Is Abortion Really the Best We Can do for Women?

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

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

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

But is this true?

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

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

As the anonymous author writes in FemCatholic:

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

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

The author also writes about her other experiences:

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

Her message is both simple and profound:

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

 

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

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

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

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

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

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

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

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

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

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

Professor Kaczor concludes from this:

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

CONCLUSION

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

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

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

I know that choosing life is the ultimate victory!

My Review of “Gosnell: The Trial of America’s Biggest Serial Killer”

I just saw the movie “Gosnell: The Trial of America’s Biggest Serial Killer” and was moved to tears even though I already knew much of the story about the notorious Philadelphia abortionist who ran an outrageously filthy clinic where he executed late-term babies who survived abortion by callously cutting their spinal cords. I also knew that some of the women died, suffered serious complications or contracted diseases from dirty instruments during the 30 years Dr. Kermit Gosnell ran his politically protected clinic.

This PG 13 movie scrupulously avoids sensationalism but through great acting, writing and accurate depictions of the clinic and Gosnell himself (actual pictures were shown at the end of the movie), the enormity of the evil cannot be ignored.

The movie starts much like an episode of “Law and Order” portraying a drug bust but then expands as police raid Gosnell’s abortion clinic for evidence of illegal prescription drug sales and find even greater problems. After the initial reluctance to prosecute by the District Attorney because the case involves abortion, a courageous assistant district attorney puts her job on the line to prosecute Gosnell.

The trial of Gosnell is riveting, especially when an expert witness abortionist describes how to correctly perform a late-term abortion that is unnervingly similar in callousness to Gosnell’s. The testimony of girls as young as 15 when they were trained by Dr. Gosnell to be his unlicensed assistants is also devastating as they describe an aborted baby swimming in a toilet or another struggling to keep breathing. The trial is very contentious but a stunning development late in the trial determines the result.

I highly recommend seeing this movie that even opened the eyes of people like Ann McElhinney who was neutral on abortion until she worked on this film.

CONCLUSION

Although one of the most shocking aspects of the Gosnell trial was his cutting the spinal cords of babies who survived abortion, Kermit Gosnell was not the first known abortionist to deliberately end the lives of babies who survived abortions.

In 1999, nurse Jill Stanek was shocked to discover a live baby boy left to die after an induced-labor abortion  and found this was a common practice in her hospital. Her courageous testimony led to the 2002 “Born-Alive Infants Protection Act” which extended legal protection to infants born alive after an abortion.

However, the lack of legal enforcement power in this Act led to the current “Born-Alive Abortion Survivors Protection Act that not only requires physicians and abortion facilities to afford “the same degree” of care to a baby born alive during an abortion that would apply “to any other child born alive at the same gestational age,” including transportation to a hospital, but also mandates fines and the possibility of imprisonment for medical professionals found to be noncompliant.

This bill was passed in the US House of Representatives this year and sent to the Senate where (because of procedural hurdles), it might need 60 votes to pass and be signed into law by President Trump.

Although it might be difficult to pass the Act now because of the political entrenchment of abortion supporters in the Senate, passing this law would provide at least one fitting endnote to the horrors of Dr. Kermit Gosnell’s clinic.

Two Wonderful Stories: A Prenatal Misdiagnosis; Man Saves Grandchild from Abortion

A PRENATAL MISDIAGNOSIS

 Drew and Adriann Corpstein were devastated when they were told at 20 weeks that their unborn baby had a lethal brain abnormality called semilobar holoprosencephaly, an abnormality of brain development in which the brain doesn’t properly divide into right and left hemispheres. They were told that the baby might only live a few days as a “vegetable” and encouraged the couple to consider a late-term abortion.

Instead they decided to trust God, deliver their baby and love him for whatever time they had with him.

Baby Matthew was born on July 29 but just the next day, the doctor gave them the stunning news that Baby Matthew did NOT have the lethal brain condition but rather hydrocephalus-an excess of fluid around the brain that can be treated with a shunt. Baby Matthew could then survive and even have the chance of a fully functioning life! (Click here to see a beautiful video of Baby Matthew and his parents.)

Personally, I have seen more than one prenatal diagnosis turn out to be wrong.

Of course, prenatal testing is not always wrong but there is cause for concern about the number of unborn babies misdiagnosed, especially with some newer screening blood tests. (Please see my February blog A Dark Side of Prenatal Testing” )

But there are alternatives to abortion when the prenatal diagnosis turns out to be accurate.

As Baby Matthew’s parents mentioned in the article, they prepared for end of life care for him when he was expected to die shortly after birth and there are often such hospices available in many areas.

There are also organizations like Prenatal Partners for Life  and Be Not Afraid that provide support, information, resources and encouragement for carrying to term with an adverse prenatal diagnosis.

These organizations’ websites also have parents’ stories of their children with a range of prenatal diagnoses ranging from lethal ones like anencephaly to disabilities like Down Syndrome or Spina Bifida.

MAN SAVES GRANDCHILD FROM ABORTION

This month, I read an uplifting story that personally resonated with me.

With a heavy heart because his wife was “dead-set” on abortion for their 16 year old daughter, “Brian” took his daughter to A Woman’s Pregnancy Center  in Tallahassee, Florida. But when his daughter went in to speak to a counselor, “Brian” was surprised when a male counselor wanted to speak with him.

“Brian” didn’t know that when a client comes into A Women’s Pregnancy Center (a crisis pregnancy center) with another person, the staff determines the other person’s relationship to the client and invites the support person to speak with a different counselor about their thoughts and feelings on the client’s situation.

“Brian” told the counselor that his wife wanted their daughter to have an abortion and he wanted their daughter to be safe. But when the counselor told him, in effect, that ‘You are made in the image of God for a reason and a purpose. You are Eliza’s father AND the grandfather of her child. He is the Creator of the Universe and has given you this role. Trust Him, and He will equip you to take care of your family’, “Brian” changed.

He went to his daughter and said “Baby girl, we’ve got this.” He told his daughter to look at him and said “I’m going to take care of you.” His daughter burst into tears of relief.

Sherri Daume, director of client services at the clinic, explained about ministering to a support person when a woman is considering abortion:

“The support person is often as confused and scared for their loved one as the client herself. They might have a grandchild or niece or nephew in the picture. They usually want to help the client but don’t know how. We equip the support person with information and resources that help them support their loved one in a relevant way.”

I totally agree with this and I have personally seen the effects of such support.

When my oldest daughter Marie became pregnant at 18, her friends were “pro-choice” on abortion. But, as she told me, she knew too much about unborn babies and abortion from growing up in a pro-life family. For Marie, abortion was out of the question.

Marie was surprised but pleased when she told her “pro-choice” friends that she would not have an abortion and they enthusiastically supported her decision. Many even offered to help. However, they did not support her anguished but brave decision to release her baby for adoption.

I told her that I would support her if she decided to raise her baby herself but she decided that her and the father’s problems would keep her baby from having the best life possible.

That decision was hard for our family to accept but our beautiful oldest granddaughter turned 20 this week with the loving and proud parents who adopted her after birth. And despite my daughter’s untimely death almost 9 years ago, we are so grateful that our family will also be able to celebrate this milestone with her and the family who adopted her.

 

 

Caught in Social Media Bias

I have been hearing about Facebook blocking or restricting “conservative” content on the internet. Recently, there was a National Right to Life News story about a Republican judge from my state of Missouri who could not “boost”  (pay for reaching a wider audience) a pro-life video of his nephew overcoming a life-threatening birth defect detected prenatally. Facebook’s stunning rationale?

“Your Ad wasn’t approved because it doesn’t follow our Advertising Policies. We don’t allow ads that contain shocking, disrespectful or sensational content, including ads that depict violence or threats of violence.” (Emphasis added)

A short time ago, I saw that a shared written item from #NoAbortionCoercion on protecting conscience rights for healthcare providers on our National Association of Prolife Nurses (NAPN) Facebook page  was not allowed to be “boosted” because it also conflicted with Facebook’s advertising policies.

The item read:

“Conscience rights of healthcare providers must always be protected. As nurses, the government is constantly telling us what we must and mustn’t do when caring for our patients. There can be no coercion to act against our consciences. Compassion and love is and will always be at the center of what we do. #NoAbortionCoercion”

Our NAPN media nurse says that this has happened before and he has been told that some ads are considered “political”.

However, NAPN is a 501C3 educational organization, not a political one. We have only volunteers, not salaried employees. We do not endorse candidates.

I am a spokesperson for NAPN and as our NAPN website states :

“NAPN is a not-for-profit organization uniting nurses who seek excellence in nurturing for all, including the unborn, newborn, disabled, mentally and or/physically ill, the aged and the dying. Beginning in 1973, when abortion was accepted as a legal alternative to pregnancy, healthcare professionals have been confronted by an ever-increasing number of morally challenging life issues. The list of ethical dilemmas continues to grow: in vitro fertilization, cloning, fetal experimentation, organ donation and transplantation, nutrition and hydration, patient rights, certain sterilization practices, looming rationing of medical resources, assisted suicide and euthanasia, and stem cell research with its promise of advances in the treatment of disease. No one is more affected by these morally challenging issues than the nurse and the pressure to utilize unethical techniques and practices in the care of patients is increasing. Through a united, educational, professional organization such as NAPN, nurses can, in good conscience, deliver the best possible patient care while preserving, protecting and defending respect for human life.”

NAPN also helps to support nurses facing conscience rights legal battles and even offers a $1000 pro-life scholarship award each year to the school of the winning nursing student based on his or her essay, academic achievements, demonstration of leadership and participation in pro-life activities. Applications for the next 2018-2019 award will be posted soon on our website and Facebook page.

CONCLUSION

Of course, NAPN is only one of many groups and individuals complaining about apparent bias against pro-life or conservative groups on social media.

Facebook founder Mark Zuckerberg testified in April before the US Congress that he had no knowledge of bias against conservatives but as Lifenews.com and other news sources have found, there is conservative speech being suppressed not only by Facebook but also Twitter, Google and YouTube. We need more than just reassurances that improvements will be made while the problems are still ongoing.

With so much of the mainstream media enthusiastically supporting abortion, assisted suicide and other deliberate death decisions while ignoring or negatively reporting on issues like conscience rights and alternatives like crisis pregnancy centers, it is especially important for the public to be able to access social media sites like NAPN’s for real facts.

In today’s volatile legal and cultural climate, we need all available information-not a double standard.

3 Tips for Safeguarding Your Loved One in a Nursing Home

I have had many relatives and friends who lived in nursing homes and, especially as a nurse, I am always saddened by how few of the other residents had any visitors, even family members. I have even heard relatives say they would just prefer to remember their relative “the way they were”.

This is not only tragic for the family member’s or friend’s psychological well-being but also potentially for their safety. Nursing home residents without visitors are at greater risk of neglect or even abuse. With sometimes inadequate staffing and/or high nurse and aide turnover, it is important that people in a nursing home have someone who knows them to look out for them.

Here are 3 tips that can help safeguard a friend or relative:

  1.  Get to know the staff and tell them about your friend or relative, especially likes or dislikes. Visit at different times or days in order to know the staff and when it is most convenient to talk with them.
  1. Notice “red flags” like poor personal hygiene, unexplained injuries, weight loss, emotional changes, environmental hazards etc. and know who to contact if you see a problem.
  1. Especially if you are have health care power of attorney for your relative or friend, ask about care conferences so that you can attend them. Such conferences usually cover how the resident is doing in terms of activity, possible pain, eating, mobility, etc. It is also crucial to know what medications have been ordered and given, especially the PRN (as needed) ones. For example, you may notice a change such as sleepiness or fatigue that can be helped with a medication change.

CONCLUSION

By 2020, it is projected that the global population of human beings who are 65 and older will surpass those under 5 for the first time in human history. At the same time, families have fewer children, older adults are more likely to have never married or to be divorced and adult children often live far from their parents. This makes it harder for many older people who prefer to live independently in their own homes indefinitely without help.

According to the CDC, 1.4 million people are nursing home residents in the US and, as I wrote in last week’s blog “‘Rational’ Suicide and the ‘Elderly'”, those residents really benefit from visitors as do all of us who volunteer to help the elderly!

 

 

“Rational” Suicide and the “Elderly”

An article in the May, 2018 issue of the Journal of the American Geriatrics Society titled “Rational Suicide in Elderly Adults: A Clinician’s Perspective”  by Meera Balasubramaniam, MD, MPH  recently appeared in both medical and nursing news sources.

Dr. Balasubramaniam begins with a case study of  “Mr. A” who at age 72 is considered a “baby boomer”, along with a whole section on the “baby boomer” generation-those born between 1946 and 1964 (ages 54-72).

Mr. A was a retired widower who had recently undergone successful cancer surgery and used a walker. He had no terminal illness but  he told a nurse that he always entertained the idea of ending his life “while I’m still doing well” and that if his health showed signs of failing or became too arduous, he would consider suicide. He stated “I’ve lived a good life. I’ll see how it goes, but it’s better to die well in my early 70s than have a life in which I have to be anxious before every doctor’s visit or have repeated surgery or end up in a nursing home.” (Emphasis added) A psychiatric consult showed no mental health problem.

Dr. Balasubramaniam says she wrote this article to “explore whether ethical arguments in favor of physician–assisted suicide apply to elderly adults who are tired of living but are not terminally ill”. (Emphasis added)

While claiming to not take a view on “whether suicide in non–terminally ill elderly adults can be rational”,  Dr. Balasubramaniam states that “It is important to consider the possibility that the combination of negative perceptions toward aging and dependency, greater social isolation, increasing access to drugs, greater need for autonomy, and an overall generational familiarity with suicide may be accounting for a higher proportion of older adults like Mr. A expressing the wish to end their lives on their own terms”. (Emphasis added)

DEATH AND THE BABY BOOMERS

It may seem incredible to even consider “tired of life” and older age as a “rational” reason for medically assisted suicide. However, Holland and Switzerland already allow it and the article itself cites the UK group “My Death My Decision” (formerly SOARS, The Society for Old Age Rational Suicide) that supports the idea that mentally competent older adults should have the right to assisted suicide rather than face an uncertain life that may be “fraught with frailty and dependence”.

As a Baby Boomer myself, we baby boomers were among the first teenagers exposed to a growing societal acceptance of new concepts like divorce , “free love” with the help of the birth control pill and legalized abortion, the “population bomb” predicting global cataclysm if people didn’t stop reproducing, the use of illegal drugs like marijuana and LSD for recreation, the rejection of religious principles and the slogan “don’t trust anyone over 30”.

So perhaps it should not be puzzling that people over 55 comprised the majority of people dying by physician-assisted suicide in the latest Oregon report since we saw so many of the traditional civil and moral moorings in society pulling loose when we were at an especially vulnerable age.

CONCLUSION

As one sage said, “Old age ain’t for sissies!” But, of course, this is not a “rational” excuse for legalizing assisted suicide for anyone-of any age.

Still, our older citizens are an especially high risk group for elder abuse, household accidents, money scams, social isolation, age-related medical bias and poor or even dangerous nursing home care.

Having friends, family and a meaningful purpose in life becomes harder when older people see their loved ones die or move far away and physical or mental limitations develop in themselves. Many older people fear losing their independence as well as being a “burden” on others.

Medically assisted suicide is not the answer but what else can we do to help?

We can start with our own family members, friends and neighbors. Like all of us, older people need to feel loved and appreciated. Look for ways to assist an older person that he or she might not have considered or be too embarrassed to ask about.

When I was a young wife and mother, our church parish started a Good Samaritan program to identify and help people with special needs of any age. It was a great success and our parish became more inclusive and accessible to everyone, especially the elderly. That was a benefit to all of us.

Other programs such as visiting one person for one hour each week in a local nursing home have helped some parishes to combat the sad reality I have seen that few people in nursing get  visitors, especially people with dementia.

Many of us naturally feel uncomfortable about going to nursing homes, but such places are usually thrilled to have volunteers and most have training programs.

Personally, my first volunteer activity was as a young teenager in a nursing home and it changed my perception of “old people” and life itself. I was amazed by the wisdom and stories the residents told as well as how much they appreciated anything I did. It was a great experience for a shy, gawky teen like myself.

Many years later, I took my young children to visit their grandmother in a nursing home after telling them what to expect in terms of sights, smells and sounds. Afterwards, my youngest daughter asked why everyone wanted to touch her leg while I held her. When I explained that the residents rarely saw a 2 year old and were so glad to see her, she grinned and said “OK!”.  She understood even at that young age.

In a society that seems to constantly celebrate youth and health, we need to make sure that our elderly also feel valued and supported.

And we might just save a life!

 

 

 

 

Don’t Write Off The Elderly

Late last year, my 95 year old friend I will call “Melissa” fell and fractured her hip which is especially serious at her age. In one study of people over 65 who fractured a hip, up to 50% died in 6 months with the highest mortality rates found in people over 90 years old.

In Melissa’s case, she also had long-term chronic congestive heart failure when she fell in her bathroom at home. She underwent successful surgery and was sent to a rehab facility where she developed a blood clot that went to her lungs. After successful treatment of that complication, she later developed a life-threatening pneumonia after returning to the rehab facility. She had difficulty breathing even with 100% oxygen by mask and 911 was called. I was with her when the ambulance arrived and I followed it to the hospital.

In the Emergency Room, the doctor asked her son and I about how aggressive to be if her heart or breathing worsened. I said “Ask her!” and the doctor was stunned when she vehemently said “Yes!”, even after he explained the potential problems with cardiopulmonary resuscitation and ventilators. My friend has a durable power of attorney naming her daughter as her health decision maker but the doctor wrongly assumed my friend was not able to speak for herself and that Melissa’s son and I were her decision makers. Thanks to our smartphones, Melissa’s daughter and I were in constant phone contact during that time.

After a few weeks in the hospital, Melissa astonished the doctors by recovering with antibiotics and a temporary BiPap (a face mask machine to support her breathing) until the antibiotics took hold. Then, after another short stint in a facility, my friend was finally able to go home with outpatient rehab and help from family and friends.

Going home was Melissa’s first goal.

This week, she accomplished the second of her goals: returning to Friday Mass and breakfast at Chick-Fil-A for her weekly outing with friends again. Her last goal is to celebrate at her 96th birthday party in August and none of us would bet against her achieving that also.

Elder Bias

In a society that seems to almost venerate youth and material success, those of us who are older can be made to feel useless and even a burden.

That can be fatal.

For example and just this month, 104 year old Australian scientist David Goodall who had no terminal illness traveled to Switzerland for physician-assisted suicide and to actively promote it.

According to USA Today, he said that:

My abilities and eyesight are declining, and I no longer want to live this way...I hope something positive will come out of my story and that other countries will adopt a more liberal view of assisted suicide.”

Sadly, he also added that he “had no pressure from his family to change his mind.” (Emphasis added)

David Goodall was a renowned biologist who produced more than 100 research papers and earned three doctorates when:

“In 2016, at 102, the university ordered him to leave his office, calling him a safety risk to himself. Goodall challenged the decision, which was reversed after an outpouring of public support.

Earlier this year, however, Goodall fell while at home alone in his one-bedroom apartment and remained on the floor for two days until he was found by his cleaner, according to The New Daily.

Afterward, Goodall said he was considered incapable of looking after himself. Moreover, most of his friends were dead.”

Philip Nitschke, director of Exit International, a right-to-die organization in Australia called Goodall’s “story of elective, rational suicide by the elderly is an important one.” (Emphasis added)

CONCLUSION

What a sad, depressing story Mr. Goodall’s story is compared to Melissa’s!

This should be a wake-up call to the rest of us not only about the frightening expansion and promotion of physician-assisted suicide but also about how all of us need to recognize the value, wisdom and even inspiration of older people.

We must also recognize that we all need help at some point in our lives. We are totally dependent on others when we are born and many of us need at least some help near the end of our lives. But when we truly care for each other, both the helper and the person being helped are enriched to live their best lives.

 

 

My Book Review on “Nurses and Midwives in Nazi Germany: The ‘Euthanasia Programs’”

“Nurses and Midwives in Nazi Germany-The ‘Euthanasia Programs’”
Edited by Susan Benedict and Linda Shields
Routledge Studies in Modern European History. London: Routledge 2014

My book review (abstract) was just published in the Linacre Quarterly journal. Here are some excerpts from my review with all emphasis added only for this blog.

In my nursing education during the 1960s, the Nazi euthanasia program was covered during a class but mainly as a ghastly aberration that was unthinkable today with our now strong ethical principles. As students, we were shocked and horrified by the revelation that nurses were integral to Nazi killing programs. We had little knowledge of the mechanisms that existed to encourage nurses to kill those patients whose lives were deemed “not worth living.”

Unfortunately, it is difficult these days to find information about nurses during the Nazi regime, even on the American Nurses Association website. Thus, the editors of this book do nurses and the public a great service by examining the little-known but crucial role of nurses in the Nazi euthanasia programs. Knowing this history is more important than ever as efforts to legalize assisted suicide and euthanasia continue to grow.

The authors explain the history, education, propaganda, and pressures that led so many nurses to participate in the killing of hundreds of thousands of helpless men, women, and children in the 1930s and 1940s; they also propose a model for teaching nursing ethics using the Nazi euthanasia program to encourage nursing students to examine ethical principles and their own values as a nurse in today’s health-care system.

……

The authors start with the rise of the influential eugenics movement in the early twentieth century in countries like the United States where the American Eugenics Society even held conferences on eugenics, such as the 1937 one which included the topic “The Relation of Eugenics to the Field of Nursing.” Eventually, the US eugenics movement fell out of favor after the Nazi euthanasia programs were discovered in World War II.

Even prior to World War II, German professional nursing publications discussed eugenics as “providing a scientific basis for the positive eugenics promoting reproduction among the healthy (often of northern European descent) middle to upper classes and negative eugenics encouraging limited reproduction and forced sterilization of the ‘unfit’ (who were often poor, uneducated, and more recent immigrants) as reasonable”.  Eugenic language was most prevalent in public health and psychiatric nursing texts and in discussions of poverty, immigrants, cleanliness, and social problems.

The editors also point to the influence on Adolf Hitler of the 1920 book titled Approval of the Extermination of Worthless Human Lives by Germans Karl Binding, a jurist, and Alfred Hoche, a psychiatrist. Binding and Hoche noted that there were no legal arguments preventing legalizing the killing of those whose lives were considered not worth living. (Emphasis added)

There was extensive propaganda aimed at increasing the acceptance of euthanasia by the public and health-care providers. Only a few months after Hitler seized power, the first law, affecting people diagnosed with psychiatric conditions, was passed. It mandated sterilization for people with hereditary disorders including alcoholism and epilepsy. Propaganda emphasized wastefulness of providing health care to the chronically mentally ill and the hereditary nature of undesirable physical, mental, and social traits.

Hitler did not propose the systematic killing of psychiatric patients during peacetime because he anticipated the opposition of the churches and the German people. The beginning of World War II muted moral objections and distracted the populace with concerns of conserving resources for the war effort and was the start of state-sponsored euthanasia. The first documented killing occurred in 1939 when Hitler granted the euthanasia request of a father whose son was born blind, missing a leg and part of an arm and who “seemed to be an idiot” .

In 1939, the German Ministry of Justice proposed two new clauses:

1.“Whoever is suffering from an incurable or terminal illness which is a major burden to himself or others can request mercy killing by a doctor, provided it is his express wish and has the approval of a specially empowered doctor.”

2. “The life of a person who, because of incurable mental illness, requires permanent institutionalization and is not able to sustain an independent existence may be prematurely terminated by medical measures in a painless and covert manner” . (Emphasis added)

The program started targeting those in asylums and the disabled in nursing homes for death by lethal gas, starvation, drugs, and neglect. The Jewish population was especially targeted regardless of health.

………

 

In 1933, Adolf Bartels, the deputy leader of the Reich’s medical profession, provided a blueprint of the future of nursing under the Nazis. He emphasized that German nurses in social and medical service had to meet standards in the new Reich that were very different from before. The new Reich not only wanted to look after the sick and weak but also wanted to secure a healthy development of all Germans “if their inherited biological predisposition allows for it” (p. 38). Above all, the new state wanted to secure and promote a genetically sound, valuable race, and, in contrast to the past, “not to expend an exaggerated effort on the care of genetically or racially inferior people”. (Emphasis added)

As a Nazi politician stated, “a nurse is the one who should carry out the will of the State in the health education of the people”. It was not necessary for the majority of nurses to become ardent supporters of the Nazi regime for them to do the will of the Reich. One source noted that the majority of nurses who participated in a secret euthanasia program known as T4 tried to remain good nurses; an estimated 10 percent or fewer were enthusiastic supporters of Nazi practice. But, as in other areas of public life, the Reich absorbed professional nursing organizations, leaving the nursing profession with no means of expressing opposing or dissenting views as well as no organizational support for refusing to participate. (Emphasis added)

……

 

Using midwives, the Reich took various measures both to prevent those regarded as having a “hereditary disease” or who were “racially inferior” from reproducing while increasing the birth rate of those considered valuable and healthy. Thus, the traditional midwife focus on the mother and child was changed to focus on the nation as a whole.

Midwives could initiate proceedings for forced sterilization, and it was now a duty for midwives to report to public health officers “deformed” births and small children with disabilities before their third birthday. Reports received from doctors and midwives were reviewed by medical examiners, and based solely on the reports, the examiners decided whether the child was to be killed or spared.

Parents with such children were told about institutions for children who needed special care that were being established through the country. They were persuaded to admit these children and were assured that the children would receive the best possible care. Parents could refuse but had to sign forms stating their responsibility to supervise and care for their children. The identified children in these institutions were killed by starvation or lethal injection. Parents were told that their children had died from natural causes.

……..

The world was riveted by the 1945 Hadamar trial, the first mass atrocity trial after the Nazi regime was defeated in World War II. This trial came before the infamous Nuremburg trials that included doctors. Hadamar was covered extensively by American media but ignored by the American Journal of Nursing even though nurses were charged.

The trial involved one of the largest and most important killing centers, Hadamar Psychiatric Hospital, one of the six institutions in Germany designated for killing the mentally ill. In 1943, a ward (called an “educational home”) was set up for mixed-race children with Jewish heritage within Hadamar. Completely healthy children were killed with lethal injections. The actual numbers are not known because employees were required to take an oath of secrecy. It is estimated that more than 13,000 patients were killed in 1941 and 1942, even before the ward was set up.

 

In the first Hadamar trial, Head Nurse Irmgard Huber was tried with six others for killing over 400 men, women, and children. Nurse Huber was charged with “obtaining the lethal drugs, being present when some of the fatal injections were given, and being present when the false death certificates were made out”. Two male nurses were charged with administering the lethal injections. All pleaded not guilty. Their defense was that they were powerless and had inadequate knowledge to judge the morality of their actions. All denied accountability. (Emphasis added)

Trial testimony confirmed that the nurses prepared patients for their deaths, directed the entire nursing staff of the institution, and were present at the daily conferences where the falsified death certificates were completed. Duties to patients were limited to so-called kindnesses that consisted of bringing small gifts to pediatric patients and taking care to prevent patients from knowing that they would soon be killed. Head Nurse Huber insisted that she wished to render a last service to these patients and did not want to do them any harm and that she had a clear conscience.

…….

The second Hadamar trial in 1947 did not receive the same attention as the first. Twenty-five members of the Hadamar staff were charged. At this trial, Head Nurse Huber was charged with killing 15,000 German mental patients. All but one of the defendants were found guilty and served sentences ranging from two and a half to five years. The one nurse found not guilty claimed she had feigned pregnancy in order to achieve release from the killing center. (Emphasis added)

In the end, Head Nurse Huber was released from prison in 1952; the others by 1954.

………

The book presents a model used for two innovative teaching programs about this subject, one in Israel and one in Australia, perhaps the most important contribution of this book. The editors believe that the Nazi era should be taught to students, “highlighting the danger of failing to see each individual as a valuable member of human society. And while the heart of nursing and midwifery continues to be care and caring practices, it is fundamental for students to confront this history to develop insights into the causes and social constructs that enabled nurses and midwives to distort the goal of nursing practice and theory to harm and murder patients.”

The results of these programs and the responses by students appear encouraging. The editors hope that by raising these issues, students will be forced to confront their own values and beliefs, sometimes an intensely uncomfortable experience. They also believe students who are exposed to this “dark element of nursing and midwifery history” will be better prepared to face pressure or to report and oppose violations of the trust that is central to any relationship between nurses and patients

 

CONCLUSION

Decades after the Nazi atrocities, we are seeing a resurgence of the same “life unworthy of life” justification that drove Nazi eugenics. We see how this perspective increasingly approves the deliberate termination of some lives as “merciful” and “humane.” There is an emerging, shocking consensus that we can—or perhaps even should—choose to have our own lives terminated when our lives are considered not worth living either by ourselves or by others if we cannot speak for ourselves.

The authors of this book make it clear: we all need to know and understand the past in order not to repeat it. Hopefully, it is not too late to turn the tide of history back toward respect for all life.

 

 

You Don’t Want to be a Burden, Do You?

An April 13, 2018 USA Today op-ed titled “Make an End-of-life plan or Lose your Money and Choices in your Dying Days” by Hattie Bryant begins with the statement “End-of-life care can bankrupt your family and rob you of choices. End the denial about dying. Make a plan in case you end up seriously ill and frail.” (Emphasis added)

Ms. Bryant is very upfront about using the economic argument about aging and the enormous toll it can take financially and personally on the family as well as medical costs. She states that “in 2011, Medicare spent $554 billion and 28%, or about $170 billion, on patients’ last six months of life. After $170 billion is spent, those patients are still dead.”

Her solution is a new kind of economic advance directive she developed (and is selling as a book titled “I’ll Have It My Way: Taking Control of End-of-Life Decisions“ ) “that deals with how you want your funds spent when you are seriously ill or frail.” (All emphasis added)

SHOULD WE HAVE A “DUTY TO DIE”?

Back in 1984, Governor Richard Lamm of Colorado found himself in the middle of a firestorm of outrage when, as the New York Times reported, “Governor Lamm Asserts Elderly, If Very Ill, Have a ‘Duty to Die”.

Here is an excerpt from the article:

Elderly people who are terminally ill have a ”duty to die and get out of the way” instead of trying to prolong their lives by artificial means, Gov. Richard D. Lamm of Colorado said Tuesday.

People who die without having life artificially extended are similar to ”leaves falling off a tree and forming humus for the other plants to grow up,” the Governor told a meeting of the Colorado Health Lawyers Association at St. Joseph’s Hospital.

”You’ve got a duty to die and get out of the way,” said the 48-year-old Governor. ”Let the other society, our kids, build a reasonable life.”

This philosophy was echoed in 2014 by one of the architects of Obamacare, Dr. Ezekiel J. Emanuel, when he wrote “Why I Hope to Die at 75-An argument that society and families—and you—will be better off if nature takes its course swiftly and promptly” for The Atlantic Magazine.

At age 57 at the time, Dr. Emanuel states that while death is a loss, there “is a simple truth that many of us seem to resist: living too long is also a loss” that “renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.” (Emphasis added)

He states that he will stop trying to prolong his own life by age 75.

CONCLUSION

Helping to care for many terminally ill or seriously disabled relatives, friends and patients of all ages for many decades both professionally and personally, I have a different perspective.

We are all born dependent on others for care and many of us need at least some help from others at the end of our lives. This can be hard at times-as even parents of newborns will attest-but the rewards are great both for the helper and the person being helped.

I remember when my mother with Alzheimer’s and terminal thyroid cancer was dying in 1988. It wasn’t the most convenient time for us, to say the least. I was a suddenly single parent with three young children and financially struggling.  My mother no longer recognized me but, as I told a friend, the most important issue was that I recognized her.  As a family, we did what was medically reasonable for my mother to help her without either prolonging or hastening her dying.

Taking care of my mother was a wonderful, if occasionally difficult, experience and I am grateful that we were able to keep her at home almost to the very end.

The final result was that my mother was kept  safe, comfortable and loved. Her funeral was truly a celebration of her life and my children learned an important lesson about the circle of life and taking care of each other. We still talk fondly about their time helping with grandma, even after 30 years.

When I made out my own advance directive, I made sure that it was as protective as possible against a hastened death. I don’t fear death. I do fear the bioethicists  and others who use economics and fear to push especially older people into prematurely signing away their rights to even basic care and what this does to our society.

The Opioid Crisis and Suicide

Statistics show that more than 115 Americans a day die after overdosing on opioids. Opioids  are a class of drugs that include both illegal drugs like heroin and legal prescription pain relievers such as codeine and morphine.

We are told that we have an opioid crisis that needs immediate solutions such as suing drug manufacturers, spending more on drug treatment centers, making drugs like Narcan more available to reverse the overdose if given in time, prescribing few-in any-opioids after surgery, adding more drug education in schools, etc.

Some of these ideas are worthy but are we missing a big existential part of the problem?

In a recent Kaiser Health News article asking  “How Many Opioid Overdoses are Suicides?”, reporter Martha Bebinger relates a heartbreaking interview with a young drug addict:

“She wanted to be dead, she said, glancing down, a wisp of straight brown hair slipping from behind an ear across her thin face.

At that point, said Ohlman, she’d been addicted to opioids — controlled by the drugs — for more than three years.

“And doing all these things you don’t want to do that are horrible — you know, selling my body, stealing from my mom, sleeping in my car,” Ohlman said. “How could I not be suicidal?…You realize getting clean would be a lot of work,” Ohlman said, her voice rising. “And you realize dying would be a lot less painful. You also feel like you’ll be doing everyone else a favor if you die.”” (Emphasis added)

Having had a daughter with drug addiction and relapses for 16 years who finally succumbed to suicide in 2009 using a horrific assisted suicide technique, I recognize the same pain this young woman expresses. I also know the frustration and fears of families and friends desperate to help.

The Kaiser article goes on to quote Dr. Maria Oquendo, immediate past president of the American Psychiatric Association, who said that “[Based on the literature that’s available], it looks like it’s anywhere between 25 and 45 percent of deaths by overdose that may be actual suicides,” *(Emphasis added).

The article also quotes a pair of distinguished economists who say that “opioid overdoses, suicides and diseases related to alcoholism are all often ‘deaths of despair’” caused by “underlying deep malaise”. (Emphasis added)

We have both a suicide and a drug crisis that often overlap due to an overwhelming sense of hopelessness and helplessness.

EXAMINING THE SCOPE OF THE PROBLEM

As psychiatrist Dr. Oquendo notes in a related article, US suicide rates were declining until they “abruptly stopped in1999” and now have increased 25%, especially among adolescent girls.

Now, there are about 123 reported suicides per day in the US  but the real figure may be as high as 3 to 5 times that number because many suicides go unreported as suicide  because of reasons like the stigma of suicide and the difficulty in determining intent.

Additionally, nearly half of US adults have a close friend or family member with a current or past drug addiction.

We have more drug treatment centers and suicide prevention programs than ever (with unfortunately varying levels of quality and allowed family involvement) but the problems continue to persist and even worsen.

CONCLUSION

What has happened in the US since suicide rates started rising two decades ago and drug abuse has surged?

First, we must recognize that American culture, law and politics changed radically in the last two decades and this has drastically affected all of us, especially our young people. For example, the legalization and glamorization of assisted suicide and mind altering drugs like recreational marijuana have not helped anyone want to embrace personal responsibility and caring for others as worthy goals.

We also now have a culture where religious values are often derided as judgmental and even harmful to social progress. Obscene language and violent, hypersexualized entertainment is applauded as liberating rather than offensive. Having children is portrayed as more of a potential economic, professional and personal burden rather than a joyful manifestation of love, commitment and family.

We owe our society and especially our young people a more hopeful, less selfish view of life rather than just the pursuit of  money, fame and pleasure.

Without a strong foundation of love, strong ethics and ideals, the resilience required to weather both the ups and downs of life without drugs or succumbing to suicide can be lost.

As much as we need good, affordable suicide and drug treatment programs, we adults also need to be examples of a truly “good life” and step up to fight the dangerous influences  that are killing our young people.

And we must never give up!