law

Sparks Fly at Conception-Literally

nancyvalko abortion, conception, law, medical ethics, prenatal testing

I remember the shock I felt when I first read these words in the 1973 Roe v. Wade abortion decision:

“We need not resolve the difficult question of when life begins. When those trained in the respective disciplines of medicine, philosophy, and theology are unable to arrive at any consensus, the judiciary, at this point in the development of man’s knowledge, is not in a position to speculate as to the answer.”

I could not believe that anyone could deny the obvious: life begins at conception.

Just 5 years later, the first child conceived through in vitro fertilization was born. While I recognize the several ethical problems with this procedure, I thought that at least this obviously proved that life begins at conception since the process was monitored from the beginning. Unfortunately, not to the pro-abortion movement that then pivoted to we don’t know when human personhood begins.

Ironically, presidential candidate Hilary Clinton recently revealed the hypocrisy of this pivot when she said “The unborn person doesn’t have constitutional rights” on NBC’s Meet the Press TV show. (Emphasis added)

Flash of Light

But now researchers at Northwestern University have discovered a flash of light that occurs at the moment of conception!  To see the video of this phenomenon, go to the link at LifeNews.com.

Here is the science behind this:

“The bright flash occurs because when sperm enters and egg it triggers calcium to increase which releases zinc from the egg. As the zinc shoots out, it binds to small molecules which emit a fluorescence which can be picked up my camera microscopes.

Over the last six years this team has shown that zinc controls the decision to grow and change into a completely new genetic organism.

In the experiment, scientists use sperm enzyme rather than actual sperm to show what happens at the moment of conception.

“These fluorescence microscopy studies establish that the zinc spark occurs in human egg biology, and that can be observed outside of the cell,” said Professor Tom O’Halloran, a co-senior author.”

And

Dr. Teresa Woodruff, a professor at Northwestern said, “We discovered the zinc spark just five years ago in the mouse, and to see the zinc radiate out in a burst from each human egg was breathtaking. It was remarkable.”

An Ethical Downside

Regrettably, the scientists say that the intensity of the flash of light also appears to indicate the egg’s quality and the embryo’s future health. This could allow more in vitro fertilization embryo selection with the destruction of embryos thought to be of lesser “quality”.

Therefore, instead of celebrating this physical proof of conception, Dr. Eve Feinberg, who co-authored the study, said

 “Often we don’t know whether the egg or embryo is truly viable until we see if a pregnancy ensues… If we have the ability up front to see what is a good egg and what’s not, it will help us know which embryo to transfer, avoid a lot of heartache and achieve pregnancy much more quickly.”

However, real heartache comes with infertility, desperate medical procedures to obtain a baby by any means possible, and the termination of life both inside and outside the womb.

But in the meantime, we can still rejoice in the apparent discovery of a true “spark of the Divine”.

 

Why Are Suicide Rates Climbing after Years of Decline?

nancyvalko assisted suicide, culture, law, medical ethics, mental health

After years of declines, the US suicide rate rose 24% over 15 years according to a new report from the national Centers for Disease on suicide rates in the US from 1999-2014.  The suicide rate rose for everyone between the ages of 10-74 between 1999-2014.

National media like the Wall Street Journal  and CNN   speculated that the economic downturn, drugs and lack of mental health resources could be factors in the 24% increase.

However, one huge factor was totally ignored: the legalization and promotion of physician-assisted suicide.

The Legalization of Physician-Assisted Suicide and Suicide Contagion

It must not be dismissed as mere coincidence that the new rise in suicides correlates to the implementation of the first physician-assisted suicide law in Oregon.

A 2012 report on suicide trends and risk factors for the Oregon Health Authority found the state’s overall suicide rate had risen 41 percent higher than the national rate . This is the “regular” suicide rate. Physician-assisted suicides are not included.

Since Oregon, four more states (California, Vermont, and Washington) have legalized physician-assisted suicide via legislation with a Montana supreme court ruling in favor of assisted suicide but without a regulatory framework. But it is only now that the media is noticing a suicide rate that has been increasing for 15 years.

There is a well-known and recognized suicide contagion effect after reported suicides. Both national media guidelines   and  World Health Organization guidelines   warn against media glamorization or normalization of suicide by the media that could lead to more suicides.

Yet, since the legalization in Oregon, the media has become increasingly positive in reporting on physician-assisted suicide. This reached a peak when People magazine devoted it cover story  and some subsequent issues to Brittany Maynard , her impending assisted suicide, and her Compassion and Choices led foundation to raise money to promote the legalization of physician-assisted suicide throughout the US.

That’s not just glamorizing or normalizing physician-assisted suicide. That’s advertising.

And it is having an enormous effect. Now the media is bowing to the pro-assisted suicide movement’s propaganda by changing even the terminology. Instead of physician-assisted suicide, news reports now use more soothing terms like “death with dignity”, “aid in dying” or “physician-assisted death”.

Make no mistake. This is a calculated tactic to increase support of physician-assisted suicide by denying reality.

Why Don’t  Physician-Assisted Suicide Laws Require Psychiatric or Psychological Evaluation?

As most of you may know,  I am the mother of a physically healthy 30 year old daughter who killed herself in 2009 using a technique the medical examiner called “textbook Final Exit”, the title of a book she read by assisted suicide supporter Derek Humphry. But I am also an RN with 46 years of experience who has cared for terminally or seriously ill people considering even physician-assisted suicide who changed their minds after suicide prevention and treatment interventions.

I am appalled that no physician-assisted suicide law actually requires a psychiatric or psychological evaluation before a person is given the lethal overdose prescription. For example in Oregon, the physician-assisted suicide law only states “If in the opinion of the attending physician or the consulting physician a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, either physician shall refer the patient for counseling.”   (Emphasis added)  Not surprisingly, very few such evaluations are currently done, according to Oregon’s annual reports.

That stands in stark contrast to the standard evaluations given to other suicidal patients.

There must be no medical discrimination based on a predicted  prognosis when it comes to standard suicide prevention and treatment interventions. Suicide for any reason is always a tragedy to be prevented when possible.

The terrible despair that leads to suicide must not be ignored in favor of a cold piece of paper with a lethal prescription.

 

 

Canada’s Assisted Suicide Law to Cover Mental illness, Dementia and Minors

nancyvalko assisted suicide, Canada, disability, euthanasia, law

In a Canadian CBC News article titled “Mature minors, mentally ill should have right to doctor-assisted death, report advises”, a special committee of MPs (members of Parliament)  and senators issued a 70 page report “Medical Assistance in Dying: A Patient-Centred Approach”  stating that mature minors and mentally ill people should not be excluded from the right to “doctor-assisted death” (physician-assisted suicide).  It also states that Canadians should have the right to make an “advance request” for physician assisted suicide, termed “medical aid in dying”,  after being diagnosed with certain debilitating, but not necessarily terminal, conditions.

There is not even a requirement that the lethal overdose be oral or self-administered and the Canadian province of Quebec has already started lethal injections.

Ironically, capital punishment existed in various forms in Canada until 1998, when the federal government completely abolished the death penalty.

How can lethal injections be “cruel and inhumane” for convicted murderers but a civil right when it is chosen by an ill person?

And while physician-assisted suicide laws in the US routinely provide immunity for physicians, the Canadian recommendations also exempt nurses, pharmacists and other health care practitioners from key criminal code provisions.

Age of Consent

Although the Canadian Pediatric Society pushed to exclude minors regardless of competence, the report states that

“Given existing practices with respect to mature minors in health care and the obvious fact that minors can suffer as much as any adult, the committee feels that it is difficult to justify an outright ban on access to medical assistance in death for minors.”(Emphasis added)

Mental Illness

The report states that the right to assisted death should not be limited to physical conditions, and that Canadians with psychiatric conditions should not be excluded from “doctor assistance to end suffering” (physician-assisted suicide).

However

“As reported by Medscape Medical News, the inclusion of psychiatric suffering in assisted death laws in European countries such as Belgium has sparked significant debate, particularly with research showing that many individuals who have a history of suicide attempts later regret taking such action.

“Most people who consider or attempt suicide never die by suicide [and] the conviction that there is no alternative but to end their lives often passes with the resolution of an acute crisis,” medical ethicist Paul S. Applebaum, MD, told Medscape Medical News.

“By making the option of suicide easier, ie, a painless, certain death with medical assistance, the Dutch, Belgian, and similar laws may encourage many people, especially women, who would not have ended their lives to do so,” said Dr Applebaum, Dollard Professor of psychiatry, medicine, and law and director of the Division of Law, Ethics, and Psychiatry at Columbia University College of Physicians and Surgeons, in New York City.” (Emphasis added)

“Advance Consent” for Assisted Suicide for People with Dementia

The advocacy group Dying With Dignity Canada applauded the report’s recommendations, especially the one to allow advance consent.

“Patients deserve real choice,” said CEO Shanaaz Gokool in a release.

“Without the option to consent in advance to assisted dying, Canadians with dementia who want to die in peace with the help of a physician face a dire choice: access assisted dying prematurely, while they are still competent; or risk losing competence before their wishes can be carried out, only to be condemned to the exact fate they sought to avoid.” (Emphasis added)

Actually, that result was already on the agenda when “living wills” were first proposed by Chicago lawyer Louis Kutner in his 1969 article “Due Process of Euthanasia: The Living Will, A Proposal” .

Some people say that Holland, Switzerland and Belgium are not like the US so that their virtually unregulated euthanasia policies should not affect us. But no one can deny the potential lethal impact on our own society from this terrible “right to be killed” propagated by our neighbor to the north.

Arguing Life, Death and Assisted Suicide

nancyvalko assisted suicide, Canada, disability, euthanasia, law, medical ethics, mental health, palliative care

In the article “Sides discuss NY proposal for aid in dying”, the exchange between Diane Coleman, a founder of Not Dead Yet, the foremost disability organization fighting physician-assisted suicide, and  Dr Timothy Quill, who fought for the constitutionality of physician-assisted suicide in the landmark 1997 US Supreme Court Vacco v Quill decision, is very enlightening.

Diane Coleman of Not Dead Yet spoke simply and eloquently:

“I don’t think I speak for all (opponents), but the disability community’s core message is that if assisted suicide is legal, some people’s lives will be lost due to mistakes, coercion and abuse, and that’s an outcome that can never be undone.

There is inherent discrimination in assisted-suicide laws. Most suicidal people receive suicide prevention. Assisted suicide laws would carve out an exception to that, and that exception would apply to people who are elderly, ill, disabled, and those are devalued groups in society. … Assisted-suicide laws would say, ‘these certain people, we not only agree with their suicide but give them the means to carry it out.’ We’re saying it comes down to social justice. Equal rights means equal suicide prevention.”

And

“It’s really not about physical pain. If you look at Oregon reports, about reasons people want to commit suicide, the reasons are things like feeling like the person has lost their autonomy, they’ve lost their dignity, they can’t do the things they used to do. They feel like a burden on their families. Those are psychosocial reasons that relate to the disability that people have when they have an advanced stage or chronic condition.”

On the other hand, Dr. Quill portrayed assisted suicide as little more than a benign discussion:

“Whether or not this practice is legalized, seriously ill patients are asking us to talk about it, they’re asking us to consider it” said Quill, founding director of the palliative care program at URMC and a board-certified palliative care consultant. (Emphasis added)

But to the question “Why do people with a terminal illness want to end their lives?”, Dr. Quill telling states:

“Some of it has to do with severe symptoms. I would say that’s not the majority. The majority is people who are tired of dying. It’s going on way too long for them. The kind of debility and weakness that accompany it, particularly for people that are used to being in charge of their lives, is very, very, very hard. Some of those people want to talk about what options they have to accelerate the process.” (Emphasis added)

This is very different from the way physician-assisted suicide has been sold to the public as a necessary last resort for terminally ill people in “unbearable pain”. However, as a 2014 article  “Dignity, Death, and Dilemmas: A Study of Washington Hospices and Physician-Assisted Death” admits, pain is not even a requirement for receiving physician-assisted suicide  in Oregon and Washington state:

The authorizing legal statutes in both states make no reference to the experience of severe pain or intolerable suffering as an indication for a patient to make a request for physician-assisted death but rely entirely on the entitlement due a patient in respect of their personal dignity. A patient rights framework provides the primary moral structure… (Emphasis added)

Thus, physician-assisted suicide is really about power and control over death, not the  suffering of the individual. And it is this power and control that has led European countries like the Netherlands to expand physician-assisted suicide even to non-terminally ill people who cannot or have not made the death decision themselves such as babies with deformities and people with dementia, mental illness or other impairments.

Closer to the US, the Canadian Supreme Court  has legalized physician-assisted suicide but still  without formalized rules, even on conscience rights.  In the province of Quebec, legal injection euthanasia kits  can be distributed to any doctor who wants them.

The Assisted Suicide Agenda in the US

It is alarming that the influential American Academy of Hospice and Palliative Medicine that had this same Dr. Timothy Quill in the article as a recent past president and honoree of their Visionary award. But it should not be surprising that the AAHPM has changed its former position of opposition to physician-assisted suicide to a position of “studied neutrality” towards what it now calls “physician-assisted death”.  Neutrality is progress to physician-assisted suicide activists like Dr. Quill and organizations like Compassion and Choices that need to neutralize medical opposition as much as possible while quietly setting up relentless campaigns to legalize assisted suicide in every state. If enough states give in, a new Supreme Court decision may even overturn the Vacco v Quill decision and legalize physician-assisted suicide throughout the US.

But in the meantime, trying to sell “neutrality” to doctors and convincing the media to change the term “physician-assisted suicide” to  “physician-assisted death” cannot mask the inevitable and lethal damage done not only to individuals but also to our medical and legal institutions that can no longer ensure ethical protection for our lives.

My testimony for Simon’s Law

nancyvalko disability, futility, law, medical ethics, Simon's Law

On February 16,  a hearing was held by the Health committee of the Missouri Legislature on Simon’s Law.

Here is my submitted testimony to Dr. Frederick and all the committee members:

I am a past member of the Down Syndrome Association in St. Louis, an RN and legal nurse consultant and most importantly, the mother of a daughter who had special needs.
I cannot be at the hearing tomorrow but please accept my testimony in favor of Simon’s Law:

In September 1982, I gave birth to a beautiful baby girl we named Karen. Karen was born with both Down Syndrome and a severe heart defect called a complete endocardial cushion defect. A pediatric cardiologist was called in and even before I left the recovery room, he gave me the bad news about our Karen’s heart defect and even said that it was inoperable. He said to take Karen home where she would die in 2 weeks to 2 months.

This doctor turned out to be wrong. Further testing revealed that Karen’s heart defect could be fixed with one open heart operation and she had a 90% chance of survival.

My husband (a doctor) and I (an ICU nurse) were determined that our daughter receive the best medical care possible for her heart condition and without bias because she had Down Syndrome. We knew about the recent Baby Doe case where the parents of baby boy with Down Syndrome and an easily correctable tracheoesophageal fistula refused surgery so that their baby would die. The case went to court and a judge ruled that the parents could make that lethal choice. As medical professionals, we were appalled by this case but at least we could make sure that our daughter would have her chance at life. Or so I thought.

The bias against children like Karen soon became apparent when the cardiologist said he would support us “100%” if we chose to let our Karen die without surgery. I had to insist that Karen be treated for her heart defect the same way any other child would be treated for the same heart defect. To do otherwise was medical discrimination and illegal.

Then, the surgeon recommended for Karen’s pre-op heart catheterization was overheard questioning the wisdom of even treating “all these little mongoloids”! Another doctor sympathetically told us that “people like you shouldn’t be saddled with a child like this.” We were stunned by this negative view of children with Down Syndrome.

Later on when Karen developed a pneumonia that was being successfully treated in the hospital, I found out that my trusted pediatrician had even made Karen a “Do Not Resuscitate” behind my back because I “was too emotionally involved with that retarded baby”. The DNR was rescinded and we took Karen home but I found it hard to trust any doctor after that.

Unfortunately, Karen developed another bout of pneumonia and died of complications just before her scheduled open-heart surgery. But even at the very end, when Karen was apparently dying, a young resident physician “offered” to pull all her tubes so that she would die as soon as possible. I reported this young man to the chief of pediatric cardiology who was furious with the resident. (This chief of cardiology later started a clinic for children with Down Syndrome to meet their special health needs.)

Although we lost Karen when she was just 5 ½ months old, I still treasure my time with her and because of her, I became an advocate and volunteer for people with disabilities.
I wish I could say that my story is unique but I have seen many similar situations over the last three decades involving people of all ages with disabilities.

Therefore, I beg you to approve Simon’s Law. It will potentially save lives as well as send a strong message that medical discrimination against the disabled based on subjective judgements of “medical futility” and/or predicted “poor quality of life” is wrong.

Sincerely,

Nancy Valko, RN ALNC

Justice Antonin Scalia, RIP

nancyvalko family, law

The sudden death of US Supreme Court Justice Antonin Scalia was announced Saturday, February 13, 2016.

His death was not just the devastating loss of a brilliant, wise and witty man but also the loss of the Supreme Court Justice I most admired and read over the years. Justice Scalia and his writings inspired me to pursue the study of the Constitution and law.

I never met Justice Scalia personally but I was privileged to be asked to serve on a panel to discuss end of life issues at a 2009 conference organized by his son, Fr. Paul Scalia.

Fr. Paul was apparently used to people like me gushing about his father but Fr. Paul himself is very proud of his father. Fr. Paul is great example of his father’s deep devotion to his wife and 9 children.

The loss of Justice Scalia has tremendous national implications since so many important cases have been decided by a 5 to 4 majority of justices and now there are several crucial cases being considered, including cases involving abortion and religious rights. It is widely recognized that with the loss of Justice Scalia, there are four justices who lean liberal and four justices who lean more conservative.

With only 8 justices now, such close cases may result in very different decisions than if Justice Scalia were there.

However, our country has been very fortunate to have someone like Justice Scalia both for his personal and his professional example of excellence.

May he rest in peace.