NEW MEXICO GOVERNOR SIGNS LATEST US LAW TO LEGALIZE ASSISTED SUICIDE AS ARKANSAS GOVENOR SIGNS THE “MEDICAL ETHICS AND DIVERSITY ACT”

On April 8, 2021, New Mexico became the latest and ninth state (along with Washington D.C.) to legalize “medically assisted suicide”.

Note the new terminology used is no longer called “physician-assisted suicide”. This is no accident but rather reflects the persistent expansion of assisted suicide law to allow even non-physicians like physician assistants and nurse practitioners to determine that a requesting patient has six months or less to live and provide them with the suicide drugs.

Ironically, Medicare benefit rules for certifying a terminal illness with a life expectancy of six months or less to be eligible for hospice states that “No one other than a medical doctor or doctor of osteopathy can certify or re-certify a terminal illness”. (Emphasis added) And having worked as a home hospice, ICU and oncology nurse, I know how difficult it is to predict when a patient is expected to die.

And, like other assisted suicide laws, New Mexico’s law also has unenforceable and easily circumvented “safeguards’ like mental health evaluations that are required for any other suicidal patient.

The law also requires that terminally ill patients has “a right to know” about all legal options including assisted suicide and that healthcare providers who refuse to participate in medically assisted suicide must refer that patient to another willing provider.

Nevertheless, New Mexico Gov. Michelle Grisham said she signed the law HB0047 to secure the “peace of mind and humanity this legislation provides.”

THE MEDICAL ETHICS AND DIVERSITY ACT

In a striking contrast to New Mexico’s assisted suicide law, Governor Asa Hutchison signed the “Medical Ethics and Diversity Act” just days earlier on Friday, March 26, 2021 which expanded conscience rights in the state.

As the statute eloquently states:

“The right of conscience is a fundamental and unalienable right.

“The right of conscience was central to the founding of the United States, has been deeply rooted in the history and tradition of the United States for centuries, and has been central to the practice of medicine through the Hippocratic oath for millennia … The swift pace of scientific advancement and the expansion, of medical capabilities, along with the notion that medical practitioners, healthcare institutions, and healthcare payers are mere public utilities, promise only to exacerbate the current crisis unless something is done to restore the importance of the right of conscience.

It is the public policy of this state to protect the right of conscience of medical practitioners, healthcare institutions, and healthcare payers. It is the purpose of this subchapter to protect all medical practitioners, healthcare institutions, and healthcare payers from discrimination, punishment, or retaliation as a result of any instance of conscientious medical objection.”

However, opponents of the law like the Human Rights Campaign and the American Civil Liberties Union, have argued that it would allow doctors to refuse to offer a host of services for LGBTQ patients.

In response to this criticism, Governor Hutchinson stated:

“I have signed into law SB289, the Medical Ethics and Diversity Act. I weighed this bill very carefully, and it should be noted that I opposed the bill in the 2017 legislative session. The bill was changed to ensure that the exercise of the right of conscience is limited to ‘conscience-based objections to a particular health care service.’ I support this right of conscience so long as emergency care is exempted and conscience objection cannot be used to deny general health service to any class of people. Most importantly, the federal laws that prohibit discrimination on the basis of race, sex, gender, and national origin continue to apply to the delivery of health care services.”

CONCLUSION

As a nurse myself, I would not and never have refused to care for any patient. Discrimination has no place in healthcare.

However, I have been threatened with termination when I have refused to follow an order that would cause a patient’s death. It wasn’t the patient I objected to but rather the action ordered.

Conversely, I would not want a healthcare provider caring for me who supports assisted suicide, abortion, etc. This is why I ask my doctors about their stands on such issues before I become their patient.

Our country and our healthcare systems need laws, healthcare providers and institutions that we can trust to protect us. Conscience rights protections are a critical necessity for that to happen.

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NEW MEXICO GOVERNOR SIGNS LATEST US LAW TO LEGALIZE ASSISTED SUICIDE AS ARKANSAS GOVENOR SIGNS THE “MEDICAL ETHICS AND DIVERSITY ACT”

On April 8, 2021, New Mexico became the latest and ninth state (along with Washington D.C.) to legalize “medically assisted suicide”.

Note the new terminology used is no longer called “physician-assisted suicide”. This is no accident but rather reflects the persistent expansion of assisted suicide law to allow even non-physicians like physician assistants and nurse practitioners to determine that a requesting patient has six months or less to live and provide them with the suicide drugs.

Ironically, Medicare benefit rules for certifying a terminal illness with a life expectancy of six months or less to be eligible for hospice states that “No one other than a medical doctor or doctor of osteopathy can certify or re-certify a terminal illness”. (Emphasis added) And having worked as a home hospice, ICU and oncology nurse, I know how difficult it is to predict when a patient is expected to die.

And, like other assisted suicide laws, New Mexico’s law also has unenforceable and easily circumvented “safeguards’ like mental health evaluations that are required for any other suicidal patient.

The law also requires that terminally ill patients has “a right to know” about all legal options including assisted suicide and that healthcare providers who refuse to participate in medically assisted suicide must refer that patient to another willing provider.

Nevertheless, New Mexico Gov. Michelle Grisham said she signed the law HB0047 to secure the “peace of mind and humanity this legislation provides.”

THE MEDICAL ETHICS AND DIVERSITY ACT

In a striking contrast to New Mexico’s assisted suicide law, Governor Asa Hutchison signed the “Medical Ethics and Diversity Act” just days earlier on Friday, March 26, 2021 which expanded conscience rights in the state.

As the statute eloquently states:

“The right of conscience is a fundamental and unalienable right.

“The right of conscience was central to the founding of the United States, has been deeply rooted in the history and tradition of the United States for centuries, and has been central to the practice of medicine through the Hippocratic oath for millennia … The swift pace of scientific advancement and the expansion, of medical capabilities, along with the notion that medical practitioners, healthcare institutions, and healthcare payers are mere public utilities, promise only to exacerbate the current crisis unless something is done to restore the importance of the right of conscience.

It is the public policy of this state to protect the right of conscience of medical practitioners, healthcare institutions, and healthcare payers. It is the purpose of this subchapter to protect all medical practitioners, healthcare institutions, and healthcare payers from discrimination, punishment, or retaliation as a result of any instance of conscientious medical objection.”

However, opponents of the law like the Human Rights Campaign and the American Civil Liberties Union, have argued that it would allow doctors to refuse to offer a host of services for LGBTQ patients.

In response to this criticism, Governor Hutchinson stated:

“I have signed into law SB289, the Medical Ethics and Diversity Act. I weighed this bill very carefully, and it should be noted that I opposed the bill in the 2017 legislative session. The bill was changed to ensure that the exercise of the right of conscience is limited to ‘conscience-based objections to a particular health care service.’ I support this right of conscience so long as emergency care is exempted and conscience objection cannot be used to deny general health service to any class of people. Most importantly, the federal laws that prohibit discrimination on the basis of race, sex, gender, and national origin continue to apply to the delivery of health care services.”

CONCLUSION

As a nurse myself, I would not and never have refused to care for any patient. Discrimination has no place in healthcare.

However, I have been threatened with termination when I have refused to follow an order that would cause a patient’s death. It wasn’t the patient I objected to but rather the action ordered.

Conversely, I would not want a healthcare provider caring for me who supports assisted suicide, abortion, etc. This is why I ask my doctors about their stands on such issues before I become their patient.

Our country and our healthcare systems need laws, healthcare providers and institutions that we can trust to protect us. Conscience rights protections are a critical necessity for that to happen.

The Assisted Suicide Juggernaut Continues in the U.S.

Since Oregon passed the first physician-assisted suicide law in 1997, 8 more states and the District of Washington, D.C. passed assisted suicide laws by 2020. They are:

  • California (End of Life Option Act; approved in 2015, in effect from 2016)
  • Colorado (End of Life Options Act; 2016)
  • District of Columbia (D.C. Death with Dignity Act; 2016/2017)
  • Hawaii (Our Care, Our Choice Act; 2018/2019)
  • Maine (Death with Dignity Act; 2019)
  • New Jersey (Aid in Dying for the Terminally Ill Act; 2019)
  • Oregon (Death with Dignity Act; 1994/1997)
  • Vermont (Patient Choice and Control at the End of Life Act; 2013)
  • Washington (Death with Dignity Act; 2008)

So far in 2021, 13 more states have new proposed assisted suicide bills and 4 states with assisted suicide laws are facing bills to expand their assisted suicide laws.

These 13 states are  Arizona , Connecticut, Indiana, Iowa, Kansas, Kentucky, Massachusetts, Minnesota, Nevada, New Mexico, New York, North Dakota and Rhode Island. Most of these states have been repeatedly hounded for years to pass an assisted suicide law.  

The 4 states with bills expanding their assisted suicide laws are California , Hawaii , Vermont, and the state of Washington.

The expansions range from expanding “qualified medical providers” from doctors to a range of non-doctors including nurses to eliminating so-called “safeguards” such as 15 day waiting periods, in person requests and even to allow electronic prescribing and shipping of lethal overdoses. Compassion and Choices (the former Hemlock Society) and other assisted suicide supporters have long portrayed assisted suicide “safeguards” as “burdensome obstacles”.

CONSCIENCE RIGHTS AND CENSORSHIP

Conscience rights for health care providers has been a very real problem since the 1974 Roe V. Wade U.S. Supreme Court decision legalized abortion in the U.S. The legalization of assisted suicide in several states has made this even worse for nurses, doctors, pharmacists and other healthcare workers. Even healthcare institutions have faced discrimination problems.

The Christian Medical and Dental Association even compiled a long list in 2019 of “Real-life examples of discrimination in healthcare” .

Now, we are seeing censorship. A March 28, 2021 Wall Street Journal op-ed titled “Big Tech Censors Religion, Too stated that:

“In January, Bishop Kevin Doran, an Irish Catholic, tweeted: “There is dignity in dying. As a priest, I am privileged to witness it often. Assisted suicide, where it is practiced, is not an expression of freedom or dignity.” Twitter removed this message and banned Bishop Doran from posting further. While the company reversed its decision after public opposition, others haven’t been so lucky.” (Emphasis added)

CONCLUSION

Back in 2014, I wrote a blog “Should a Pro-Life person Become a Nurse” about a worried pro-life student nurse who wrote me asking “what area of nursing can I move into that does not demand that I do things that I absolutely will not do?”

I wrote her back and told her that I had that challenge in several areas I worked in over 45 years but was able to live up to my ethics despite some difficult situations and that I never regretted becoming a nurse.

However, conscience rights are a not a luxury but rather a necessity.

That is why some of us nurses in Missouri worked so hard to get a conscience rights law passed in 1992 after the Nancy Cruzan starvation and dehydration death that, although not as strong as we wanted, is still in effect today. And I was thrilled when the Trump administration announced a new Conscience and Religious Freedom Division  in 2018 to enforce “federal laws that protect conscience and the free exercise of religion and prohibit coercion and discrimination in health and human services”.

Society has long insisted that health care professionals adhere to the highest standards of ethics as a form of for society. The vulnerability of a sick person and the inability of society to monitor every health care decision or action are powerful motivators to enforce such standards. For thousands of years doctors (and nurses) have embraced the Hippocratic standard that “I will give no deadly medicine to any one, nor suggest any such counsel.” Should that bright line to separate killing from caring now be erased by legislators or judges?

Without a strong resistance movement, the assisted suicide movement will only keep expanding. So far, much of the public has been shielded from the real truth by euphemisms and false reassurances from assisted suicide supporters, a mostly sympathetic mainstream media and often spineless professional and health care organizations.

We all must educate ourselves to speak out before it is too late.

Think the Political and Cultural Divisions in Our Country are Bad? The Divisions in Medical Ethics Could Cost Your or a Loved One’s Life!

I wanted to be a nurse since I was 5. I was drawn to nursing not only because I wanted to help people but also because medical ethics standards were so high, especially in contrast to some of the corrupt business practices that I saw.

I graduated from a Catholic nursing school in 1969 and spent the next 50 years working mostly in intensive care but also in home health and hospice, oncology (cancer), kidney dialysis, volunteer work and on ethics committees.

I first noticed the change in medical ethics when the US Supreme Court’s Roe v. Wade decision in 1973 legalized abortion for the first three months of pregnancy. I was working in intensive care at the time and found that my fellow medical professionals who supported the abortion decision angrily rebuked those of us who were shocked that the first rule of medical ethics we were taught-First, Do No Harm-was eroding.

Then in 1982, my doctor husband and I were shocked by the Baby Doe case where the parents received a judge’s approval to let their newborn son with Down Syndrome die instead of repairing an easily correctable hole between the tube that leads from the throat to the stomach and the  tube that leads from the throat to the windpipe and lungs.  While lawyers were appealing his case and many parents (including my husband and me) wanted to adopt Baby Doe, the newborn starved and dehydrated to death without the desperately needed surgical repair.

My husband asked “What has happened to medical ethics??” but we both knew the answer: babies with Down Syndrome are often unwanted and aborted.

Five months after Baby Doe died, our third child Karen was born with Down Syndrome and a reparable heart defect but the heart doctor gave us a choice to “let” our baby die without surgery. We refused but my former trust in the medical system was shattered.

After I suddenly became a single parent in 1988, I had to return to a paid nursing job to support my three children but found a drastically different medical ethics system.

I found that during the 1970s, medical ethics began to evolve into the newer “bioethics”, even in Catholic hospitals.

This new bioethics has essentially four principles:

1. Respect for autonomy (the patient’s right to choose or refuse treatment)

2. Beneficence (the intent of doing good for the patient)

3. Non-maleficence (not causing harm)

4. Justice (“fair distribution of scarce resources, competing needs, rights and obligations, and potential conflicts with established legislation”) Emphasis added.

Unfortunately, those principles are malleable and then used to justify actions and laws that would have been unthinkable when I graduated from nursing school. That bioethics mindset changed not only medical and nursing education but also the principles that informed our work.

Even 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.

SOME MEDICAL ETHICS DIVISIONS THAT CAN COST YOU OR A LOVED ONE’S LIFE

Abortion

The American Medical Association, the American Congress of Obstetricians and Gynecologists and the American Nurses Association and other healthcare organization that used to condemn abortion are now supporting “abortion rights”.

Abortion on demand and taxpayer-funded has now been deemed a “civil right” by Planned Parenthood and many Democratic politicians throughout pregnancy to birth and even beyond. Alternatives to abortion such as free pregnancy tests, counseling, ultrasounds, maternity and baby clothes, diapers, car seats, bassinets, etc. are not options at Planned Parenthood but rather at non-profit crisis pregnancy centers.

As a parent of an unwed teenage daughter, I support these services and give thanks for my now 22 year old granddaughter.

Assisted suicide/euthanasia

In the early 1970s when I was a young ICU nurse, none of us medical professionals had even heard of a “living will”. There was a universal presumption for life and “quality of life” was something to be improved, not judged.

Nevertheless, sick people could and did refuse treatment and even check themselves out of the hospital against medical advice. When patients appeared to be dying, they or their families could agree to a “do not resuscitate” (DNR) order. Treatments could be ethically refused when such measures were considered medically futile or excessively burdensome for the patient. But one thing we didn’t do was offer to withhold or withdraw medical care like tube or even spoon feedings to cause or hasten a patient’s death. And it was unthinkable that medical professionals could assist even a dying patient’s suicide.

Unknown to us, all this began to change after Louis Kutner, a Chicago lawyer, wrote a 1969 article in the Indiana Law Journal titled Due Process of Euthanasia: The Living Will, A Proposal” in 1969. (emphasis added).

By 1970, The Euthanasia Society of America (later renamed the Society for the Right to Die) distributed 60,000 living wills. In 1976, California passed the nation’s first “living will” law and in 1990, The US Congress passed the Patient Self-Determination Act that requires information to be given to patients about their rights under state laws governing advance directives (commonly called “living wills), including the right to accept or refuse medical or surgical treatments.

Now, 8 states and the District of Columbia have assisted suicide laws and Compassion and Choices, the largest advocacy group for medically assisted suicide, is using the Covid 19 pandemic to push for telehealth (the provision of healthcare remotely by means of telecommunications) for medically assisted suicide.

Infanticide

In my nursing school 50 years ago, we were taught medical ethics and one example used was the case of a newborn with Down Syndrome who needed life-saving surgery but whose parents refused, choosing to let him die. We were told that the law would protect such children from medical discrimination-even by the parents.

Now we have cases like Charlie Gard and Simon Crosier and others whose parents chose life for their babies with disabilities but were thwarted by doctors and courts.

Organ donation

When I started working in an ICU in 1971, I had questions about the brain death diagnosis for organ harvesting but was told not to worry because there were strict rules.

However and over subsequent years, I discovered that the rules for organ donation have been changing from brain death to other criteria including severe brain injury. There have even been proposals for “presumed consent” state laws where people would have to register an “opt-out” or be automatically presumed to consent to organ donation.

I do not have an organ donor card nor encourage others to sign one. Instead, I once offered to give a friend one of my kidneys as a living donor. Although I was not able to donate then, my family knows that I am willing to donate tissues like corneas, bone, etc. that can be ethically donated after natural death and will only agree to that donation

Conscience rights

Doctors and nurses used to be protected when asserting their conscience rights when refusing to deliberately hastening or causing a patient’s death.

Now, even that protection-which protects both patients and medical professionals-is under attack.

I discovered this personally several years ago when I was almost fired for refusing to increase a morphine drip “until he stops breathing” on a patient who didn’t stop breathing after his ventilator was removed.

CONCLUSION

The bottom line is that everyone must remain vigilant when they or a loved one becomes seriously ill, regardless of the hospital or institution. It is also important not to be afraid to ask questions.

There are also non-denominational, non-profit groups like the National Association of Pro-life Nurses, the Healthcare Advocacy and Leadership Organization and state and national pro-life organizations that have much useful information and resources for patients, families and the public.

The bottom line is that what we don’t know-or allowed to know-can indeed hurt us. We need to demand transparency and the highest ethical standards from our doctors and healthcare system before they can earn our trust.

And without a change in laws, policies and attitudes promoting deliberate death as an answer to human suffering, those of us medical professionals who believe we should never cause or hasten anyone’s death may become an endangered species-as well as our medically vulnerable patients.

Ventilator Rationing, Universal DNRs and Covid 19 (Coronavirus)

As a nurse myself, it is hard to watch my fellow nurses bravely fighting on the front lines of this pandemic without being able to be there with them.

Nurses are a special breed. In my over 50 years as a nurse, I found that most of us chose nursing because we want to help people and alleviate suffering. We work the long hours on our feet, skip meals, hold hands and listen, cry when our patients die, etc. because we truly do care.

But the health care system has been changing. A dark new ethics movement is infecting our system and telling us not only that our patients have a right to choose to end their lives but also that some of our patients even “need” to die and that we can’t care for all of them during the Covid 19 pandemic.

Worst of all, we are being told that we can now know how to decide which patients are “expendable”.

VENTILATOR RATIONING

A 71 year old man with a heart condition arrives at a hospital is diagnosed with Covid 19. His condition worsens and he is placed on a ventilator to help him breathe. Then the infection rate spikes in the city and the hospital is overrun with severely ill patients, many between 20 and 50 years old and otherwise healthy.

The health care team is forced to decide which patients should they focus on and care for.

This is the scenario posed in a March 20, 2020 Medpage article “Ethics Consult: Take Elderly COVID-19 Patient Off Ventilator?— You make the call” along with an online survey with 3 questions:

1. Would you prioritize the care of healthier and younger patients and shift the ventilator from the elderly man to patients with a higher probability of recovering?
2. Would you change your decision if the elderly patient had been in intensive care for a non-COVID-19-related illness?
3. Would you prioritize the older man over college students who had likely been
infected during spring break trips?

After almost 4000 votes, the survey showed 55.65% voting yes on prioritizing the care of the healthier and younger patients, 78.11% voting no on changing their decision about the elderly patient if he didn’t have Covid 19 and 71.12% voting no on prioritizing the elderly man over college students likely to have been infected on a spring break trip.

So while most people fear becoming infected with Covid 19, less well-known ethical dangers may also affect us-especially those of us who are older or debilitated.

Every day, we hear about the shortage of ventilators needed for Covid 19 patients and the overworked and understaffed health care professionals providing the care. Now both mainstream media and medical journals are publishing articles about the ethical dilemma of denying CPR (cardiopulmonary resuscitation) or a ventilator to older patients or those with a poor prognosis with Covid 19 in a triage situation.

Triage is defined as “A process for sorting injured people into groups based on their need for or likely benefit from immediate medical treatment. Triage is used in hospital emergency rooms, on battlefields, and at disaster sites when limited medical resources must be allocated.” (Emphasis added)

But this definition does NOT include deciding how to triage people based on age or “productivity”.

UNIVERSAL DNRs

A March 25, 2020 Washington Post article “A Framework for Rationing Ventilators and Critical Care Beds During the COVID-19 Pandemic” posed the question: “how to weigh the ‘save at all costs’ approach to resuscitating a dying patient against the real danger of exposing doctors and nurses to the contagion of coronavirus.”

This is not just an academic discussion.

As the article reveals, “Northwestern Memorial Hospital in Chicago has been discussing a do-not-resuscitate policy for infected patients, regardless of the wishes of the patient or their family members — a wrenching decision to prioritize the lives of the many over the one.” (Emphasis added) And Lewis Kaplan, president of the Society of Critical Care Medicine and a University of Pennsylvania surgeon, described how colleagues at different institutions are sharing draft policies to address their changed reality.

Bioethicist Scott Halpern at the University of Pennsylvania is cited as the author of one widely circulated model guideline being considered by many hospitals. In an interview, he said a universal DNR for Covid 19 patients was too “draconian” and could sacrifice a young person in otherwise good health. He also noted that the reality of health-care workers with limited protective equipment cannot be ignored. “If we risk their well-being in service of one patient, we detract from the care of future patients, which is unfair,” he said.

The article notes that “Halpern’s document calls for two physicians, the one directly taking care of a patient and one who is not, to sign off on do-not-resuscitate orders. They must document the reason for the decision, and the family must be informed but does not have to agree.” (Emphasis added)

This could not only upend traditional ethics but also the law as “Health-care providers are bound by oath — and in some states, by law — to do everything they can within the bounds of modern technology to save a patient’s life, absent an order, such as a DNR, to do otherwise.”

Both disability and pro-life groups have condemned such health care rationing with Covid 19, especially for older people and people with disabilities.

However, this and more is apparently already happening.

In an April 1, 2020 Wall Street Journal article “What the Nurses See: Bronx Hospital Reels as Coronavirus Swamps New York” a co-worker told the nurse interviewed that the nurses were no longer doing chest compressions to resuscitate Covid 19 patients because “it uses lots of protective gear and puts workers at greater risk than chemical resuscitations”. This was corroborated by other nurses who said this has become an “unspoken rule.”

CONCLUSION

How can we protect ourselves and our loved ones in these circumstances?

At the very least and whether or not we are older or have disabilities, we should consider or reconsider our advance directives.

As the Life Legal Defence Foundation  writes in their “SPECIAL MESSAGE ABOUT COVID-19 AND ADVANCE HEALTH CARE DIRECTIVES”:

As COVID-19 spreads around the globe, the public is learning about the importance of mechanical ventilators in providing temporary breathing support for many of those infected. Ventilators are saving lives!

A false understanding of respirators and ventilators has become commonplace in recent years. Many people think that these and similar machines’ only role is prolonging the dying process. The widely publicized treatment of COVID-19 patients is helping to dispel that myth. Many patients rely on machines temporarily every day for any number of reasons and go on to make full recoveries.

Unfortunately, many individuals have completed advance health care directives stating or suggesting that they do not wish to receive breathing assistance through mechanical ventilation.

Please take the time to review any advanced medical directives (including POLST forms) signed by you or your loved ones to make sure they are clear that mechanical ventilation is not among the forms of care that are refused. If there is any ambiguity, you may want to consider writing, signing, and dating an addendum specifying that mechanical ventilation is authorized. (Emphasis in original)

I would add that other treatments or care such as DNRs and feeding tubes also not be automatically checked off. I believe it is safer to appoint a trusted person to insist on being given all information concerning risks and benefit before permission is given to withdraw or withhold treatment.

Even as the nation is racing to get more ventilators and staff as we cope with this terrible pandemic, we all must continue to affirm the value of EVERY human life.

 

Euthanasia: Canada, Conscience and Coercion

A January 22, 2020 CNA article titled Perform Euthanasia or Lose Government Funding”, Canadian Hospice Told” revealed that a secular Canadian hospice was at risk of losing its government funding over its refusal to euthanize patients who request an “assisted death.”

How could this happen?

First of all, Canadian health care (known to Canadians as “medicare”) is 69% publicly funded for “medically necessary” care administered by the 13 provinces and territories with different rules. 31% of Canadian health care costs are paid by the private sector for services not covered or only partially covered by medicare, such as prescription drugs, dentistry and optometry.

The problems started when the Canadian Supreme Court legalized MAiD (Medical Assitance in Dying” in 2015.

Soon after, the province of Quebec drew up guidelines for MAiD and made “euthanasia kits” for lethal injections available to every doctor in Quebec. Now most MAiD deaths in Canada are done by lethal injection.

In September 2016, about three months after euthanasia became legal in Canada, British Columbia’s Fraser Health Authority ( the publicly-funded organization responsible for administering healthcare in British Columbia) introduced a new policy which required all hospices receiving more than 50% of provincial funding for their beds to offer euthanasia to their residents. However, the hospice was operated by the non-profit organization the Delta Hospice Society, which is opposed to Canada’s MAiD

One doctor said that there are “‘strong lobbies’ backing this new effort to expand MAiD into additional institutions which receive provincial funding, including faith-based hospitals or hospices.(Emphasis added)

HOW ONE CATHOLIC HEALTH CARE FACILITY RESPONDED TO MAiD

Unfortunately and in 2018, the Catholic Covenant Health system in the province of Alberta, Canada released a revised MAID policy:

“after consultations with more than 100 individuals and groups including doctors, Catholic bishops, Alberta Health Services, the Alberta government, patient advisers, families, ethicists and community members.
Under the policy, witnessing and signing of legal documents and assessments of eligibility can take place on Covenant Health sites. Patients deemed eligible for MAID would still be transferred to other facilities.” (Emphasis added)

A current check of the Covenant website on MAiD shows no change in policy.

THE CANADIAN “SLIPPERY SLOPE” ALSO CONTINUES

In January, 2020 the Halifax Group, published “MAiD Legislation at a Crossroads: Persons with Mental Disorders as Their Sole Underlying Medical Condition” that supported MAiD not only for non-dying persons ” experiencing enduring, intolerable and irremediable suffering from physical conditions” but also for persons who have “a mental illness as their sole underlying medical condition.” (Emphasis added)

This month, The Expert Advisory Group responded to the Halifax group, warning that the Canadian medical suicide law is the “most permissive in the world”.

THE EFFECT OF MAiD ON DOCTORS AND NURSES

Last year, The Canadian Catholic Nurses joined the National Association of Catholic Nurses in opposing the American Nurses Association’s draft position for neutrality on physician-assisted suicide (unfortunately later approved) and gave a chilling look at what may be our future if legalized assisted suicide is not opposed:

“Our association formed in 2018 primarily in response to Canadian nurses’ moral distress regarding the nation-wide legalization of medically induced death.

Professional associations and licensing bodies across Canada endorsed the legal changes, requiring conscientious objectors to participate in “Medical Assistance in Dying” by “effective referral” to facilitate access at the patient’s request. Faith-based health care facilities are pressured to participate. Nurse practitioners are trained and qualified to prescribe and administer lethal doses of medication to patients that they or others deem eligible for euthanasia.”

and

The Canadian experience with assisted suicide and euthanasia provides evidence for your continued resistance to the practice.

Unlike Oregon, Canada has not experienced a growth in palliative care along with the rapid expansion of induced death. Instead, we experience ongoing demands for access to lethal injections for new categories of patients, including “mature minors;” those who write advanced directives; and those whose mental illness is the sole condition underlying their request.”

A 2018 study “Medical assistance in dying (MAiD): Canadian nurses’ experiences” stated that:

“It is vital to understand how MAiD is influencing nurses in the Canadian context to ensure a smooth transition of this end‐of‐life care option across settings and communities. ” (Emphasis added)

The study acknowledges some nurses’ “moral distress” but describes “how participating in, or declining to participate in MAiD is shaping the participants’ perceptions of nursing as a profession“. The authors suggest promoting concepts like “Providing holistic care without judgment, Advocating choice, Supporting a good death” to positively reinforce  that MAiD was “not a significant departure from their professional goals”. (Emphasis added)

(Ironically, 77% doctors in Laval, Canada refused to provide MAiD 18 months after legalization with the most common reason that MAiD was “too much of an emotional burden to bear”.)

CONCLUSION

Last year it was reported that More than one in every 100 deaths in Canada is administered by a doctor but that even this number is likely higher because parts of Canada currently do not report such deaths.

The numbers are also likely to get higher as the Canadian euthanasia laws expand the eligibility criteria and health care professionals worry about losing their jobs if they refuse to participate.

Unfortunately, most of the US mainstream media ignores the Canadian euthanasia experience while approvingly reporting on the increasing number of US states legalizing physician-assisted suicide.

What all of us need to understand is that the legalized killing of any patient ultimately leads to the destruction not only of the patient but also of a trustworthy health care system and a truly safe and civilized society.

Are We Witnessing the Coming Extinction of Conscience Rights?

Last month, Wesley Smith, the well-known writer and lawyer who opposes assisted suicide and abortion, wrote an article titled “Bioethicist Wants to Morally Cleanse Medical Schools”  about plans to weed out pro-life potential doctors and nurses from even entering medical and nursing schools:

“Make no mistake. Schuklenk and his ilk — such as the adamant opponent of medical conscience, Ezekiel Emanuel — are deadly serious about crushing all dissent within the medical professions to emerging cultural paradigms, and plan to morally cleanse the ranks of doctors, nurses, pharmacists, and institutions of all  wrong thinkers, particularly of the religious and pro-life kind.”

As Wesley warns after speaking with such prospective medical and nursing students, “such culling already occurs outside of official policy”.

CONSCIENCE RIGHTS FOR HEALTH CARE INSTITUTIONS

Now health care institutions that forbid their employees from participating in abortion and euthanasia are at risk.

As an October 29, 2019 article in the Journal of the American Medical Association (JAMA) titled “Colorado End-of-Life Options Act-A Clash of Organizational and Individual Conscience” explains, a new court case may result in conscience rights being legally upheld when a doctor agrees to help a patient commit assisted suicide against a religious healthcare institution’s policy.

This came about when the Colorado legislature could not pass a physician-assisted suicide in 2014 and 2015 but a new, problematic referendum was introduced and passed by Colorado voters in 2016.

While hospitals and clinics in other states with assisted suicide laws are allowed to prohibit their employees from participating, the Colorado, the referendum added a little-noticed provision in the 2016 Colorado referendum that stated:

“A health care facility may prohibit a physician employed or under contract with the facility from prescribing medication to an individual who intends to use the medication on the facility’s premises. The facility must provide advance written notice of its policy to the physician and its patients. A health care facility may not discipline a physician, nurse, pharmacist, or other person for actions taken in good faith or for refusing to participate in any way.” (Emphasis added)

As the JAMA article notes,This provision virtually guaranteed the Colorado law would eventually be challenged”.

This set up the current case Mahoney et al v. Centura Health Corporation” involving Neil Mahoney, a Colorado man with advanced cancer, who wanted physician-assisted suicide and found geriatrician Barbara Morris, MD. Dr. Morris was willing to write the lethal overdose prescription. However, the religiously based Centura Health System where she was employed forbade participation in assisted suicide. Mr. Mahoney and Dr. Morris filed a lawsuit on August 21, 2019 and the doctor was fired on August 26 for violating the ethical directives provided for Catholic health care services.

The article concludes that:

“the case seems destined to have a potentially significant effect on national policy. If the courts rule that the Constitution allows hospitals to exert control over individual physicians’ claims of professional conscience, it will be a victory for corporate medicine.

But if the state law is upheld, the case could establish that physicians’ professional conscience claims hold or take precedence over the ethical and religious directives of religiously affiliated hospitals. It is possible that at least some religiously affiliated health systems might rather close than allow that outcome.” (All emphasis added)

CONCLUSION

As Wesley Smith writes, eliminating pro-life health care providers and institutions is  becoming part of an utilitarian agenda in the bioethics movement where “legalized euthanasia, free and unfettered abortion at all stages of gestation, infanticide, eugenic embryo engineering, invidious forms of health-care rationing based on ‘quality of life,’ etc., are all part of the mainstream bioethics agenda, or at the very least, are seen as respectable advocacy memes.”

With the current support of a predominantly sympathetic mainstream media, well-funded and politically active groups like Planned Parenthood and Compassion&Choices are also putting pro-life health care providers and their supportive institutions in grave danger of becoming an endangered species in law, politics and health care.

If this happens, our health care system will radically change-especially for the unborn, the elderly and people with disabilities.

When dedicated and compassionate people are denied entry into the health care professions because they refuse to deliberately end lives, harassed and/or fired when they refuse to participate in a deliberate death decisions and religiously based healthcare institutions are forced by law to allow lives to be ended by “choice” or close their doors, will any of us be able to trust our healthcare system when we need it the most?

We need to educate ourselves and the public before it’s too late.

Northern Ireland Forced into Legalizing Abortion on Demand

My husband and I just returned from a long-anticipated and wonderful trip to Ireland with our friends, one of whom was born in Ireland to an unwed mother at the infamous Magdelene Laundries and adopted by a St. Louis family when she was 2 1/2 years old.

We traveled all around Ireland and Northern Ireland, enjoying the friendly people, beautiful old churches, stately castles, charming villages and great food.

We were able to see or read some news there but the topics were mainly about the Brexit deal for Ireland to leave the European Union.

Returning home, I was flabbergasted to read about the sudden legalization of abortion on demand in Northern Ireland forced by the UK that occurred October 22 when we were on our trip.

A BRIEF HISTORY OF ABORTION IN IRELAND

The United Kingdom legalized abortion with the Abortion Act in 1967, years before the 1973 Roe v Wade decision that legalized abortion in the US. But the Abortion Act was never extended to include Northern Ireland, a part of the UK, which then only allowed abortion for “a severe and long-term physical or mental risk to the woman’s health”.

In 2016, the United Nations tried to pressure Ireland into legalizing abortion on demand and overturn Ireland’s Eighth Amendment that protected both unborn babies and their mothers equally as deserving a right to life. This made Ireland one of the safest places in the world for pregnant mothers and their unborn babies and with one of the lowest maternal mortality rates in the world.

But tragically in May 2018, a voter referendum to legalize abortion in Ireland passed. On January 1, 2019, the law took effect even though 95% of Irish doctors refuse to perform abortions.

And after the Irish voter referendum on abortion passed in May 2018, a poll by Amárach taken in October found that 60% of Irish residents oppose taxpayer-funded abortions, 80% say health care workers should not be forced to carry out abortions against their conscience, 79% favor a woman seeking an abortion being offered the choice of seeing an ultrasound before going through with the abortion and 69% of those surveyed believe doctors should be obliged to give babies that survive the abortion procedure proper medical care rather than leaving the babies to die alone.

But in Northern Ireland, recent rulings in the High Court in Belfast and the Supreme Court in London stated that the abortion situation in Northern Ireland was “incompatible with human rights legislation”. So now, Northern Ireland is being forced to accept abortion up to 24 weeks or beyond if “the mother’s health is threatened or if there is a substantial risk the baby will have serious disabilities”. But, as happened in Ireland, hundreds of medical professionals-including doctors, nurses and midwives-say they will not participate.

Andrew Cupples, a Northern Irish GP, said that some medical professionals have even said they will walk away from the healthcare service itself if they are forced to participate in abortion services.

Nurses&Midwives4Life Ireland  and Doctors For Life Ireland have been especially vocal and active in opposing abortion and those of us in the National Association of Pro-life Nurses have been enthusiastically supporting their efforts and encouraging others to do so as well.

CONCLUSION

My husband and I, as well as our friends, are very proud of our strong Irish heritage and firmly pro-life so this news about Northern Ireland was a blow.

But like the good doctors and nurses of Ireland, we will never give up.

As the abortion movement grows ever more hardened and radical, none of us must give up exposing the terrible truth about abortion as well as showing the life-affirming dedication to caring for both mother and unborn child that truly defines the pro-life movement.

 

 

 

Nurse Vindicated After Being Forced to Participate in an Abortion

In 2018, I wrote about “The New Federal Conscience and Religious Freedom Division” established by the Trump administration as a desperately needed help for those of us health care professionals whose conscience rights have been ignored or threatened and included a link to report complaints even online.   Now in fiscal 2018 alone, the division says it has received and dealt with more than 1300 complaints.

Most recently and thanks to the Conscience and Religious Freedom Division and with help from the American Center for Law and Justice, an unnamed nurse who was forced into assisting in an elective abortion in 2017 has been vindicated.

On August 28, 2019, the US Department of Health and Human Services, Office for Civil Rights (OCR) announced that, after a thorough investigation and attempts to resolve the issue, the OCR issued a Notice of Violation to the University of Vermont Medical Center (UVMMC) for forcing that nurse to assist in an elective abortion over her conscience-based objections and even though other nurses were available.

The OCR found that the UVMMC had discriminatory policies that assign or require employees to assist abortion procedures even after they record their moral or religious objections. UVMMC now must conform its policies to the long-standing Church amendments that protect the conscience rights of individuals or entities that object to performing or assisting abortions and take corrective action or “face potential action by the HHS from which UVMMC has received federal funding”.

The notice also noted that for the last 3 years UVMMC “reported that it cumulatively expended $1.6 million of federal financial assistance.”

The unnamed nurse, who no longer works at UVMMC, told the American Center for Law and Justice that she was misled into thinking she was assisting in a miscarriage but then found out that it was an elective abortion. However, her superiors “callously refused to relieve her”.  Fearing retaliation, she went through with assisting the abortion and was traumatized.

According to the American Center for Law and Justice, at least four other nurses, have now confirmed that they had been subjected to similar violations of their conscience rights.

As the American Center for Law and Justice also noted, even though the Church amendments were enacted after the US Supreme Court legalized abortion in 1973,  they always lacked a mechanism for enforcement by private citizens. Enforcement depended on the Health and Human Services department. Unfortunately that enforcement has, for all intents and purposes, been nonexistent until recently.

Now the new division has put some teeth into enforcement.

CONCLUSION

As I have written before, groups like Compassion and Choices (the former Hemlock Society) and Planned Parenthood have vehemently criticized the Conscience and Religious Freedom Division, claiming that it would allow medical professionals “to impose their own religious beliefs on their patients and withhold vital information about treatment options” as well as “pave the way for discrimination against people for a variety of reasons.”

The fundamental right not to perform or assist in deliberate death procedures terrifies these organizations that depend on medical professionals willing to assist suicides or perform abortions.

Therefore, we must all make sure that the whims of politics never again interfere with the fundamental right of medical professionals to “Do no harm”.  This is not only for their protection but also for our own.

 

 

 

The National Association of Pro-life Nurses Statement Opposing the Palliative Care and Hospice Education and Training Act (2019)

The National Association of Pro-life Nurses joins the Euthanasia Prevention Coalition USA and the Healthcare Advocacy and Leadership Organization (HALO) and other organizations in opposing the  Palliative Care and Hospice Education and Training Act (2019) H.R. 647, S.2080.  (HALO has issued an action alert with the contact numbers for legislators on the Senate committee considering this bill.)

As nurses, we strive to care for our seriously ill, disabled and terminally ill patients with compassion and the highest ethical standards. We applaud the medical innovations and supportive care options that can help our patients attain the highest quality of life possible.

However now many of us nurses are now seeing unethical practices such as assisted suicide, terminal sedation (with withdrawal/withholding of food, water and critical medicines), voluntary stopping of eating, drinking and even spoon feeding, etc. used to cause or hasten death but often called palliative, “comfort” or routine hospice care for such patients.

We believe that the Palliative Care and Hospice Education and Training Act (2019) will allow federal funding to teach and institutionalize such unethical practices without sufficient oversight, safeguards or penalties.

For example, the Section 5 Clarifications (p. 21) against federal funding for objectionable practices “furnished for the purpose of causing, or the purpose of assisting in causing, a patient’s death, for any reason” is toothless. Such practices are already  considered acceptable by many influential hospice and palliative care doctors like Dr. Timothy Quill, a board-certified palliative care physician, 2012 president of the American Academy of Hospice and Palliative Medicine and promoter of legalizing physician-assisted suicide and terminal sedation.

It is also disturbing the Compassion and Choice, the largest and best funded organization promoting assisted suicide and other death decisions,  has a mission statement stating:

“We employ educational training programs, media outreach and online and print publications to change healthcare practice, inform policy-makers, influence public opinion and empower individuals.”

and a “Federal Policy Agenda / 2016 & Beyond”  goal to:

Establish federal payment for palliative care consultations provided by trained palliative care professionals who will advocate for and support the values and choices of the patient….” (All emphasis added)

As nurses, we are also very concerned that the Act contains no conscience rights protection for those of us-doctors and nurses alike-who will do anything for our patients except deliberately end their lives or help them kill themselves.

Many of us have already faced threats of termination of employment for refusing to participate in unethical, life-ending practices without support from our nursing organizations like the American Nurses Association that recently dropped their traditional opposition to physician-assisted suicide and voluntary stopping of eating and drinking.

For the sake of protecting our patients, the integrity of our medical and nursing professions as well as our healthcare system, we urge the public and our congressional representatives to oppose this dangerous Act.