end-of-life

Dead Donor Rule Violations Draw Federal Sanctions

nancyvalko brain death, brain injury, dementia, end-of-life, futility, law, medical ethics, organ donation

In an Aug.7, 2026 post by Thaddeus Mason Pope, JD, PhD, HEC-C on his Medical Futility blog titled Dead Donor Rule Violations Draw Federal Sanctions, he writes that:

“Most violations of the dead donor rule are not enforced. When they are, it is usually through state criminal law. But this week, we see federal government enforcement of the dead donor rule. ” (Emphasis added)

The U.S. Department of Health and Human Services decertified the Lexington, Kentucky-based organ procurement organization, Network for Hope, after the DHHS found “persistent patient safety failures,” including moving forward with harvesting the organs from TJ Hoover despite him being alive and later recovering. ” (Emphasis added)

In my February 6, 2026 blog “Two States Are Facing Challenges in Death Decisions Regarding Death Determination Errors and Assisted Suicide”, I quote Mr. Pope’s statement on death determination:

“In Kentucky, Thaddeus Pope states his January 29th blog, Death Determination Errors Addressed in New Legislation, that:

“The goal in death determination is 100% accuracy: zero false positives. So, it is regrettable that we need legislation to address roles and responsibilities when a patient who was determined and declared dead is not dead. But we now have such legislation. 

Kentucky H.B. 510 provides that “during any organ donation recovery, preservation, or procurement activity … a pause in procedure shall be initiated if any individual … reports on any of the following: (1) Observed or suspected change in neurological status; (2) Observed or suspected indication of life; or (3) Uncertainty regarding the accuracy or completeness of neurological status or death declaration assessments.” (Emphasis added)

The goal in death determination is 100% accuracy: zero false positives. So, it is regrettable that we need legislation to address roles and responsibilities when a patient who was determined and declared dead is not dead. But we now have such legislation. 

Kentucky H.B. 510 provides that “during any organ donation recovery, preservation, or procurement activity … a pause in procedure shall be initiated if any individual … reports on any of the following: (1) Observed or suspected change in neurological status; (2) Observed or suspected indication of life; or (3) Uncertainty regarding the accuracy or completeness of neurological status or death declaration.” (Emphasis added)

CONCLUSION

I agree with Mr. Pope.

I first began my questioning about brain death when I went to a patient’s room in our ICU and found a group of doctors around a patient who had just been removed from a ventilator.

When I questioned what they were doing, the doctors told me that they were checking to see if the patient was brain dead.

When I said that brain cells would be dying from a lack of oxygen after several minutes and making him worse, the doctors looked stunned and told me that “Greater minds than yours have worked this out”.

I later learned that a pregnant woman on a ventilator continued her pregnancy until birth, and about cases like Zack Dunlap and Jahi McMath who survived after being declared brain dead.

I also discovered that some mothers declared “brain dead” were able to gestate their babies for weeks or months to a successful delivery before their ventilators were removed and that there were many cases of “brain dead” people who lived for months or years and even grew proportionally and achieved puberty.

If the legal definition of brain death is “irreversible cessation of all functions of the entire brain, including the brain stem” (Emphasis added), these cases would seem to be impossible.

And when I served on a hospital medical ethics committee, I was horrified when one doctor found a less rigorous set of brain death tests at another local hospital and proposed that we adopt this standard so that more of our patients could be declared “brain dead” for organ donation.

Investigating further, I also found “near-miss” cases like Zach Dunlap’s. Zach Dunlap is a young man who was declared brain dead after an accident in 2007. Testing showed no blood flow to his brain, and he was being considered for organ donation when a relative discovered a physical response. Four months later, Zach was making plans to return to work. In an interview, he said he heard a doctor say he was dead and it “just made me mad inside”.

CONCLUSION

As I pointed out in my Spring 2016 NCBC Quarterly journal article titled “Brain Death: Do We Know Enough?” :

“When cases like those of Jahi McMath and Zack Dunlap who survived after being thought brain dead are routinely dismissed instead of rigorously investigated to establish the facts, medical certainty is not achieved and medical integrity is undermined. In addition, when hospitals set their own standards and policies for determining brain death without external accountability, lives—as well as the essential and necessary trust in the health care system—can and possibly will be lost.” (Emphasis added)

Personally, I am not against all organ donation.

In the past, I have offered to be a living donor for a friend who needed a kidney, watched my grandson cured of a rare disease through a bone marrow transplant, and I told my family that I wanted to donate my corneas and any other tissues that can be taken after natural death.

I am open to new facts, but until then, I refuse an apnea test or any other test to specifically determine brain death if I have a severe brain injury.

And I will not sign an organ donor card.”

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Two States Are Facing Challenges in Death Decisions Regarding Death Determination Errors and Assisted Suicide

nancyvalko advance directives, assisted suicide, brain death, civil rights, conscience rights, end-of-life, law, Living wills, medical, medical ethics, mental health, organ donation, suicide

Delaware and Kentucky are facing challenenges to lasws r4gatding end of life deicisions.

In Kentucky, Thaddeus Pope in his January 29th blog Death Determination Errors Addressed in New Legislation states:

“The goal in death determination is 100% accuracy: zero false positives. So, it is regrettable that we need legislation to address roles and responsibilities when a patient who was determined and declared dead is not dead. But we now have such legislation. 

Kentucky H.B. 510 provides that “during any organ donation recovery, preservation, or procurement activity … a pause in procedure shall be initiated if any individual … reports on any of the following: (1) Observed or suspected change in neurological status; (2) Observed or suspected indication of life; or (3) Uncertainty regarding the accuracy or completeness of neurological status or death declaration assessments.” (Emphasis added)

The goal in death determination is 100% accuracy: zero false positives. So, it is regrettable that we need legislation to address roles and responsibilities when a patient who was determined and declared dead is not dead. But we now have such legislation. 

Kentucky H.B. 510 provides that “during any organ donation recovery, preservation, or procurement activity … a pause in procedure shall be initiated if any individual … reports on any of the following: (1) Observed or suspected change in neurological status; (2) Observed or suspected indication of life; or (3) Uncertainty regarding the accuracy or completeness of neurological status or death declaration.”

And in Delaware, a lawsuit has been filed by several disability organizations and others, after the bill was signed by the governor and took effect January 1, 202. the plaintiffs state that:


  1. Delaware’s End of Life Options Act, 16 Del. C. § 2501C, et seq. (“EOLOA” or the
    “Act”), is scheduled to go into effect on January 1, 2026 (or as soon as final regulations are in
    place), and will allow providers, including Advanced Practice Registered Nurses (“APRN”), to
    prescribe drugs—not to alleviate pain or suffering—but to cause the death of the patient and
    intentionally facilitate suicide.

  2. Plaintiffs, people with life-threatening disabilities and organizations that represent
    and advocate for people with life-threatening disabilities, belong to a class of protected individuals
    who are at imminent risk of harm if the Act is allowed to go into effect. To protect themselves
    from this fast-approaching threat, Plaintiffs bring this action to stop Defendants, government
    officials, from putting in place this deadly and discriminatory system. The Act—if allowed to go
    into effect—will steer people with life-threatening disabilities away from necessary lifesaving and
    mental health care, medical care, and disability supports, and toward death by suicide under the
    guise of “mercy” and “dignity” in dying.

  3. Throughout the country, a state-endorsed narrative is rapidly spreading that threatens people with disabilities: namely, that people with life-threatening disabilities should be directed to suicide help and not suicide prevention. This world view is being touted as a common-sense objective: people who have life-threatening disabilities should be able to readily obtain physician-assisted suicide. At its core, this is discrimination plain and simple. With cuts in healthcare spending at the federal level, persons with life-threatening disabilities are now more vulnerable than ever.

  4. EOLOA’s passage is clear and present danger to people with life-threatening
    disabilities in Delaware. Persons who are identified as “terminal”—i.e., people with life-threatening disabilities- are able to obtain assisted suicide. The new law does not require any evaluation, screening, or treatment by a mental health professional for serious mental illness, depression, or treatable suicidality, all of which could are necessary for informed consent and a
    truly autonomous choice, before the lethal prescription is written. The provider need not have
    expertise with the patient’s specific illness or condition and need not be trained on mental health
    symptoms or side effects associated with the patient’s illness or treatment. While the provider is
    supposed to discuss “feasible” alternatives to suicide, including available treatment options and
    the foreseeable risks and benefits of each, the provider is not required to do anything to help the
    patient obtain access to these frequently difficult to obtain services, nor are insurers required to
    cover them.
  1. Assisted suicide under EOLOA violates federal disability rights laws and the U.S.
    Constitution’s Equal Protection clause, which protects people with disabilities from discrimination,
    exclusion, and life-threatening state action. Under federal law, a public entity may not withhold
    services or make services available on unequal terms based on disability. EOLOA, however, does
    just that. EOLOA is offered to people with life-threatening disabilities. Not only is this facially
    discriminatory, it also places persons with disabilities in a much more vulnerable position.

The lawsuit makes several other important points. I suggest anyone concerned with this issue read them all, especially those of us fighting assisted suicide laws.

The Choice Was “Comfort Care” or a Trial of Life

nancyvalko culture, education, end-of-life, inspiration, medical, medical ethics

In a November 19, 2025, article by Kevin Reece titled “”Micro-preemie’ born at less than one pound thrives after state-of-the-art careMicro-preemie’ born at less than one pound thrives after state-of-the-art care”, he describes a mother’s dilemma when Annie Babcock gave birth to a daughter at just 24 weeks gestation:

“Annie Babock was in trouble. The baby she was carrying had been diagnosed with intrauterine growth restriction and Annie, her pregnancy at just 24 weeks gestation, was diagnosed with preeclampsia and placental abruption. 

Her doctors in Bedford delivered a sentence she will never forget.

“They said we can either deliver here and do comfort care and let the baby pass, or go to Texas Health in Fort Worth and do a trial of life.” (Emphasis added)

THE PARENTS CHOOSE THE TRIAL OF LIFE

“Nora Babcock was born March 10. She weighed 13.1 ounces and was just 10.5 inches long – roughly the size of a soda can. Rushed into the Neonatal Intensive Care Unit at Texas Health Harris Methodist Fort Worth, Nora would need prolonged respiratory assistance and a delicate procedure to repair a heart defect. It would be 10 days before Annie Babcock was able to hold her. 

“It was terrifying,” Annie Babcock said. 

“It was our first bonding experience, but it sure was scary,” she said of holding her tiny daughter while the infant was supported by multiple wires, monitors, and tubes.

EIGHT MONTHS LATER

“She came home July 10,” Babcock said. “So we’ve been in the NICU more days than we’ve been out of the NICU.”

Nora weighs 10 pounds now and is, according to her doctors, the picture of health.

“It was a huge shock when they said she was going to be born at 24 weeks,” Babcock said. “I had no idea a baby less than a pound could be born and also live. It was terrifying, but also like miraculous.”

“You look at her now, and it’s hard to even think about that,” Owen Babcock said of his daughter’s precarious start at life.

“When she was born so small I didn’t think she could live,” Annie Babcock said. “And the nurses are like, no, she’s going to thrive.”

A DOCTOR SPEAKS

“A case like Nora is still quite rare, mostly because of her size,” said Dr. Megan Schmidt, neonatologist at Pediatrix Neonatology of Texas and Texas Health Harris Methodist Fort Worth Hospital. 

Nora is considered a “micro-preemie” – a baby born before 26 weeks gestation or less than 2.2 pounds.

You’re really battling against nature,” Schmidt said. “And trying to get this body that is not ready to be in this world and be in the outside world, you’re trying to force it to stay in this outside world and to function. It takes highly highly specialized care to even be able to have a chance to have these babies survive.”

“These sorts of things and these innovations that have been developed over the last 10-plus years are things that are making big changes for our babies now,” Schmidt said. “We couldn’t have done these things as early as 30 years ago that we can do now. So there is hope.”

The Parents Speak

“Just the advancements that have been made over the last decade are incredible,” said Owen Babcock.

Owen and Annie Babcock will tell you they have taken a “ridiculous” amount of pictures. They were also allowed to keep Nora’s first blood pressure cuff – barely big enough to fit on an adult finger.

“I think of this little fighter who was ready to come into the world too soon, but she was ready to come fighting, and she never gave up,” Annie Babcock said while looking at the handprints and footprints the hospital gave them – the footprint barely the size of an adult thumb.

“I will tell her she’s the strongest person I’ve ever met in my whole life,” Annie Babcock said when asked what she will tell her daughter when she is older. “I really hope she’s a neonatologist someday. I’m trying to manifest it.”

There is a photo wall in the Babcock’s dining room that includes the phrase – “I still remember the days I prayed for the things I have now.” After their ordeal, they are truly thankful

“I can’t thank Dr. Schmidt enough for just believing in her and not like never giving up hope,” Annie Babcock said.

Hope that they want other parents of preemie babies to know is possible for them too.

“What they do as their work,” she added, “it’s amazing.”

CONCLUSION

This story is heartwarming but also disturbing.

The choice between “comfort care” and more aggressive care can mean life or death for any critically ill person of any age. Families deserve ALL pertinent information and options!

New Dementia Directive Developed to Avoid Late-Stage Dementia

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

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

The authors state:

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

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

CONCLUSION

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

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

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

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

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

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

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

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

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

It took several long days for him to die.

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

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

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

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

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

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

Nancy Valko, RN

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

By Susan Harvath and Nancy Guilfoy Valko                                                                    

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

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

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

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

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

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

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

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

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

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

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

Trump Pardons 23 Pro-Life Activists the Day before the March for Life

nancyvalko abortion, end-of-life, medical ethics, mental health, nursing, Planned Parenthood, pro-life, suicide

In a January 23, 2025 article in the New York Post titled “Trump pardons ‘peaceful’ pro-lifers imprisoned for protesting outside abortion clinics” states:

” President Trump pardoned nearly two dozen pro-life activists Thursday who were convicted under a federal law of illegally trying to block abortion clinic entrances or otherwise keep women from undergoing the procedure.

The pardons, Trump said in the Oval Office, will go to 23 “peaceful protestors” who were prosecuted under the Biden administration. He did not reveal the names of those who will be pardoned. 

“Twenty-three people were prosecuted who should not have been prosecuted. Many of them are elderly people. They should not have been prosecuted,” the president said. “This is a great honor to sign this.”

The Freedom of Access to Clinic Entrances (FACE) Act, enacted in 1994 by former President Bill Clinton, prohibits use of physical force, threat of physical force, or physical obstruction to injure, intimidate or otherwise interfere with “any class of persons [in] obtaining or providing reproductive health services.”

The law also has the same stipulations allowing free access to places of worship — but conservatives say Democratic administrations have been more interested in prosecuting abortion clinic obstruction.”

MY FIRST TIME AT AN ABORTION CLINIC

I was a new nurse when Roe v Wade legalized abortion.

I was shocked and saddened while my other medical colleagues thought this was great.

“What would you do if you found out you were pregnant?”, they asked.
I told them I would have the baby and consider adoption. They thought that was crazy.

I later joined the St. Lous Archdiocese Pro-Life Commitee, the first in the US, and donated items to the Birthright organization that offers “free, confidential resources to any woman regardless of age, race, circumstances, religion, marital status or financial situation.”

In 1987, I was invited to join a group holding signs outside the Planned Parenthood Clinic in St. Louis offering information and help to the women entering. I was nervous walking with my then 2-year-old daughter but there were strict rules about staying on the sidewalk and I was relieved to see the signs with phone numbers and offers to help the women entering the clinic.

But suddenly my 2-year-old daughter dropped my hand and ran to play on the grass in front of the clinic. I panicked, picking her up and running to the sidewalk. I had heard that we could be arrested. Luckily, we weren’t.

CONCLUSION

I am glad President Trump pardoned those peaceful pro-life people but being pro-life is about more than picketing.

Every pro-life person I know is also a person who reaches out to anyone in need.

I know I have been blessed by helping single moms in difficult circumstances, families caring for children with disabilities, people considering suicide, women regretting their abortion, older people facing their impending death, and others.

Being pro-life is not just about ending the horror of legalized abortion but rather about cherishing and caring for all lives!

That is why I am so proud of the National Association of Pro-life Nurses’ button that simply says “I care”.

Hawaii Doctor Investigated for Assisted Suicide Murder

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

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

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

The newspaper states:

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

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

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

CONCLUSION

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

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

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

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

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

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

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

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

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

They describe the program they started in California:

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

RESULTS OF THE SURVEY

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

The authors of this study conclude that there is:

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

CONCLUSION

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

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

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

When Food and Water Withdrawal is Recommended to Hasten Death

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

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

He wrote:

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

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

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

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

It took 4 long days for him to die.

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

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

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

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

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

CONCLUSION

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

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

Gallup Poll: Most Americans Favor Legal Euthanasia

nancyvalko Alzheimer's, assisted suicide, end-of-life, euthanasia, faith, family, grief, law, media, medical ethics, pro-life, suicide

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

and

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

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

However, as Gallup reports,:

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

The Perceived Morality of Doctor-Assisted Suicide

Gallup says that:

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

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

CONCLUSION

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

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

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

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

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

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

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

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