nursing

Great News: Governor Finally Vetoes Delaware Assisted Suicide Bill

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

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

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

Ms Kamman explains that:

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

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

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

Ms. Kamman reported NAPN’s response:

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

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

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

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

Conclusion-Great News

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

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

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

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

And just in time!

“New Study: Brain-injured patients who died after life support ended may have recovered”

nancyvalko bereavement, brain injury, disability, education, end-of-life, futility, grief, medical, medical ethics, nursing, vegetative state, ventilators/life support

Over the years, I’ve written about several of my patients like “Mike”, “Jack”, Katie” and “Chris” in comas or “persistent vegetative states” who regained full or some consciousness with verbal and physical stimulation. I have also recommended Jane Hoyt’s wonderful 1994 pamphlet “A Gentle Approach-Interacting with a Person who is Semi-Conscious  or Presumed in Coma” to help families and others stimulate consciousness. Personally, I have only seen one person who did not improve much from the so-called “vegetative” state during the approximately two years I saw him weekly.

Since then, I have written several blogs on unexpected recoveries from severe brain injuries, most recently the 2018 blog “Medical Experts Now Agree that Severely Brain-injured Patients are Often Misdiagnosed and May Recover” and my 2020 blog “Surprising New Test for Predicting Recovery after Coma.

Now, there is an important new study “New Study: Brain-injured patients who died after life support ended may have recovered”

As the article states:

“Using data gathered over a 7 1/2-year period on 1,392 traumatic brain injury patients in intensive care units at 18 U.S. trauma centers, the researchers designed a mathematical model to calculate the likelihood that life-sustaining treatment would be discontinued. They based their model on demographics, socioeconomic factors and injury characteristics.

Then, they paired patients continuing on life-sustaining treatment to individuals with similar model scores, but for whom life-sustaining treatment was stopped.

Based on follow-up, the estimated six-month outcomes for a significant proportion of the withdrawn group were either death or recovery of at least some independence in daily activities. Of the survivors in the not-withdrawn group, more than 40% recovered at least some independence.” (All emphasis added)”

and

“While many people recover consciousness over a few hours or a day, others remain in the intensive care unit, relying on life support, such as a breathing tube, said Bodien, who also is an assistant professor in the department of physical medicine and rehabilitation at Spaulding Rehabilitation Hospital in Charlestown, Mass.

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

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

Currently, no medical guidelines or precise algorithms determine which patients with severe traumatic brain injury are likely to recover. The most common reason families opt for withdrawing life support measures is physicians relaying information that suggests a poor neurologic prognosis.“

And:

“In the study, researchers found that some patients for whom life support was withdrawn may have survived and recovered some independence a few months after injury. Postponing decisions on withdrawing life support may be helpful for some patients, they noted.” (All emphasis added)

ADVOCATING FOR BRAIN-INJURED PATIENTS

I personally know how important and often difficult it is for healthcare professionals like myself as well as families when doctors recommend withdrawing treatments on a comatose patient.

For example and many years ago, I received a phone call from a distraught fellow nurse living in California. Her sister, “Rose”, was comatose from complications of diabetes and had been in an intensive care unit for three days. Now the doctors were telling the family that Rose’s organs were failing and that she had no chance to survive. The doctors recommended that the ventilator and other treatments be stopped so that she could be “allowed to die”. My nurse friend was uncomfortable with the speed of this recommendation even though the rest of the family was ready to go along with the doctors.

As I told her, back when I was a new nurse in the late 1960s, we would sometimes see patients in the intensive care unit who seemed hopeless and we would speak to families about Do Not Resuscitate (DNR) orders. However, the one thing we didn’t do was to quickly recommend withdrawal of treatment. We gave people the gift of time and only recommended withdrawing treatment that clearly was not helping the person. Some patients did indeed eventually die but we were surprised and humbled when an unexpected number of these “hopeless” patients went on to recover, sometimes completely.

About six weeks after the initial phone call, my nurse friend called back to tell me that the family decided not to withdraw treatment as the doctors recommended and that her sister not only defied the doctors’ prediction of certain death but was now back at work. I asked her what the doctors had to say about all this and she said the doctors termed Rose’s case “a miracle”.

“In other words” she noted wryly, “these docs unfortunately didn’t learn a thing.”

CONCLUSION

In 1983, I personally dealt with a withdrawal of treatment situation like this in my own family when my baby daughter with Down Syndrome and a severe heart defect developed pneumonia was placed on a ventilator. She was unresponsive and critically ill.

We hoped to get her stable enough for her planned heart surgery.

One day, a young resident came in and suggested “getting this over with” by removing her ventilator and “letting her die”. I told him that I would sue if he tried.

I went to the chairman of pediatric cardiology whom I knew well and told him what happened and the chairman said he would fire him. Instead, I suggested that he try to educate the young doctor first but, if he didn’t get the point, then he should be fired.

Karen did eventually die in the ICU on the ventilator but I was comforted by the fact that her death was not unnecessarily hastened as well as the fact that later, this wonderful chairman started the first clinic for people with Down Syndrome in the US to deal with their health issues.

This important study should be mandatory reading for all healthcare professionals and families who need to know the facts.

NATIONAL ASSOCIATION OF PRO-LIFE NURSES JOINS ASSOCIATION CHALLENGING CHEMICAL ABORTION IN LANDMARK SUPREME COURT CASE

nancyvalko abortion, law, medical, medical abortion, medical ethics, nursing

Washington, D.C. — The National Association of Pro-Life Nurses (NAPN) has proudly joined the Alliance for Hippocratic Medicine, an association of medical organizations suing the United States Food and Drug Administration (FDA) for its reckless removal of essential safeguards for the use of chemical abortion drugs.

The Alliance for Hippocratic Medicine, other medical organizations, and individual doctors argue that the FDA’s actions not only blatantly disregard established protocols for drug safety but also gravely jeopardize women’s health. This case now heads to the Supreme Court asking that the Court hold the FDA accountable for its callous disregard for women’s health and safety.

The lawsuit, brought forth by the Alliance for Hippocratic Medicine and others, highlights the following concerns:

  • Removal of safety standards: The FDA removed safeguards for mifepristone and misoprostol, even though its own label states that nearly 1 in 25 women who consume these drugs will end up going to an emergency room.
  • Increased patient risks: The removal of abortion drug safety standards could lead to a greater number of complications, including hemorrhage, life-threatening infection, and incomplete abortions.
  • Lack of informed consent: Remote prescription practices and the elimination of in-person doctor visits endanger women, particularly those at risk for ectopic pregnancies.

https://nursesforlife.org/press-releases

NAPN President Dorothy Kane issued the following statement on behalf of the organization:

“Nurses are on the front lines witnessing the serious harms to women caused by the FDA’s reckless removal of essential safeguards for the use of chemical abortion drugs. Women deserve the ongoing, in-person care of a medical professional when taking high-risk drugs. The FDA has compromised patient safety and shown a callous disregard for women’s health and safety. This case is about safeguarding women’s health, protecting the integrity of the healthcare profession, and committing to evidence-based care.”

For more information on the legal case, visit Alliance Defending Freedom, the legal organization representing the Alliance for Hippocratic Medicine: https://adflegal.org/case/us-food-and-drug-administration-v-alliance-hippocratic-medicine

                                                               ###

The National Association of Pro-Life Nurses (NAPN) is dedicated to promoting respect for every human life from conception to natural death, and to affirming that the destruction of that life, for whatever reason and by whatever means, does not constitute good nursing practice.

Victory: “After Initial Hope, Medically Assisted Suicide Bill Won’t Move Forward in Maryland”

nancyvalko ANA, assisted suicide, conscience rights, culture, education, end-of-life, euthanasia, food and water, law, medical ethics, nursing, VSED

In 2019, I testified in Maryland against another “medically assisted suicide” bill that was expected to pass and wrote a blog about it titled “Lessons from the Victory against Assisted Suicide in Maryland”. It failed to pass by one vote.

Now, yet another attempt to pass an assisted suicide bill in Maryland failed by “one or two votes”, according to a Baltimore Sun article titled “After initial hope, medically assisted suicide bill won’t move forward in Maryland”, thanks to efforts like that of Mary Bogdan BSN, MA-C, DNP-S, ALNC who wrote an excellent expert witness testimony stating in part:

“The physician assisted suicide bill has been called many things: medical aid in dying, euthanasia, withholding of food and water, etc., etc., etc. The bottom line is this: I did not become a nurse to kill people. The American Nurses Association (ANA) says that nurses should support patient autonomy, the desire to have control over one’s life. I submit this; if we allow patients to end their lives as desired by them, we subject ourselves to unfathomable consequences.” (Emphasis added)

Note this sentence from the article in the Baltimore Sun “I think that as we slowly got closer to the vote and had more in depth discussions with their constituents, folks just expressed unreadiness to move on it at this time,” Smith said. “I’m obviously very disappointed, but you have to respect the decisions of the individual senators who were listening to their constituents and listening to their conscience.” (Sen. Will Smith is chair of the Judicial Proceedings Committee and a previous sponsor of the bill)

CONCLUSION

Nurse Bogdan’s testimony ends with a powerful quote from Dr.  Harvey Max Chochinov, MD, PhD in his December 2023 recent Medpage article ” Intensive Caring: Reminding Patients They Matter— How to care for those who no longer care about themselves”:

“There is abundant evidence that patients approaching death are susceptible to feeling that they no longer matter. When patients feel life is no longer worth living, healthcare professionals must affirm their intrinsic worth to patients for all that they are, all that they were, and all that they will become in the collective memories of those they will eventually leave behind.” (Emphasis added)

Virginia is now facing SB 280, an assisted suicide bill.

Unfortunately, the assisted suicide proponents never seem to give up and we must continue to be vigilant in every state and continue to educate legislators, healthcare providers, and the general population about these dangerous assisted suicide laws.

Victory on Assisted Suicide, Conscience Rights and AMA Proposed Resolutions

nancyvalko AMA, ANA, assisted suicide, conscience rights, culture, euthanasia, law, medical ethics, nursing

“First Do No Harm-Hippocrates”

Last November, I wrote my blog “NAPN Position Paper on AMA Considering New Resolutions on Assisted Suicide”.

Now, the Life Legal Defense Foundation has announced a great victory on this as well as conscience rights.

I have personally worked with The Life Legal Defense Foundation for years and they are awesome!

Here is their statement:

VICTORY over DEATH PEDDLERS in the American Medical Association…! – LIFE LEGAL DEFENSE FOUNDATION

/ Active Euthanasia / By Life Legal / January 9, 2024:

“In 2022, Life Legal sued California Attorney General Rob Bonta to stop enforcement of SB 380, which would have prohibited physicians from opting out of the state’s assisted suicide scheme. SB 380 required doctors to provide most of the documentation needed for their patients to receive so-called “aid-in-dying” drugs – even if doctors were morally opposed to participating in assisted suicide. The law imposed draconian punishments on physicians who refused to comply, including civil and criminal penalties and professional discipline.

Life Legal, along with Alliance Defending Freedom, represented the Christian Medical and Dental Association (CMDA) in the lawsuit – and we won! After a hard fight, we were able to get the law enjoined (blocked). Life Legal, Alliance Defending Freedom, and the CMDA were victorious in protecting physicians’ rights of conscience – but the wins did not stop there.

Recently, the CMDA joined with members from the Catholic Medical Association (CMA) to oppose two American Medical Association resolutions supporting physician-assisted suicide. As a result of the pro-life stance taken by the CMDA and the CMA, the American Medical Association declined both resolutions. This means the AMA officially remains in opposition to assisted suicide, holding that “permitting physicians to engage in assisted suicide would ultimately cause more harm than good. Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”

We are honored to represent pro-life physicians and we are grateful for their powerful witness in opposition to assisted suicide.” (Emphasis in original)

CONCLUSION

We nurses are also grateful for this victory and so should everyone who cares about healthcare ethics!

INSPIRATIONAL GERONTOLOGIST TRANSFORMED DEMENTIA CARE

nancyvalko Alzheimer's, assisted suicide, Compassion & Choices, dementia, end-of-life, family, food and water, inspiration, medical, medical ethics, mental health, nursing, palliative care, VSED

I don’t normally read obituaries but this obituary I recently read in the January 11, 2024 Wall Street Journal titled “Naomi Feil, Who Transformed Dementia Care, Dies at 91” was inspiring and, most of all, educational!

MY STORY

When I was 13, I became a volunteer in our local nursing home to help feed the elderly patients, some of whom had dementia. I loved it but was told I should be feeding the patients faster instead of listening to their stories.

When I said that these stories were great and really enjoyed by all the patients at the table, the nurses told me that most of the stories were probably not true anyway!

When I began my nursing career in 1969, patients with dementia were often considered just “difficult” or even “crazy”. Some were put in restraints for safety but that just seemed to agitate them more. I found that sitting and listening to them helped a lot.

So I have long had an interest in people with dementia-most often Alzheimer’s disease, not only because of the patients I cared for as a nurse, but also because of my late mother and brother who also have had the condition.

That’s why I have written blogs about the condition such as ““Repairing Our View of Dementia” and “Five Things my Mother (and Daughter) Taught Me about Caring for People with Dementia”, hoping these blogs would help other caregivers, patients and their families.

NAOMI FEIL’S STORY

Naomi’s obituary is subtitled “Instead of forcing people to remember facts, she helped them express their anger and sorrow. She found it made all the difference.”

Here are some excerpts from the obituary:

“Caregivers, struggling to help people with dementia, often see their role as offering scraps of reality—reminding them what year it is, for instance, or who is in the White House.

Naomi Feil had a different strategy. As a social worker in nursing homes, she resisted the impulse to yank disoriented people back to her reality. Instead, she sought to enter their realities and affirm their emotions. Rather than offering a cup of tea or chirping that everything would be fine, she helped her charges express their anger and sorrow—and found they often were more at ease afterward.”

In the 1960s and 1970s, Feil devised what she called the validation method for dementia care. She wrote books, led workshops and established 24 validation-training centers in 14 countries.

Feil’s ideas have become fundamental to what is now called person-centered dementia care, which focuses on discovering individual needs and preserving dignity rather than following standard routines, said Sam Fazio, a senior director of the Alzheimer’s Association. In such care, he said, “You’re meeting them in their reality versus expecting them to meet us in our reality when they are no longer able to do that.” (Emphasis added)

NAOMI’S HISTORY

“When she was 4 years old, her Jewish family fled Nazi Germany. They eventually settled in Cleveland, where her father was the administrator of a nursing home, which doubled as living quarters for her family. Some of her earliest friends were very old people.”

“Her work was with the troublemakers other staff members avoided. These were the blamers, the martyrs, the moaners, the wanderers, the yellers, the pacers, the pounders whom nobody wanted,” she wrote in one of her books, “The Validation Breakthrough.”

“Sometimes nursing assistants tied people to their chairs so they wouldn’t wander off and make trouble. When she tried to engage with these misfits, a nursing assistant scolded her: “You’re getting them all worked up…. You can’t help them. I’ve been working here for five years, and I ought to know.” 

“Feil persisted and gradually learned from her encounters. ‘I learned not to contradict, patronize, argue, or try to use logic or give insight,” she wrote. Instead, she made clear she was listening. If an old person imagined the nurses were stealing her jewelry, Feil might say, ‘You loved that necklace, didn’t you. Who gave it to you?’ She could share the emotion and then explore deeper.” (Emphasis added)”

As a social worker in the 1960s and 1970s, she developed her methods through trial and error. “

“No lies

“She opposed the idea of telling comforting lies. Lies could be detected, even by those who seemed most deluded, and that would destroy trust. When an old woman said she needed to see her mother right away, Feil wouldn’t point out that her mother was dead. Nor would she promise that the mother would visit soon. Instead, she would make it a conversation: ‘You really need to see your mother! What would you like to tell her?’”

“You don’t argue, you don’t lie,” she said in a TEDx talk. “You listen with empathy and you rephrase.”

When old people were weepy, it was a bad idea to tell them things weren’t so bad, she found. It was better to let the tears flow and talk about what made them sad.”

CONCLUSION

While so much more is known now about dementia and developing treatments, many people still consider it a fate worse than death and a burden on their family. Some have even chosen assisted suicide or voluntary stopping or eating and drinking (called VSED) through “right to die” organizations such as Compassion and Choices.

But, as I wrote last February in my blog “Alzheimer’s Association Ends Agreement with Compassion and Choices”, the Alzheimer’s Association has now ended it’s agreement with Compassion and Choices (the pro-assisted suicide organization) stating:

“In an effort to provide information and resources about Alzheimer’s disease, the Alzheimer’s Association entered into an agreement to provide education and awareness information to Compassion & Choices, but failed to do appropriate due diligence. Their values are inconsistent with those of the Association.

We deeply regret our mistake, have begun the termination of the relationship, and apologize to all of the families we support who were hurt or disappointed. Additionally, we are reviewing our process for all agreements including those that are focused on the sharing of educational information.

As a patient advocacy group and evidence-based organization, the Alzheimer’s Association stands behind people living with Alzheimer’s, their care partners and their health care providers as they navigate treatment and care choices throughout the continuum of the disease. Research supports a palliative care approach as the highest quality of end-of-life care for individuals with advanced dementia.” (All emphasis added)

Good for the Alzheimer’s Association and as I can personally and professionally attest, caring for people with dementia can be a wonderful- if sometimes challenging- experience, for healthcare providers and especially the person with dementia and their families!

Are “Anti-abortion activists” Really Looking “To Rebrand Themselves As Not Religious”?

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

Last May, I was interviewed by Dr. Anne Whitesell, an Assistant Professor of Political Science at Miami University “as part of a research project to understand the work of pro-life organizations post-Dobbs and common misconceptions about the movement.”

Dr. Whitesell was very gracious during the interview, and we had a long conversation about what motivates pro-life people-and especially nurses.

I told her about our National Association of Pro-life Nurses and the why and how we do what we do because we call about all lives.

I also told her that the National Association of Pro-life Nurses was not a religious organization but rather open to nurses of any religion or none.

I explained how the National Association of Pro-life Nurses is a “registered non-profit organization that brings nurses together who look for excellence in advancing ethics in nursing practice “and “seeks to establish and protect ethical values of the nursing profession. The organization educates its members on a wide range of bioethical issues” from conception to natural death”.

I also told Professor Whitesell that we are not about being judgmental but rather about truly caring and offering help to desperate people in crisis situations and the people around them before-or even after- a person has chosen abortion or is considering medically assisted suicide. (see “Pro-Life and Other Resources for Help and Information to Protect Human Life”)

Our motto is “I Care” and we even have developed a button with that simple message for our nurses to wear.

PROFESSOR WHITESELL’S NOVEMBER 6, 2023 ARTICLE

Professor Whitesell said she would send me a copy of her eventual article but instead I discovered her November 6, 2023 article titled “As Ohio and other states decide on abortion, anti-abortion activists look to rebrand themselves as not religious.”

Here are some excerpts:

“My research shows that anti-abortion organizations in the U.S. fall into one of three camps. Some are openly religious. Others may have religious staff, but refrain from using religion in their advocacy. A small proportion outright reject the use of religion.

“In my interviews, anti-abortion rights activists said they understood that the public views their movement as anti-woman and driven by conservative Christians. More recently, the movement has adopted pro-woman messaging to counter the perception that they do not support women.

These organizations are increasingly choosing to speak less about religion and more about human rights and science to combat the narrative that the anti-abortion movement is solely a Christian movement.”

and

“Most of the activists I interviewed said their organization does not have a formal stance on religion. Approximately one-quarter of the 45 activists I interviewed, however, said their organizations are explicitly Christian. (Emphasis added)

Professor Whitesell concludes that:

“Instead of using religion to bolster their arguments against abortion, these activists frame abortion as a human rights issue. For them, any loss of human life is tragic, whether it is from abortion, war or the death penalty.

This kind of framing could help the anti-abortion movement shift conversations about abortion away from religious beliefs.” (All emphasis added)

CONCLUSION

Unfortunately, the abortion rights movement’s animus against using religious beliefs in discussions about abortion has real world consequences.

For example, a January 16, 2024, CNA article titled “Religious Americans’ lives possibly at risk in 2024, new report by U.S. bishops says” states:

“Since the overturn of Roe v. Wade in the June 2022 Supreme Court Dobbs v. Jackson Women’s Health Organization decision, attacks against the Catholic Church as well as pro-life organizations have risen considerably. The bishops said that annual hate crime statistics gathered by the FBI in 2022 reported anti-Catholic crimes as nearly 75% higher than for any other bias.“

All this is compounded with, the bishops said, a “general failure” on the part of the “federal government to apprehend and prosecute the perpetrators of such attacks.” (All emphasis added)

It is disheartening that articles like Professor Whitesell’s and most mainstream news reporting about abortion and the pro-life movement continue to misrepresent the “anti-abortion movement” as primarily religious rather than a movement based on science, human rights and, above all, helping those involved in crisis situations.

Intensive Caring: Reminding Patients They Matter

nancyvalko assisted suicide, Cancer, culture, dementia, disability, end-of-life, medical ethics, nursing

Last month, there was a beautiful article on Medpage titled “Intensive Caring: Reminding Patients They Matter-How to care for those who no longer care about themselves” by Harvey Max Chochinov, MD, PhD.

Dr. Chochinov quotes Dame Cicely Saunders, the founder of the modern hospice movement, for her famous statement “”You matter because you are you, and you matter to the last moment of your life”.

That statement became an integral part of medical and nursing education in the past and a powerful argument against the current push for legalizing medically assisted suicide.

As Dr. Cochinov states in his article;

“There is abundant evidence that patients approaching death are susceptible to feeling that they no longer matter. When patients feel life is no longer worth living, healthcare professionals must affirm their intrinsic worth to patients for all that they are, all that they were, and all that they will become in the collective memories of those they will eventually leave behind.” (Emphasis added)

and

” A foundational element of this approach is nonabandonment, which demands committed, ongoing care and caring, even when patients no longer care about themselves. Absent someone who cares, suffering, like cancer, can grow, spread, and even kill.” (Emphasis added)

and in contrast:

“Intensive caring sees healthcare professionals hold or contain hope when patients can no longer do so themselves. This means expanding one’s therapeutic imagination to include the possibility that patients may find psychological, spiritual, and physical comfort, tolerable suffering, and for those near the end, a peaceful death. Toward the end of life, hope tends to conflate with meaning and purpose and may be nurtured through connections to those who, or things that, matter.” (Emphasis added)

MY EXPERIENCE

As a new nurse, I was nervous when I was assigned to terminally ill patients.I asked the senior nurses how to approach these patients and if I should be solemn or cheerful. The senior nurses said they didn’t know.

So I came up with a plan. After I clocked out after my shift, I started just visiting with them and listening to whatever they had to say.

I found that there were two basic questions that needed to be answered: “What do you want?” and “What are you afraid of?”

These patients opened up about wanting to die at home without burdening their families and not being in terrible pain at the end. I was able to tell them about good home healthcare options, pain management and being open with their doctors and families. This opened the door to great conversations and often even a lot of laughter!

(I was later chastised by some nurses who criticized the laughter coming from these rooms. I responded by asking them who needed to laugh more than patients in these situations?)

I also started spending time with the relatives who had questions of their own. They were relieved to talk about their fears and sadness and wanted to know how to help their loved ones.

Once, on an on an oncology (cancer) floor, an elderly woman with terminal cancer told me that she wished she could have just one more overnight sleepover with her granddaughter before she died. I told the other nurses and they all enthusiastically joined in with snacks and sodas to make it happen during one night shift, remembering their own special times with their grandmothers.

It was a great success, even though I was caught by an administrator who said I should not make this a habit.

In another case, an elderly woman with advanced cancer was considering another chemo treat but confided that she feared becoming more of a “burden” on her daughter’s family with whom she lived.

I told her that I had just spoken to her daughter the day before and the daughter told me how grateful she was for her mother’s presence and help. For example, the daughter said that since she and her husband both worked, they were relieved to have the mother there for their school-age children when classes ended. The daughter told me how the children loved climbing into bed with grandma and telling her about their day.

My elderly patient was almost reduced to tears by this revelation but then she laughed and admitted that sometimes she fell asleep when the children were talking to her.

I told my patient that whatever else she needed to consider before agreeing to the chemo, fear about being a “burden” should be eliminated.

CONCLUSION

Sadly, Dr. Chochinov cites studies that have shown when patients feel abandoned and bereft of care, they are more likely to contemplate or die by suicide. In addition, he cites studies on the desire for death in the terminally ill “report lower family support relative to those who don’t.”

According to an October 4, 2023 Medical Net news article “Review of Oregon’s assisted dying law finds significant data gaps”:

“Since 2017, fear of being a burden has been cited by around half of those opting for assisted death“. (Emphasis added)

It’s important to remember that no one has to be a medical professional to ask a friend, neighbor, church member, etc. in difficult circumstances to ask “What can I do to help?”.

Just visiting with the person, watching tv with them or bringing a favorite food can be a real day brightener and give family members a much needed boost.

Personally, I know how lonely it can be taking care of a loved one with a terminal illness or a disabling condition without the support of friends or family. Family caregivers also need support and encouragement.

But I also know the wonderful benefits of helping others, both personally and professionally, even just by being there.

NAPN: Ohio’s Issue 1 Abortion Vote Marks a Temporary Setback, Not a Surrender

nancyvalko abortion, adoption, conscience rights, culture, education, law, medical ethics, nursing, pro-life

FOR IMMEDIATE RELEASE

November 7, 2023

National Association of Pro-Life Nurses

Contact: media@nursesforlife.org

Columbus, Ohio – The National Association of Pro-Life Nurses (NAPN) is expressing deep disappointment over the passage of Ohio’s extreme, deceptive abortion initiative. Despite the passage of Issue 1, NAPN remains committed to upholding ethics in healthcare practice.

Issue 1 undermines common-sense health and safety protections by lowering the standard of care in Ohio. Its passage will enshrine discriminatory abortion practices into the state’s constitution, including for reasons of gender or disability. Further, the ballot initiative will expand abortion into the third trimester, when a preborn child is capable of feeling pain. Issue 1 is radically out of touch with the 7 in 10 Americans who support common-sense abortion limits after 15 weeks. NAPN firmly believes in upholding the principles of compassion, empathy, and respect for all human life, echoing the fundamental principles of the nursing profession.

Executive Director Marie Ashby, on behalf of the NAPN, stated, “While we are deeply concerned by the passage of extreme, anti-life legislation, it does not diminish our resolve to protect human life in all its stages. We must continue to support families facing unexpected pregnancies through pregnancy resource clinics and Federally Qualified Health Centers. NAPN remains steadfast in advancing a higher standard of patient care, which is fundamentally incompatible with abortion.”

NAPN will continue to push back against healthcare disinformation, as it paves the path forward for excellence in nursing practice. The National Association of Pro-Life Nurses calls upon policymakers to consider the profound ethical implications of legislation that erodes patient protections. The association stands ready to counter public health threats by educating lawmakers and healthcare providers on policies that seek to undermine patient care.

The National Association of Pro-Life Nurses is a not-for-profit organization uniting nurses who are dedicated to promoting respect for every human life from conception to natural death, and to affirming that the destruction of that life, for whatever reason and by whatever means, does not constitute good nursing practice.

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For further inquiries or interviews, please contact:

Marie Ashby

Executive Director

National Association of Pro-Life Nurses

marie@nursesforlife.org

www.nursesforlife.org

NAPN Position Paper on AMA Considering New Resolutions on Assisted Suicide

nancyvalko AMA, assisted suicide, Compassion & Choices, law, medical ethics, nursing, suicide, VSED

A May 1, 2023, article by Dallas R. Lawry, DNP, FNP-C, AOCNP® from the University of California, San Diego in the Journal of the Advanced Practitioner in Oncology titled “Rethinking Medical Aid in Dying: What Does It Mean to ‘Do No Harm?’” at Rethinking Medical Aid in Dying: What Does It Mean to ‘Do No Harm?’ – PMC (nih.gov) reveals that:

“Until 2019, the American Medical Association (AMA) maintained that MAID (medical aid in dying aka assisted suicide) was incompatible with their code of ethics and a physician’s responsibility to heal (AMA, 2022)“.

 But now, the AMA Medical Code of Ethics is considering two provisions that support both positions on MAID, including: “Physicians who participate in MAID are adhering to their professional, ethical obligations as are physicians who decline to participate” (AMA, 2019, 2022; Compassion & Choices, 2022) (Emphasis added)

Now, such ethical dissonance has now led the AMA to considering two new resolutions  at the Interim meeting of the AMA House of Delegates on November 10-14, 2023:

“Resolution 4 is to change the position of the AMA on Medical Aid in Dying (Resolution Link).

Resolution 5 is for the AMA to adopt a neutral stance on Medical Aid in Dying (Resolution Link).”

and, as Alex Schadenberg writes:

“It is important to note that Resolution 4 would remove the AMA statement on not performing euthanasia or participating in assisted suicide:

Physicians must not perform euthanasia or participate in assisted suicide. A more careful examination of the issue is necessary. Support, comfort, respect for patient autonomy, good communication, and adequate pain control may decrease dramatically the public demand for euthanasia and assisted suicide. In certain carefully defined circumstances, it would be humane to recognize that death is certain and suffering is great. However, the societal risks of involving physicians in medical interventions to cause patients’ deaths is too great in this culture to condone euthanasia or physician- assisted suicide at this time.

Both resolutions use the term Medical Aid in Dying (MAiD) rather than Physician Assisted Suicide. The term Medical Aid in Dying is not limited to assisted suicide, it also includes euthanasia. The assisted suicide lobby wants to legalize euthanasia (medical homicide) in America.”

NURSES AND ASSISTED SUICIDE

In 1995, the American Nurses Association stated:

“The American Nurses Association (ANA) believes that the nurse should not participate in assisted suicide. Such an act is in violation of the Code for Nurses with Interpretive Statements (Code for Nurses) and the ethical traditions of the profession. “ (Emphasis added)

But in 2017, the ANA revised its’ position on VSED (voluntary stopping of eating and drinking) “with the intention of hastening death” to “People with decision-making capacity have the right to stop eating and drinking as a means of
hastening death.” (Emphasis added)

In 2019, the American Nurses Association revised their position on assisted suicide titled “The Nurse’s Role When a Patient Requests Medical Aid in Dying”, stating that nurses:

“• Remain objective when discussing end-of-life options with patients who are exploring medical aid in dying.

• Have an ethical duty to be knowledgeable about this evolving issue.

• Be aware of their personal values regarding medical aid in dying and how these values might affect the patient-nurse relationship.

• Have the right to conscientiously object to being involved in the aid in dying process. (But “Conscience-based refusals to participate exclude personal preference, prejudice, bias, convenience, or arbitrariness”)

• Never “abandon or refuse to provide comfort and safety measures to the patient” who has chosen medical aid in dying (Ersek, 2004, p. 55). Nurses who work in jurisdictions where medical aid in dying is legal have an obligation to inform their employers that they would predictively exercise a conscience-based objection so that appropriate assignments could be made” (All emphasis added)

But while the ANA is states that “It is a strict legal and ethical prohibition that a nurse may not administer the medication that causes the patient’s death“, it is silent when some states with assisted suicide laws like Washington state’s where Governor Jay Inslee signed a new expansion to the law in April 2023 to “allow physician assistants and advanced nurse practitioners to be one of the medical providers who sign off on the procedure”, “eliminates a two-day waiting period for prescribing the drugs” and “allow the necessary drugs to be mailed to patients instead of picked up in person”. (Emphasis added) https://www.axios.com/2023/04/24/washington-death-with-dignity-law

CONCLUSION

NAPN opposes both AMA resolutions and the ANA policy on assisted suicide, not only for the safety and welfare of our most vulnerable people but also because there are now many state and national medical professional organizations that support assisted suicide, and other problematic ethical issues and this will have a discouraging effect on idealistic, ethical people considering or remaining in health care which would be devastating to our trust in the healthcare system itself.