancy Guilfoy Valko                                                                    

Just a few years ago the Missouri Legislature passed a ”living will” law that specifically excluded food and water from the kinds of care that may be withdrawn from a patient. In 1984, the National Conference of Catholic Bishops stated that legislation should ”recognize the presumption that certain basic measures such as nursing care, hydration, nourishment and the like must be maintained out of respect for the human dignity of every patient.”

Therefore, it is hoped that the Missouri Court of Appeals will overturn the recent Circuit Court decision that would deny tube feedings for Nancy Cruzan, a severely disabled woman cared for at the Missouri Rehabilitation Center. The anguish felt by the Cruzan family, which initiated the suit, is understandable. However, directly causing the death of an innocent person – even for reasons of mercy – violates that person’s basic human rights.

The Cruzan case is perceived by many to be an issue of allowing a person to die. Cruzan has been categorized by some experts as being in a ”persistent vegetative state,” an unfortunate and imprecise term at best. However, she is not dying or brain-dead. Rather, she is severely disabled from brain damage and needs no special technology to survive. Withdrawing her feeding tube would not ”allow” her to die – it would ”force” her to die. She would not die from her injuries, but rather from starvation and dehydration.

Also, starvation and dehydration cause a protracted, agonizing death in a fully conscious person. Some experts have stated that Cruzan would feel no pain if her feedings were stopped. Yet Cruzan’s nurses have testified that she has cried, smiled and even laughed in response to stimuli.

The possibility of pain during the length of time before death occurs has led some to propose lethal injections as a more ”humane” way to cause death than starvation. The passive euthanasia of withdrawing feeding logically leads to active euthanasia by injection or other means. Both are unacceptable.

A recent trend has been to classify tube feedings as medical treatment. However, unlike other medical treatments, denial of food from any person (sick or healthy, in or out of coma) will always result in that person’s death.

Ethically, treatments may be withdrawn if they are useless or burdensome to the patient. However, tube feedings are not excessively expensive or burdensome to the patient and do maintain life and prevent the discomfort of hunger and thirst. In deciding what treatment may ethically be withdrawn one must be careful to judge the treatment itself, not the ”quality” of the patient’s life. A person’s limitations do not decrease a person’s humanity or worth.

In the past few years, we have seen many court cases similar to Cruzan’s in other states. Some have involved people less severely disabled than Cruzan. A recent case in North Dakota resulted in a judgment that even feedings by mouth may be stopped. In most cases, it is not the patient who requests that feedings be stopped but rather a third party, usually a family member. Often, as in the Nancy Cruzan case, there is no clear and convincing evidence that the patient would even want the feedings stopped.

Some courts have gone even further and have stated that third parties do not need the approval of a court before a patient’s food and water is withdrawn unless there is disagreement, for example, among family members. This trend has unfortunate implications for all people with mental impairments.

There is a vast difference between not prolonging dying and causing death. In the last two decades, we have seen killing promoted as a humane and compassionate response to unwanted unborn children, newborns with handicaps, and the terminally ill. Let us not add a new category of people (the non-dying, severely disabled) to the list of expendable human lives.

Nancy Guilfoy Valko, R.N., is co-chairperson, and Sue Harvath is program director of the St. Louis Archdiocesan Pro-Life Committee.

Hawaii Doctor Investigated for Assisted Suicide Murder

nancyvalko assisted suicide, conscience rights, culture, end-of-life, law, medical ethics

A January 8, 2025 news article in the Hawaii Free Press titled “Hawaii Doctor under Investigation for Murder in Woman’s Assisted Suicide Death” reveals that authorities are investigating a doctor for murder after police say he administered assisted suicide drugs to a woman.

Under Hawaii’s assisted suicide law passed in 2018, patients who have been approved for “assisted death” are required to self-administer the lethal dose of drugs.

The newspaper states:

“In this case, the 73-year-old doctor allegedly broke the law and assisted his 88-year-old patient in taking the lethal medication on October 9, 2024. According to the police report, at one point the woman was starting to choke and motioned for the doctor to stop — but he continued, causing her death. After an autopsy, the Medical Examiner’s Office ruled the death a homicide. According to Island News, the doctor is being investigated for second-degree murder, but as of yet no charges have been filed.” (All emphasis added)

In his January 4, 2025 Medical Futility blog titled “MAID Noncompliance Leads to Murder Investigation, assisted suicide supporter Thaddeus Pope, JD.Phd. states:

“All U.S. MAID laws require that the patient self-administer the medications (typically DDMA-Ph). When someone else administers the medications, that is not MAID. Instead, that is assisted suicide which remains criminally prohibited in all U.S. jurisdictions including those that permit MAID. ” (Emphasis added)

CONCLUSION

A report released in February 2024 showed that 166 people had died by assisted suicide in Hawaii since its legalization in 2018. According to KTVZ, this is the first homicide investigation related to the OCOCA.

Suicide- medically assisted or not- is never a death with dignity for anyone!

One In Four Brain Injury Patients Who Appear Unresponsive Respond Covertly

nancyvalko assisted suicide, brain injury, culture, disability, education, food and water, futility, medical ethics, vegetative state, ventilators/life support

Back in May, I wrote the blog “New Study: Brain-injured patients who died after life support ended may have recovered” about a 7 1/2 year study of 1392 traumatic brain injury patients in ICU at 18 US trauma centers.

The researchers designed a mathematical model to calculate the likelihood that life-sustaining treatment would be discontinued “based on demographic, socioeconomic factor and injury characteristics” and then “paired patients continuing on life-sustaining treatment to individuals with similar moded scores but for whom life-sustaining treatment was stopped.”

They found that of the survivors who did not have life-sustaining treatment withdrawn, “more than 40% recovered at least some independence.” (Emphasis added)

This led one researcher to conclude that:

““Predicting who will recover following severe traumatic brain injury, and to what degree, can be challenging. Yet, families are often asked to make decisions about continuing or withdrawing life support, such as mechanical breathing, within just 72 hours of the injury,” Bodien said.

“This decision is based largely on whether the clinical team believes that recovery is possible,” she added. “It is unknown whether some people who died because life support was discontinued could have survived and recovered had life support been continued.” (All emphasis added)

NEW STUDY

Now a newer study, published in August, states that one in Four Brain Injury Patients Who Appear Unresponsive Respond Covertly | MedPage Today, finding that functional MRI and EEG tests can detect awareness in coma or vegetative states.

The authors explain that:

“Cognitive-motor dissociation — a phenomenon that occurs when patients who appear unresponsive perform cognitive tasks that can be detected on functional MRI (fMRI) or electroencephalography (EEG) — occurred in one in four people with severe brain injury, a prospective cohort study found.”

The study evaluated 241 unresponsive patients with brain injury who were given verbal commands, such as to imagine playing tennis or opening and closing their hands.

Of these, 60 patients (25%) repeatedly showed brain activation on fMRI or EEG indicating they were covertly following instructions, reported Nicholas Schiff, MD, of Weill Cornell Medicine in New York City, and co-authors in the 

Cognitive-motor dissociation was associated with younger age, longer time since injury, and brain trauma as an etiologic factor. In total, 11 patients with cognitive-motor dissociation were assessed with fMRI only, 13 were assessed with EEG only, and 36 with both techniques.

“This research shows that a substantial fraction of apparently unresponsive, severely brain-injured persons are aware and can engage in sustained cognitive activity,” Schiff told MedPage Today. These findings importantly point to the need to establish infrastructure to evaluate patients and to begin efforts to test possible therapies to help them.” (All emphasis added)

CONCLUSION

I have worked with brain-injured patients for decades both as a nurse and as a volunteer and I personally saw many amazing recoveries or improvements despite dire predictions and/or recommendations of life support removal.

One of the most amazing cases was a woman with disabilities whose husband wanted to remove life support as the doctors recommended.

As she personally told me, she frantically tried to move her hands to protest but her gestures were seen as seizures and she was given sedatives.

She persisted until finally, one nurse said she might be trying to tell us something and gave her a paper and pencil.

The patient wrote d-i-v-o-r-c-e.

She not only lived but became active in the disability community fighting assisted suicide!

Shocking Article in Academic Medicine: Helping Patients Die: Implementation of a Residency Curriculum in Medical Aid in Dying

nancyvalko assisted suicide, culture, disability, education, end-of-life, euthanasia, media, medical ethics ,

“First, do no harm” is attributed to Hippocrates and is one of the principal precepts of bioethics that all healthcare providers are (or were) taught in school and is a fundamental principle throughout the world.

But today,  the Hippocratic Oath, the oldest and most widely known treatise on medical ethics that forbade actions such as abortion and euthanasia that medical students routinely took upon graduation, has now been revised or dropped at many medical schools.

So we should not be surprised that we now have an article in the August issue of Academic Medicine (lww.com) titled Helping Patients Die: Implementation of a Residency Curriculum in Medical Aid in Dying by Spielvogel, Ryan MD, MS; Schewe, Savannah MD

The authors state the need for such a program is because:

“As more states legalize medical aid in dying (MAID), there is an ever-increasing need of physicians trained in this type of end-of-life care. However, resident curricula in MAID have not been previously reported or assessed. The authors describe a residency curriculum in MAID and evaluate the resident outcomes of this program.” (Emphasis added)

They describe the program they started in California:

“Since 2018, the Sutter Family Medicine Residency Program in California has offered training in MAID to its residents. Residents attend lectures, evaluate patients for MAID, write prescriptions for aid-in-dying medications, and attend the planned deaths of their patients if desired. In February 2023, an anonymous branching survey was sent to graduates of the program from 2019 to 2022 to evaluate residency graduation year, receipt of MAID training, currently practicing MAID, how rewarding MAID is compared with other clinical responsibilities, how stressful MAID is compared with other clinical responsibilities, comfort discussing MAID with colleagues, comfort discussing end-of-life care generally, personal view of MAID as a practice, and works where MAID is permitted.”

RESULTS OF THE SURVEY

“The authors surveyed 28 graduates and collected data from 21 former residents (response rate, 75%). Of these 21 former residents, 17 (81%) reported having opted to receive training in MAID during residency. Of the 12 residents who received training and were currently practicing in a location that allowed MAID, 7 (58%) were still practicing aid-in-dying, and of these 7 residents, 5 (71%) reported that their aid-in-dying work was more rewarding than their other clinical responsibilities.” (Emphasis added)

The authors of this study conclude that there is:

“promising preliminary evidence that MAID training in residency may be an effective strategy in the long term at closing the suspected patient access gap that purportedly exists. This preliminary evidence can be inferred by the fact that 7 of the 21 responding graduates (33%) in this study reported actively practicing MAID compared with the 30 of approximately 5,000 physicians (approximately 0.6%) practicing MAID group-wide at the large institution described above.” (All emphasis added)

CONCLUSION

Ominously, an August Gallup poll titled ” Most Americans Favor Legal Euthanasia ” stated that ” 71% of Americans polled “believe doctors should be ‘allowed by law to end the patient’s life by some painless means if the patient and his or her family request it’.”

That is a change from polling in 1950 showing only 36% support for “ending a patient’s life through painless means”. (All emphasis added)

Tragically, too many Americans are falling for the lie that it is better to be made dead than disabled or dying. Assisted suicide laws are tragically wrong and I have personally testified against them. It’s not about politics. It’s about medical ethics and the need for trust in both our healthcare system and our healthcare providers.

When Food and Water Withdrawal is Recommended to Hasten Death

nancyvalko advance directives, Alzheimer's, assisted suicide, culture, dementia, disability, end-of-life, euthanasia, food and water, hospice, law, Living wills, medical ethics, VSED , , , ,

Recently, I was contacted by a man who was concerned about hospice care for his mother.

He wrote:

“I spoke to one hospice service that was recommended and asked about AHN (artificial hydration and nutrition) and I was basically told that if my mother became unconscious, they would not attempt to provide AHN. My mother has dementia and we’ve had a few scares where we were unsure she would recover. I’d like to understand what guideline I should expect the hospice to follow and whether hospice is even worth considering. Are there prescriptive standards of care that I can reference or could you tell me basically what routine care look like?”

I wrote back that I understood his concerns, especially since I recently lost a brother with dementia, diabetes and Crohn’;s disease after a second fall down stairs. H had trouble eating so the doctors recommended a feeding tube.

Unfortunately, a person from palliative care told my sister-in-law that he would not improve so she decided to refuse a feeding tube.

I told her that newer feeding tubes were more comfortable, could make him feel better and were worth a try but she rejected this. She said my brother told her he would not want to I’ve if he developed dementia- like our mother.

It took 4 long days for him to die.

I also told him that I have been writing about this problems for years, including my 2018 blot “‘Living Wills’ to Prevent Spoon Feeding at https://nancyvalko.com/?s=living+wills+to+prevent+spoon+feeding

I have seen the deterioration of medical ethics over 50 years as a nurse from requiring life-sustaining treatment unless it was medically futile or excessively burdensome to whatever is legal.

I would recommend to you two resources from the Healthcare Advocacy and Leadership Organization (HALO):

1, “The Food and Water Dilemma” at https://halovoice.org/wp-content/uploads/5.20.21-Making-a-Difference-8.pdf

2. “Making a Difference: A Guide for Defending the Medically Vulnerable” at https://halovoice.org/wp-content/uploads/5.20.21-Making-a-Difference-8.pdf

CONCLUSION

I have worked in hospice, critical care, etc. for decades and I was glad to be able to care for my patients, my mother and others so that they had dignity, comfort and emotional support at the end of life.

I hope these resources from HALO can help bring vital information, peace and comfort to others and their families.

Great News: Governor Finally Vetoes Delaware Assisted Suicide Bill

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

In an excellent article in the Christian Post on June 28, 2024, reporter Samantha Kamman reported:

““A national coalition of pro-life nurses (NAPN, the National Association of Pro-life Nurses) says they “will not comply” with Delaware’s assisted suicide bill that passed in the Senate Tuesday as the state’s lone Catholic diocese is calling on people of faith to urge Democratic Gov. John Carney to veto the legislation. “

Ms Kamman explains that:

“H.B. 140 passed in the Senate with an 11-10 vote and will become law unless Carney vetoes it. Under the proposed law, adult patients who are “terminally ill” or have received the prognosis that they have six months or less to live can request or self-administer drugs to hasten their deaths.

Both the individual’s attending physician or attending advanced practice registered nurse (APRN) and a consulting physician or APRN must agree on the patient’s condition and decision-making capacity. Two waiting periods must pass before the patient can receive the drugs to end their life, and medical professionals who prescribe the medication must provide the patient the opportunity to rescind the request to kill themselves. 

The law would also grant immunity to medical professionals who offer life-ending drugs to patients, so long as they are “acting in good faith and in accordance with generally accepted health-care standards under this Act.” As the bill states, those “acting with negligence, recklessness, or intentional misconduct do not have criminal or civil immunity.” (All emphasis added)”

Ms. Kamman reported NAPN’s response:

“The National Association of Pro-Life Nurses, which has advocated against assisted suicide legislation for over 30 years, condemned the bill, calling it a “moral catastrophe that corrupts the very soul of healthcare.”

Marie Ashby, NAPN’s executive director, argued in a statement to The Christian Post that the bill “preys” on “the desperate and devalues the disadvantaged,” adding that it offers “poison as a perverse form of mercy” to people society deems “inconvenient.”

“Legitimate healthcare heals; it doesn’t kill,” Ashby added. “This law perverts our profession’s sacred duty, turning nurses from guardians of life into agents of death. We will not be silent. We will not comply.”

NAPN President Dorothy Kane contends, “Delaware has chosen death over dignity, despair over hope.” (All emphasis added)

Conclusion-Great News

On September 20, 2024, Delaware Governor Johns Carey vetoed HB 140, saying that:

“As I have shared consistently, I am simply not comfortable letting this piece of legislation become law. For the reasons set forth above, I am hereby vetoing House Bill 140 with House Amendment 1 by returning it to the House of Representatives without my signature.” (Emphasis added)

“Jessica Rodgers, Coalitions Director for the Patients’ Rights Action Fund told LifeNews she was delighted by the news.

“Thanks to the tireless efforts of Delaware advocates who have shown up year after year after year, assisted suicide will not be coming to their state. I have been amazed and humbled at the work of these doctors, nurses, disability rights advocates, and all who care for their vulnerable neighbors,” she said. “Time and again when the call was put out to take action, they answered. And you answered- you called and emailed Governor Carney’s office and you made the difference.”

And just in time!

Gallup Poll: Most Americans Favor Legal Euthanasia

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A shocking Gallup poll titled Most Americans Favor Legal Euthanasia published on August 2, 2024, stated that 71% of Americans polled “believe doctors should be ‘allowed by law to end the patient’s life by some painless means if the patient and his or her family request it’.”

and

“Sixty-six percent of Americans believe doctors should ‘be allowed by law to assist the patient to commit suicide’” for terminal patients living in severe pain who request it.”

That is a change from polling in 1950 showing only 36% support for “ending a patient’s life through painless means”. (All emphasis added)

However, as Gallup reports,:

” Most U.S. subgroups are somewhat more inclined to support doctors ending patients’ lives through painless means than to agree with doctors assisting patients in dying by suicide. Among the exceptions are Democrats and women, who are about equally likely to say both euthanasia and doctor-assisted suicide should be legal. Democrats (79%) are more likely than Republicans (61%) or independents (72%) to favor legal euthanasia.” (Emphasis added)

The Perceived Morality of Doctor-Assisted Suicide

Gallup says that:

“Americans’ feelings on the morality of doctor-assisted suicide are more mixed than their views on its legality, with a slim majority (53%) agreeing that the procedure is morally acceptable and 40% calling it morally wrong. More than half of Americans have considered doctor-assisted suicide as morally acceptable since 2014. In contrast, from 2001 to 2013, this sentiment was generally at or below 50%.” and that “Religiosity has the most significant impact on one’s perceptions of morality regarding this question.”

Not surprisingly, Gallup reports that “Americans in regions allowing doctor-assisted suicide are also among the most likely to say it is moral.” (All emphasis added)

CONCLUSION

Tragically, so many Americans are falling for the lie that it is better to be made dead than disabled or dying. Assisted suicide laws are tragically wrong and I have personally testified against them. It’s not about politics. It’s about medical ethics and trust in our healthcare system.

For decades, I have personally and professionally cared for many patients, friends, and relatives who were disabled or dying- either at home or in a health facility.

Pain can be controlled without killing the patient but, just as important, is helping both the patient’s and family’s emotional distress and fears.

I ask two questions: what do you want and what are you afraid of?

With patients, fear of a terrible death or being a burden on the family are usually the biggest fears. With families, fear of not being able to care for their loved ones adequately can be overwhelming. Luckily, there are many options and services available. Families and friends also need support and encouragement. Loneliness can be devasting and laughter can be therapeutic for everyone.

I have found that when patients and their relatives are allowed to talk honestly and get the support they need, relationships and old regrets can mended. A good death is possible.

I feel blessed as a nurse to witness the healing power of caring.

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