Showing posts with label Nurses Association. Show all posts
Showing posts with label Nurses Association. Show all posts

Wednesday, February 19, 2020

Euthanasia: Canada, Conscience and Coercion.

This article was published by Nancy Valko on her blog on February 18, 2020

Nancy Valko
By Nancy Valko


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

How could this happen?

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

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

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

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

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

How One Catholic Health Care Facility Responded To MAiD

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

“after consultations with more than 100 individuals and groups including doctors, Catholic bishops, Alberta Health Services, the Alberta government, patient advisers, families, ethicists and community members. 
Under the policy, witnessing and signing of legal documents and assessments of eligibility can take place on Covenant Health sites. Patients deemed eligible for MAID would still be transferred to other facilities.” (Emphasis added)
A current check of the Covenant website on MAiD shows no change in policy.

The Canadian “Slippery Slope” Continues

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

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

The Effect of MAiD on Doctors and Nurses

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

“Our association formed in 2018 primarily in response to Canadian nurses’ moral distress regarding the nation-wide legalization of medically induced death.
Professional associations and licensing bodies across Canada endorsed the legal changes, requiring conscientious objectors to participate in “Medical Assistance in Dying” by “effective referral” to facilitate access at the patient’s request. Faith-based health care facilities are pressured to participate. Nurse practitioners are trained and qualified to prescribe and administer lethal doses of medication to patients that they or others deem eligible for euthanasia.”

and

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

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

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

“It is vital to understand how MAiD is influencing nurses in the Canadian context to ensure a smooth transition of this end‐of‐life care option across settings and communities. ” (Emphasis added)
The study acknowledges some nurses’ “moral distress” but describes “how participating in, or declining to participate in MAiD is shaping the participants’ perceptions of nursing as a profession“. The authors suggest promoting concepts like “Providing holistic care without judgment, Advocating choice, Supporting a good death” to positively reinforce that MAiD was “not a significant departure from their professional goals”. (Emphasis added)

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

Conclusion

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

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

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

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

Saturday, April 13, 2019

American Nursing Association's Draft Position Statement on Euthanasia and Assisted Suicide Is "Misleading and Dangerous"

This article was published by Choice Is An Illusion on April 6, 2019.

By Margaret Dore, Esq., MBA

The ANA Center for Ethics and Human Rights Advisory Board is seeking public comment on a proposed position statement, "The Nurse's Role When a Patient Requests Aid in Dying."

"Aid in Dying" is a traditional euphemism for assisted suicide and euthanasia. The first paragraph of the proposed statement is set forth below, followed by my responding submission.

The Nurse’s Role When a Patient Requests Aid in Dying
DRAFT ANA Position Statement

Purpose: The purpose of this position statement is to provide nurses with ethical guidance in response to a patient’s request for aid in dying (AID). This statement offers assistance with understanding nurses’ ethical obligations and responsibilities amidst social and legislative shifts which make this option legal in an increasing number of U.S. jurisdictions.

The entire statement can be viewed here.

My submission:

Lines 1-6 A professional statement should be clear as to its topic. The term, "aid in dying," implies that we're talking about palliative care for a person necessarily near death, which is not the case:

1. The term, "Aid in Dying" is a traditional euphemism for euthanasia. Craig A. Brandt, “Model Aid-in-Dying Act,” Iowa Law Review, 1989 Oct; 75(1): 125-215 (“Subject: Active Euthanasia ....”) at: (Link). 
2. In the US, Oregon-style death with dignity laws have a six months to live criteria. In practice, this criteria applies to people with years or decades to live. One reason is that predictions of life expectancy can be wrong. See: (Link).  
Another reason is that the six months to live is determined without treatment. Consider, for example, my friend Jeanette Hall talked out of assisted suicide in Oregon 18 years ago: (Link).
In short, by the title alone, the statement is materially misleading.

Lines 7-22 As noted above, "aid in dying" means euthanasia. More importantly, deaths under current Oregon-style acts are not necessarily voluntary.

Perhaps these articles are helpful:

1. Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009, at: (Link).
2. Margaret Dore, "Preventing Abuse and Exploitation: A Personal Shift in Focus", ABA Senior Lawyers Division Newsletter, Vol. 25, No. 4, Winter 2014, at: (Link).

Lines 23-34 With regard to "end-of-life" conversations, I have had at least 10 people talk to me about their wanting to do legal assisted suicide/euthanasia.

  • I was trained to always ask them "why?" Get them talking about what's really bothering them, and the answers have been all over the place. One was facing economic pressure, another blamed himself for the death of a friend, another seemed to have learning issues. Most, but not all, changed their minds just by talking about it.
  • I have seen families torn apart and traumatized by legal assisted suicide/euthanasia, even when the death does not occur. This also happens with palliative dare/hospice abuse. See: (Link).
  • Other people are afraid to go to the doctor or a hospital, they no longer trust the medical profession. 
  • Allowing and/or encouraging your members to promote assisted suicide and euthanasia will make the situation worse. I urge you to reject the proposed statement, which is misleading and dangerous.
Thank you.
Margaret Dore, Esq., MBA
www.margaretdore.org
www.choiceillusion.org

Friday, April 12, 2019

While Opposition to Nursing Involvement in Assisted Suicide Grows, a Dire Warning from Canada

This article was published by Nancy Valko on April 12, 2019

Nancy Valko
By Nancy Valko

In March, I wrote a blog “Is the American Nurses Association Ready to Drop Opposition to Assisted Suicide?” about the ANA draft position paper changing its stance from opposition to assisted suicide to “The Nurse’s Role When a Patient Requests Aid in Dying”. “Aid in Dying” is the ANA’s new term for assisted suicide. I included a link for public comments on this change that gave a deadline of April 8, 2019.

Although the ANA claims that it ‘is the premier organization representing the interests of the nation’s 4 million registered nurses’, less than ten percent of the nation’s nurses are members of the ANA or other professional organizations” and that number is declining.

I belonged to the ANA decades ago but left when I saw the organization take radical positions without even informing us. Now, no nurse I know belong-unless he or she is in politics, academia or administration.

Even though I regularly get medical and nursing news updates along with constant ads from the ANA, I never see ANA’s proposed new position changes on hot button issues like VSED (voluntary stopping of eating and drinking to hasten death) and assisted suicide until alerted by people in my network. Unfortunately, although some of us wrote public comments opposing nursing involvement in VSED, the ANA approved the change.

This time, the ANA’s draft position on assisted suicide led to an outpouring of criticisms and pleas not to approve the change.



Some Responses to the ANA Draft Recommendations

The Catholic Medical Association issued a statement opposing the ANA’s draft position stating:

“These guidelines compromise not only the patient’s life, but also the conscience rights of nurses everywhere,” said Dr. John Schirger, President of the CMA.”

“A nurse or any health care provider should never abandon a patient or refuse comfort and care to a patient. But AID is not care and is the ultimate abandonment of a patient. Forcing the nurse to facilitate AID makes the nurse complicit in such abandonment,” said Dr. Marie Hilliard, Co-Chair of the CMA’s Ethics Committee.”
The National Association of Catholic Nurses issued their comments on the ANA’s draft such as:
“All the legal system can do is decriminalize AID so that nurses and physicians are not prosecuted for killing patients or helping them to kill themselves. AID is the antithesis of social justice.”

“Nursing is a moral endeavor and much is at stake when nurses breach the moral obligation to first do no harm. Harm is precisely what support of AID does. It harms the patient who is killed, the nurse who must make themselves indifferent to the patient’s suffering and convince themselves that killing is okay, the professional relationship that is built on trust that the nurse will not harm the patient, and society that will come to view nurses as potential accomplices in killing rather than as true healers and providers of authentic compassionate care. As Florence Nightingale is quoted to have said, “The very first requirement in a hospital, is that it should do the sick no harm.”
The National Association of Pro-life Nurses (NAPN) responded in their comments that:
“Social and legislative shifts” do not make a previously immoral act moral. ”

“Aid in dying IS euthanasia. It is the deliberate taking of a life whether it is requested by the patient or not.”
Wesley Smith of the Discovery Institute’s Center on Human Exceptionalism asked “Now Will Nurses Only Prevent Some Suicides?” wrote:
“I hope the membership of the ANA will oppose their leaders’ attempt to accommodate the culture of death. If nurses become “non-judgmental” — e.g., indifferent — to some suicides, the consequent failure to request specialized preventative interventions could become the precipitating omission that sends some suicidal patients into the abyss.”
Over 1000 people signed an online petition opposing the ANA draft position by the April 8, 2019 deadline.

A dire warning from Canada


The Canadian Catholic Nurses joined the National Association of Catholic Nurse in opposing the ANA’s draft position and gave a chilling look at what may be our future if legalized assisted suicide is not stopped:

“Our association formed in 2018 primarily in response to Canadian nurses’ moral distress regarding the nation-wide legalization of medically induced death. Professional associations and licensing bodies across Canada endorsed the legal changes, requiring conscientious objectors to participate in “Medical Assistance in Dying” by “effective referral” to facilitate access at the patient’s request. Faith-based health care facilities are pressured to participate. Nurse practitioners are trained and qualified to prescribe and administer lethal doses of medication to patients that they or others deem eligible for euthanasia.”
Social justice demands that nurses advocate for the protection of life until natural death, not for increased access to induced death. The Canadian experience with assisted suicide and euthanasia provides evidence for your continued resistance to the practice.

Unlike Oregon, Canada has not experienced a growth in palliative care along with the rapid expansion of induced death. Instead, we experience ongoing demands for access to lethal injections for new categories of patients, including “mature minors;” those who write advanced directives; and those whose mental illness is the sole condition underlying their request. We urge the ANA to maintain its courageous opposition to assisted suicide and euthanasia.” (All emphasis added)”

Legalized assisted suicide is more than a legal, medical or nursing problem. It is a corrupting influence on our society that will destroy the essential protections of truly ethical healthcare for us all.