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Canadian Researcher Blasts Palin Critic Who Said Choice of Life For Son Wrong

EDITOR'S NOTE: The following is an open letter to Nicholas Provenzo from Canadian researcher Brent Rooney.  Provenzo criticized Sarah Palin's decision not to abort her son, Trig, a child with Down Syndrome, in an article titled:  Palin's Down syndrome child and the right to abortion. 

To: Nicholas Provenzo
From: Brent Rooney, MSc

Subject:  More Suicides by Women Okay by Nicholas Provenzo

     In less than 20 minutes a pregnant woman can almost double her risk of

being a homicide victim in the next 8 years and multiply her risk of suicide

by 2 1/2 in the following 8 years. [Reardon, 1]  Thus, anyone suggesting that

induced abortion is a smart and moral option must be 'smoking something'.

                              

     You, Nicholas Provenzo, pretend to be an advocate of Ayn Rand's

philosophy of self-interest and unfettered capitalism.  Nicholas Provenzo

writes about Sarah Palin and her son Trig (who has Down syndrome) as follows:

 

     "Because a person afflicted with Down syndrome is only capable of being

      marginally productive (if at all) and requires constant care and supervision,

      unless a parent enjoys the wealth to provide for a lifetime of assistance that

      their child will require, they are essentially stranding the cost of their child's

      life upon others." [Provenzo, 2]

 

You, Mr. Nicholas Provenzo, founder of the Center for the Advancement of

Capitalism, state in your 16 September 2008 essay, "it is crucial to reaffirm the

morality of aborting a fetus diagnosed with Down syndrome..."  Thus, you believe 

it is moral for parents to abort 'useless eaters'; 'useless eaters' is NOT Provenzo's

term, but a term used by the Nazi's in the 1930s to persuade the public that badly

handicapped people were worthless and approximately 70,000 of these innocent 

handicapped people were murdered by the Nazis. The Nazis also used the term

'life unworthy of life'. [Glass, 3]

 

     Ayn Rand was a brilliant novelist and philosopher who advocated self-interest,

rationality and capitalism (which gets 4+ cheers from Brent Rooney).  Rand also

advised her 'objectivist' followers to prepare themselves very well before they

entered the public arena.  Sadly, Nicholas Provenzo, has failed to brief himself on

the medical disaster that is induced abortion. A 2002 study of low income

California women in the Southern Medical Journal reported that women with an IA

(Induced Abortion) had 2 1/2 times the suicide rate in the 8 years after as women

who delivered. [Reardon, 1]  In the 2 years after 'pregnancy end' women who had

an IA had twice the total risk of dying as women who delivered and in the 8

years after the women with IAs had 60% higher total risk of dying as women who

delivered. [Reardon, 1]  Can Mr. Provenzo cite just one study following women

for at least one year 'after' showing that women with induced abortions have a

lower total death risk (medical jargon: all-cause mortality) than women who

delivered?

 

     Perhaps Nicholas thinks that 2002 study of California women 'is just

one study' and that it has not been validated by any other study.  In 1997 Finnish

researchers led by Dr. Mika Gissler reported that Finnish women who ended

their pregnancy via induced abortion had 3.5 times the total death risk in the

one year 'after' as women who delivered. [Gissler, 5]  In the one year 'after'

women with an induced abortion had 6.5 times the risk of suicide and 14 times

the risk of being a murder victim as women who delivered. [Gissler, 5]

 

     Those who want to know the wide range of physical and mental damages

inflicted by induced abortion can read the online version of Women's Health

after Abortion (URL: http://deveber.org/text/whaa-chapters.html ).

[Ring-Cassidy, 5]

 

     Lastly, why would you, Nicholas  Provenzo, advocate that women undergo

experimental and unproven surgery?  The most common induced abortion procedure

is vacuum aspiration (aka 'suction') abortion.  'Suction' abortion has zero published

animal studies to support its safety. [Rooney, 6]  Dr. Sharon Camp of the Alan

Guttmacher Institute admitted in an email to Brent Rooney (MSc) on 16 January

2008 that AGI could not cite any such animal study for vacuum aspiration abortion.

Dr. Sharon Camp's email address is:  [email protected] . As you may know,

Nicholas Provenzo, to not first validate a new surgery or new drug on animals

BEFORE human trials commence violates rule 3 of the 1974 Nuremberg Code.

[Nuremberg Code, 7]

 

     [I am a medical researcher with a special focus on premature birth risk

factors.]

 

Objectively, Medically Informed, and Cordially Yours,

Brent Rooney (MSc)

Reduce Preterm Risk Coalition

Vancouver, Canada

web:  http://www.jpands.org/vol8no2/rooney.pdf

 

References 

 

1 Reardon DC, Ney PG, Scheuren F, Cougle J, Coleman PK, et al.   Deaths

   associated with pregnancy outcome: A record linkage study of low income

   women.  Southern Med J  2002;95(8):834-841  [ Abstract URL:

   http://cat.inist.fr/?aModele=afficheN&cpsidt=13850014 ]

 

2 Provenzo N.  Palin's Down syndrome child and the right to abortion

http://ruleofreason.blogspot.com/2008/09/palins-down-syndrome-child-and-right-to.htm

 

3 Glass JM. [Book:] Life unworthy of life: racial phobias and mass murder in

   Hitler's Germany.  New York, Basic Books 1997

 

4 Gissler M, Kauppila R, Merilainen J, Toukomoa H, Hemminki E.  Pregnancy-

   associated deaths in Finland 1987-1994: definition problems and benefits of

   record linkage.  ACTA Obstetrica et Gynecologica Scandinavica  1997;

   76(7):651-675  [ Abstract URL:

   http://www.informaworld.com/smpp/content~content=a791454723~db=all ]

 

5 Ring-Cassidy E, Gentles I. Women's Health after Abortion.  Toronto, deVeber

   http://deveber.org/text/whaa-chapters.html  

 

6 Rooney B, Johnston WR. Mored adverse effects of abortion.  J Am Phys Surg

   2007;12(4):97-98 [ URL: http://www.jpands.org/vol12no4/correspondence.pdf ]

 

7 Nuremberg Code  http://ohsr.od.nih.gov/guidelines/nuremberg.html 

   [accessed on 13 March 2008]

 

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Living Wills: Signing Your Own Death Warrant? A Christian Lawyer’s Perspective

by Stephen Bloom  

 

Editor’s Note: Stephen Bloom is a Christian attorney with more than 20 years experience in private practice. He is a frequent media guest, speaker, and writer on Christianity and the law, a Lecturer in Management and Business at Messiah College, and a Consultant to the United Methodist Stewardship Foundation of Central Pennsylvania. He is a legal columnist for Good News Daily, former host of the "Practical Counsel - Christian Perspective" radio program, and founder of the Estate Planning Council of Cumberland County. Bloom has been actively involved in the leadership of numerous community and ministry organizations, including his church, where he serves as a Certified Lay Speaker. He is a longtime member of the Christian Legal Society.

 

The signs of confusion are pervasive and troubling. My legal clients ask, “Should I carry my Living Will with me, in case I’m in an accident while traveling?” A major newspaper story laments that “too often” Living Wills aren’t available “when decisions about life support must be made.” Retirement community residents are directed to keep Living Wills taped to their refrigerators, for quick and easy access. Credible stories are told of first responders and emergency room personnel withholding care from patients with Living Wills.

 

What’s wrong with this picture? What does everyone seem to be missing? Isn’t this what Living Wills are all about? Well, hard as it might be to believe in the midst of a culture that seems to place less and less value on human life, no! Living Wills were never intended to prevent urgent lifesaving treatment!

 

The Living Will was developed to address situations of prolonged and permanent unconsciousness, not cases of sudden illness or injury. Yet a popular assumption seems to be taking hold across our society that people with Living Wills simply want to be left to die in the event of any medical crisis. As a practicing lawyer, I’ve observed signs that this deadly assumption is becoming so prevalent that anyone with a Living Will needs to consider whether they may have inadvertently signed their own death warrant.

 

In recent decades, the Living Will concept was promoted and recognized by law as a means for patients to decide in advance what medical treatment they wished to receive (or not receive) should they ever become permanently unconscious with no realistic hope of significant recovery. Living Wills were touted as a way to give a voice, in advance, to terminally ill patients who could no longer communicate for themselves. That idea may sound reasonable enough at first, but the emerging perception reflects a tragic misunderstanding of the original intent.

 

The promise was that Living Wills would help hopelessly ill (as determined through a careful, deliberate and measured evaluation process) patients avoid being kept alive indefinitely by prolonged artificial life support treatments. The reality is that Living Wills are too often being misused, in the heat of the moment, to rush patients into premature death.

 

For those interested in learning more about this important topic, I present an engaging discussion of the moral, spiritual, and legal issues surrounding Living Wills and end-of-life decision-making in one of the chapters of my new book, “The Believer’s Guide to Legal Issues” (Living Ink Books, 2008, ISBN 0899570313). The book, written in plain English for non-lawyers, also addresses many other commonly encountered legal issues from a practical Christian perspective. Visit my website http://www.IsThereALawyerInTheChurch.com or any major online retailer to purchase the book, or order a copy from your favorite bookstore.

 

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"Living Will" Becomes a License to Kill: The Horror Goes On In 2008

Editor's Note: Bill Beckman, Executive Director, Illinois Right to Life Committee, updates RFFM.org's readers regarding the issue of living wills.  During the last week, RFFM.org posted a series on end of life issues which were first seen on RFFM.org in 2006.  Beckman's latest column is an insightful look into the confusing and sometimes deadly result of signing a living will.

 

AUGUST 18, 2008

by Bill Beckman, Executive Director, Illinois Right to Life Committee *

While the Terri Schiavo case was in the news back in 2004, another Florida case got much less publicity.  Hanford Pinette had signed both a living will and a durable power of attorney for health care that designated his wife as agent.  When he had congestive heart failure, he needed a ventilator. 

His doctors insisted he had no hope of recovery so the provisions of his living will should be exercised by removing the ventilator.  When his wife Alice refused, hospital officials took the case to court and won.  Even though Hanford was still conscious, doctors removed his ventilator and he suffocated within two hours.  

On August 13, 2008 in Rochester, NY local TV news reported on the case of Dorothy Livadas, 97, who lives with the aid of life support.  Though she had signed documents giving her daughter, Ianthe Livadas, the power to make medical, legal, and financial decisions for her, she had also signed a "living will" instructing that she be taken off life support if she lapsed into a state where there was no reasonable expectation of recovery.

The dispute over her mother's condition forced Ianthe Livadas into a five-month legal battle against doctors, attorneys, and the Catholic Family Center.  "You don't expect a hospital to be threatening you that they're going to put aside your mother's choice of health care proxy and power of attorney, and replace you," Ianthe said.

Medical "experts" testified in court that there is no chance Dorothy will awaken or communicate.   Livadas’ daughter disagrees.  "Just the other day, I saw a sneer on her face when I mentioned someone she doesn't like very well.  When you know someone all their life, you can tell what they're thinking by subtle movements in their face that others would miss," she said.

However, the courts have ruled that Ianthe Livadas no longer has a say in her mother's care as Justice Harold Galloway awarded custody to Catholic Family Center.  He said that Ianthe "fails to appreciate her mother's true medical condition," and that she "lacks the objectivity and insight to make necessary decisions."

This is just the latest known case where signing a "living will" allows the medical profession to stop "life support" of a conscious individual because they have "no hope of recovery" even when the agent designated by a durable power of attorney for health care disagrees.  The living will simply makes it that much easier for the medical profession to get the agent declared incompetent. 

The news report did not identify whether "life support" consists simply of a feeding tube or includes a ventilator as well.  From past experience, I would be suspicious that use of the generic phrase "life support" would likely indicate that only a feeding tube was involved.  If that be true, they plan to starve Dorothy to death because doctors have agreed she has "no reasonable expectation of recovery."  That is called euthanasia!  

At the same time, more debate is occurring about the ability of the medical profession to establish the mental capabilities of disabled patients using their traditional approaches.  Michael Egnor, M.D., professor of neurosurgery and pediatrics at State University of New York, contends that the diagnosis of persistent vegetative state, in Terri Schiavo’s case specifically, and in other cases more generally, is of dubious validity.  Dr. Egnor references a study of the brain of a PVS (persistent vegetative state) diagnosed patient that reveals mental activity almost identical to that of conscious volunteers who were given the same instructions.

The results suggest that patients diagnosed as PVS are truly conscious.  Those findings certainly support the contentions of Alice Pinette about her husband’s responses and Ianthe Livadas about her mother’s responses, even though in both cases medical professionals testified in court that they were unresponsive so their living wills should be enforced. 

Would you want your “living will” enforced when you are still conscious?  Do not ever sign a “living will” because it amounts to a license to kill you!

Dr. Egnor describes the Cambridge testing scenario as follows: 

In the September 2006 issue of Science, Dr. Owen and his Cambridge colleagues published a study entitled "Detecting Awareness in the Vegetative State."  Owen and his colleagues studied the responses of a woman who was in a persistent vegetative state, which was the consequence of severe diffuse brain damage that she had suffered in an automobile accident the year before.

The patient had no evidence of any mental function. Based on a battery of standard tests, including MRI scans, electroencephalograms (EEG’s — brain wave tests), and careful bedside examinations by neurologists and neurosurgeons, she was diagnosed as being in a persistent vegetative state.  Persistent vegetative state means that she had no mental state — no consciousness.  She was, in a sense, a shell, a human body without a mind.  That’s what "vegetative" means.

Owen and his colleagues did a fascinating series of tests.  First, they asked a group of normal volunteers to have a kind of research MRI scan of their brain, called a functional MRI (fMRI). fMRI doesn’t measure the actual activity of the neurons in the brain, but it measures the blood flow and brain metabolism in specific regions of the brain.  It has been found to correlate to some extent with mental activity.  Thinking about things can make the metabolism in certain parts of the brain increase, and fMRI can detect this. The observation that brain activity can locally increase brain blood flow and metabolism was originally made a century ago, in animals in the lab, so it’s not new.  What is new is that we can now measure it in living people non-invasively, using fMRI.

The Cambridge researchers asked the volunteers to think of things, like playing tennis or walking across the room, and they recorded their fMRI brain responses.  They also presented the volunteers with nonsense words, to distinguish understanding in the brain from the mere reflex to sounds.  The response to understanding was different from the response to sound.  The fMRI test seemed to test understanding, not just reflexes.

They did the same tests to the woman who was in a persistent vegetative state.  They asked her to imagine playing tennis or imagine walking across the room, and they did the sham test with random words as well.

When they examined her fMRI responses, they found that her fMRI patterns were identical to those of the normal awake volunteers.  By fMRI criteria, she understood.  In fact, by fMRI criteria, she was as conscious as the normal volunteers.  Her brain was massively damaged, to the extent that she had been diagnosed as having no mind at all.  Yet the blood flow and metabolism patterns in her brain were those of a normal person.  And just like normal people, she showed different fMRI responses to nonsense words.  So she not only heard what was said to her, but she understood, and complied with the researchers’ requests to think about specific activities like playing tennis and walking across a room.

Owen’s study generated enormous interest among researchers, physicians and the public, not only for its implications for diagnosis of persistent vegetative state (e.g. the implications for the Terri Schiavo case), but because of what it suggests about deeper questions about the relationship between the mind and the brain. Many other studies of fMRI in patients in persistent vegetative state are underway, and several studies recently completed with other patients tend to support Owen’s findings.

Illinois Right to Life Committee's website:  http://www.illinoisrighttolife.org/

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Part VII Culture Of Death Taking Toll On Those Nearing Life's End

Overview -- by Daniel T. Zanoza

Like many others, I believed pro-life issues only concerned the saving of the innocent unborn from abortion.  However, my naiveté regarding the sanctity of life topic was clearly evident after I learned about what is taking place in our country involving the care of those approaching life's end.
 
Now, when I talk about life's end, I'm including the terminally ill, elderly, infirm and those whose circumstances have led them to face death from afar or while approaching the threshold of death's door.
 
I learned of a series of articles written and edited by Bill Beckman, Executive Director, Illinois Right to Life Committee [http://www.illinoisrighttolife.org/].
 
In reviewing Beckman's work, I quickly realized Americans were being led down a dark and foreboding path regarding end of life issues.  I quickly came to the belief a series on such issues would be one of the most important projects I would ever work on.  The information was so critical I felt one day's hesitation could cost someone's life or the life of a cherished loved one.  However, all too often, in this electronic world, we are flooded by so much data, it is impossible to process.  Therefore, I would like to take this opportunity to look back at the series and personalize what the previous six articles meant to me.
 
Perhaps the most stunning revelation was addressed in the first article of the series titled, "The Myth of Living Wills: You Are Actually Signing Your Life Away."  I learned it was a priority for my wife and I to never sign a living will.  The simple fact of the matter is; signing such a document, which is often made during times of dire circumstances, actually takes away your control over medical decisions made about your life.  I learned, if you have a living will, you should tear it up.  If others are in possession of copies of that living will, they should be informed those documents are no longer valid and should be destroyed. 
 
Taking such actions may actually save your life or the precious life of a loved one.  There are alternative documents which will ensure you have control over the medical procedures that will be taken in life and death situations.  One such alternative is the IRLC's Patient Self-Protection Document [available for review at:  http://www.illinoisrighttolife.org/pspdoc.htm] which provides a life-affirming Durable Power of Attorney for Health Care.  You can also obtain a copy by calling the Illinois Right to Life Committee at (312) 422-9300.  But the most important thing is to do it.  Act now, don't put your fate or the fate of those you love in the hands of others.
 
Article three in the series dealt with "futile care" a diabolical system by which health care providers determine whether an individual's life is worth saving.  I once experienced this in my own life regarding my late Mother.  I am quite sure if I would not have let the doctors know I cared deeply about my Mother's life, she could have easily succumbed to futile care over a decade ago.  I saw it in the doctor's eyes as he prepared to operate on my Mother and I saw his reaction when I said, "May God guide your hands."  Matters have gotten much worse in recent years.  Do not take it for granted a medical facility's primary motivation is to save the life of a patient.
 
In article four Beckman says, "You should be especially concerned if your relative is diagnosed as “brain dead”.   “Brain death” is not a definitive means to establish that a person is dead.  For this reason, IRLC has already been recommending not to choose organ donation because it could lead to your premature death.  IRLC has presented informed concerns from medical doctors about the tentative nature of this diagnosis.  For example, see Ethical Dilemmas Defining Death (www.illinoisrighttolife.org/ EthicalDilemmasDefiningDeath.htm) and "Brain Death" is Not Death!  (http://www.chninternational.com/brain_death_is_not_death_byrne_paul_md.html).
 
Perhaps the most disturbing aspect of the end of life series involved the issue of hospice care.  It is clear, in 2006 some hospice care providers see death as a compassionate means of ending suffering.  Those choosing hospice should take extraordinary precautions to understand the philosophy of the organization(s) they contact.  The failure to do so may end in the most dire circumstances.
 
In summary, I was disturbed to find life and the continuation of life is no longer a priority for many health care providers when it comes to end of life situations.  In the past, the onus was on physicians, nurses and hospitals to support the Hippocratic Oath.  Sadly, this is no longer the case in many health care facilities and organizations.  Whether this is due to economics or a new philosophical approach to health care, some hospitals have become dangerous places for the seriously ill.
 
Responsibility now lies with us all regarding the treatment we will receive in life's most trying times.  But we still have the ability to take control over our destiny.  This cannot be done by a passive approach.  We cannot hope for the best any longer.  The key to end of life health care is self-responsibility, which includes a pro-active approach to what may be the most important decisions made about our lives.

This column was first posted on RFFM.org in September of 2006.

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Part VI Some Hospice Care Providers Hasten Death Through Use Of Morphine Overdoses + Other Means?

Do Some Hospice Care Providers Hasten Death Through Use Of Morphine Overdoses + Other Means?

by Bill Beckman, Executive Director, Illinois Right to Life Committee

Editor's Note:  This is the sixth in a series of columns first posted on the Illinois Right to Life Committee's (IRLC) website [http://www.illinoisrighttolife.org/] written by Bill Beckman, IRLC's executive director.  The column discusses hospice care.  Beckman relates nightmarish, firsthand recollections regarding patients and their hospice providers.  This series warns readers about end of life issues and the need to monitor the care given to loved ones.  The IRLC director also describes what readers can do to protect themselves from the looming culture of death which permeates the thinking of many medical facilities in our nation.  Below are links to all parts in this series, plus two columns written in 2010.

The following was written by Bill Beckman *
 
Hospice has developed a good reputation for providing compassionate care for dying patients.  A key principle of this care is: hospice neither artificially prolongs life nor hastens death.
 
Unfortunately, this principle is no longer consistently followed in hospice care (as discussed in the previous article in this series).  This lack of consistency requires a “buyer beware” attitude when evaluating which hospice might be appropriate to provide truly compassionate end-of-life care.
 
Now that we have established that at least some hospices deviate from the original mission of hospice, some real life examples will clarify how hospices can act to hasten death, while justifying such actions as compassionate and caring.  These examples show how hospice care can fail to "improve the quality of a patient's last days by offering comfort and dignity."  Suggestions on the means to evaluate whether a hospice will truly care for, or likely kill, a patient are also provided below.
 
A man named "Bruce" called me on September 29, 2005.   He heard the IRLC message about the Patient Self-Protection Document  (http://www.illinoisrighttolife.org/pspdoc.htm) on WIND radio 560 AM.  Bruce called because he thought he should obtain a copy for his mother.  The background that led Bruce to that conclusion is most disturbing.  He witnessed his father being killed by a hospice nurse who used an overdose of morphine.  The nurse who came to his father’s house to provide hospice care actually tried to get Bruce’s mother to give the morphine to her husband, but she refused.  So the nurse administered the overdose of morphine herself.  Bruce said his father was not in pain.  Pain would have been justification for giving some morphine to Bruce's father, but there was no medical justification for any morphine to be administered in this circumstance.

That experience proved to be more than enough for Bruce to have his mother complete a Patient Self-Protection Document.  But there is even more that concerns Bruce.  It turns out Bruce’s sister is a hospice nurse.  Bruce's sister actually thinks she is doing the compassionate thing when she overdoses hospice patients by using morphine.

She even told her mother about providing morphine to the children of a 93-year-old man so they could relieve his suffering whenever that might become necessary.  This man happens to be a friend of Bruce’s mother, he still drives and gets along just fine.  How might Bruce's mother let her 93 year old friend know that his own children are armed with morphine and could be dangerous to his health--if he develops medical problems?

Bruce’s mother told her daughter she should leave her job as a hospice nurse “because she is killing people.”  How does she face the knowledge her daughter is ready to end her life--if she becomes too much of a burden?  This lady is legally blind and deaf, but is still able to take care of most of her needs.  Her daughter suggested she consider hospice, and she replied that a nursing home would do just fine.  This nurse works at a hospice facility near Elgin, Illinois area.  I could say, if you are considering any hospice in that area, beware of this situation, but, in actuality, you should take great care in choosing an hospice facility, no matter where it is located.

Bruce made an observation based on his experience with his sister.  He said she never came home at breaks during college, but if someone had an ailing animal to be put to sleep, she would come right home to take care of it.  Now, she apparently thinks human beings should get the same treatment.  Bruce thinks she is quite happy with her job, even though she is dealing with death, and people near death, all the time.  He observed that hospice work could easily attract people who think like his sister.

I have received additional calls from people who have witnessed similar occurrences with other hospices.  Fortunately, in one case the result was better, as expressed in an e-mail I received from a lady I will call Angie.  When Angie's husband needed hospice care, she was already knowledgeable about morphine dosages because her husband had needed it for pain control for two years.  When hospice got involved nine days before her husband died, Angie was given a schedule for morphine every 2-4 hours, but Angie only gave her husband morphine once per day until the last two days when she gave two and then three doses, but never anything even approaching 6-12 doses per day.   Angie wrote, “He was never uncomfortable, was coherent to his last breath, and telling his family he loved God and wanted to be with Jesus.”   Her family never allowed him to be left alone with a hospice nurse.  Other families are not as fortunate.  In many cases, the family members are innocently giving the morphine doses per the hospice schedule that hastens death without even realizing what is happening--until it is too late, or never knowing the truth.

Unfortunately, some relatives do not exercise the wisdom and love Angie used while taking care of her ailing husband.  In another case, a wife made a decision to get hospice involved in her husband’s care during his recovery from both surgery and another medical procedure to remove a brain tumor.  Even though the brain tumor was declared to be in total remission by the surgeon and the patient was not in pain, pain medications were forced on the patient.  This was the initial stage of the process that, too often, leads to an eventual overdose on morphine.  I was asked for advice by the patient’s niece who witnessed the mistreatment of her uncle.  The niece was eventually denied access to her uncle because she was trying to help him--rather than trying to hasten his death.

In another case, a mother was on a feeding tube and being cared for at home by one of the younger sons among her eight children.  The oldest daughter, who was the designated agent on her mother's Durable Power of Attorney for Health Care, arrived one day to take their mother to hospice “because she would not want to live this way.”  Most of the siblings, who opposed this move to hospice, needed to get an attorney involved even to get the opportunity to learn where their mother was taken so they could visit her.  They learned their mother was no longer being given food through her feeding tube.  And even though she had not been taking pain medication at home, she was now being given morphine under hospice care.  Tragically, she died within a week.

Might one conclude that morphine overdoses are being used by every hospice?  No.  I have talked to a number of people who have friends or relatives who have recently been under hospice care and have continued to live for a number of months.  Those hospices did not use these procedures to hasten death (because when hospices do use these practices, patients are often dead in three to five days after entering hospice care).

Some hospices have a policy that no patient can remain on a feeding tube upon entering hospice care.  Such a policy is a clear sign the hospice is willing to hasten death.  If a feeding tube is effectively doing the job of providing the patient with food and water, then removing it will result in a hastened death from starvation and/or dehydration.  Such action will certainly not "improve the quality of a patient's last days."  Rather, it is an immoral attack on human life.  Of course, if there are medical indications that the patient's body can no longer process the nutrients provided through the feeding tube, then removal is justified, but such individual cases cannot justify a blanket policy to end tube feeding upon entering hospice care.

How many hospices hasten death versus how many do not?  It's very difficult to know, but hospice leadership organizations, including the Hospice Foundation of America, National Hospice and Palliative Care Organization and, most likely, a significant number of others are pushing hospices in that direction.  The efforts of these organizations indicate even if a certain hospice was faithful to the original mission of hospice in the past, policies could change.  Therefore, understanding current hospice policies is always crucial when choosing that hospice for a new patient.  Whether death is hastened by denial of food and water or suppression of breathing using overdoses of morphine, this is certainly not death with dignity!

Illinois Right to Life offers a Hospice Checklist (http://www.illinoisrighttolife.org/HospiceChecklist.htm) to help evaluate the underlying philosophy of care practiced by any specific hospice.  Seeking answers to the questions on this checklist should be helpful in that evaluation. 
 
The tragic situations described above--where the patients' relatives actually wanted hospice care to hasten death--reinforce the need to be very cautious in what type of advance directive you complete and who you designate as your agent to make health care decisions for you, if you cannot make them yourself.  Even using a life-affirming Durable Power of Attorney for Health Care, such as IRLC's Patient Self-Protection Document (http://www.illinoisrighttolife.org/pspdoc.htm), will be no match, if your designated agent does not respect your life and has access to hospice care that has no problem with taking steps that hasten death.  To protect your life, you need to identify both relatives and health care professionals who respect life and reject the "Right to Die" movement's philosophy that ending life prematurely is "compassionate" and "dignified" when the patient is deemed to have a "low quality of life."
 
* Contact Illinois Right to Life Committee:   (312) 422-9300
IRLC website:   http://www.illinoisrighttolife.org/

The above column was first posted on RFFM.org in September of 2006.

RELATED ARTICLES:

The following series of columns are related to end of life issues and written by:

Bill Beckman, Executive Director, Illinois Right to Life Committee http://www.illinoisrighttolife.org 

Stephen Bloom, a Christian Attorney at Law, an expert on living wills and author of "The Believer’s Guide to Legal Issues" http://www.istherealawyerinthechurch.com/  and

Daniel Zanoza, Executive Director, RFFM.org

Part I  The Myth Of Living Wills:  You Are Actually Signing Your Life Away by Bill Beckman posted August 11, 2008 at http://rffm.typepad.com/republicans_for_fair_medi/2008/08/the-myth-of-living-wills.html

Part II  How a Living Will can bring about your premature death by Bill Beckman posted on August 12, 2008 at http://rffm.typepad.com/republicans_for_fair_medi/2008/08/how-a-living-will-can-bring-about-your-premature-death.html 

Part III  Futile Care--Knowing What It Is May Save Your Life Or The Life Of A Loved One by Bill Beckman posted August 13, 2008 at http://rffm.typepad.com/republicans_for_fair_medi/2008/08/part-iii-futile-care--knowing-what-it-is-may-save-your-life-or-the-life-of-a-loved-one.html

Part IV  Research on "brain dead" and "almost dead" patients declared "ethical" by Bill Beckman posted August 14, 2008 at http://rffm.typepad.com/republicans_for_fair_medi/2008/08/part-iv-research-on-brain-dead-and-almost-dead-patients-declared-ethical.html

Part V  Choose Hospice Care Provider Carefully: Using Hospice Care To Hasten Death Declared "Ethical" by Bill Beckman posted August 15, 2008 at http://rffm.typepad.com/republicans_for_fair_medi/2008/08/part-v-choose-hospice-care-provider-carefully-using-hospice-care-to-hasten-death-declared-ethical.html

Part VI  Some Hospice Care Providers Hasten Death Through Use Of Morphine Overdoses + Other Means? by Bill Beckman posted on August 16, 2008 at http://rffm.typepad.com/republicans_for_fair_medi/2008/08/part-vi-some-hospice-care-providers-hasten-death.html

Part VII  Culture Of Death Taking Toll On Those Nearing Life's End:  Overview -- by Daniel T. Zanoza posted on August 17, 2008 at
http://rffm.typepad.com/republicans_for_fair_medi/2008/08/part-vii-culture-of-death-taking-toll-on-those-nearing-lifes-end.html

"Living Will" Becomes a License to Kill: The Horror Goes On In 2008 by Bill Beckman posted on August 18, 2008 at http://rffm.typepad.com/republicans_for_fair_medi/2008/08/living-will-becomes-a-license-to-kill.html

Living Wills: Signing Your Own Death Warrant? A Christian Lawyer’s Perspective by Stephen Bloom posted on August 19, 2008 at
http://rffm.typepad.com/republicans_for_fair_medi/2008/08/living-wills-signing-your-own-death-warrant-a-christian-lawyers-perspective.html

 
Some Hospice Care Providers Enforcing State-Sanctioned Euthanasia Through Illinois Probate Courts posted on August 13, 2010:  http://rffm.typepad.com/republicans_for_fair_medi/2010/08/some-hospice-care-providers-enforcing-state-sanctioned-euthanasia-through-probate-courts.html

Hospice, Living Wills, Futile Care: Hospice, Hospitals & Nursing Homes Have License To Kill by Daniel T. Zanoza posted on October 5, 2010 on the Illinois Family Institute's website: http://www.illinoisfamily.org/news/contentview.asp?c=35036

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Part V Choose Hospice Care Provider Carefully: Using Hospice Care To Hasten Death Declared "Ethical"

by Bill Beckman, Executive Director, Illinois Right to Life Committee

Editor's Note:  This is the fifth in a series of columns first posted on the Illinois Right to Life Committee's (IRLC) website written by Bill Beckman, IRLC's executive director.  The column discusses hospice care and gives individuals and families the tools they need to choose a good hospice care provider.  This series warns readers about end of life issues and the need to monitor the care given to loved ones.  The IRLC director also describes what readers can do to protect themselves from the looming culture of death which permeates the thinking of many medical facilities and health care providers in our nation.

The following was written by Bill Beckman

As I noted in my previous article, the correct answers on reducing or ending treatment of seriously ill patients are often difficult to come by and rarely made with complete confidence.  When respect for life has been maintained, but a patient's prognosis is ultimately unfavorable, care requirements for the struggling patient may overwhelm family members.  Hospice has been designed to provide relief to help patients live their last days as best as they are able without putting undue stress on loved ones.

As presented on the Hospice Foundation of America web site (http://www.hospicefoundation.org/hospiceinfo/), the principles of hospice state that "hospice care neither prolongs life nor hastens death," and that "the goal of hospice care is to improve the quality of a patient's last days by offering comfort and dignity."

In practice, is hospice true to these principles?  Is the Hospice Foundation of America consistent with its stated principle not to hasten death?  Have at least some hospices ignored the principle against hastening death and instead embraced such actions as "compassionate" and "ethical"?

IRLC has received a number of reports of concern about hospice care beginning in late 2004.  Two nurses reported specifically that they witnessed how hospice care is used to quickly terminate the lives of patients through morphine overdoses.  In April 2005, one of our board members attended a conference called “Ethical Dilemmas at the End of Life” sponsored by Hospice Foundation of America (HFA).  The materials obtained from this conference express principles that seem inconsistent with the principles mentioned above that are visibly proclaimed on the HFA web site. 

Some examples from conference materials include:

* The right to refuse life-sustaining medical treatment does not depend on the patient’s life expectancy or being “terminally ill.”

* Artificial nutrition and hydration is a medical treatment that legally may be withheld/withdrawn under the same conditions as any other form of medical treatment.

* Competent patients have a right to refuse medical treatment, even if that treatment is necessary to sustain life.

The implications of these principles suggest that in practice hospices have no problem with taking steps that hasten death.  Under their definition of the term, medical treatments to sustain life include tube feeding, insulin for diabetics, kidney dialysis, and many more.   Removal of these medical treatments will certainly hasten death.

Regarding tube feeding, an article from HFA on nutrition and hydration states, “There comes a time in some cases where even nutrition and hydration are considered extraordinary means of prolonging life, and such ordinary nutrients are discontinued.  The decision to withhold food and/or fluids is made only when it is apparent to the caregivers and family that further prolongation of life would only extend discomfort.” 

These statements apply to many more cases than those where the body begins to shut down and becomes increasingly unable to process nutrients.  True medical justification for removal of nutrition only occurs when body systems are shutting down as death becomes truly imminent.  Using a criterion “that further prolongation of life would only extend discomfort” is much broader in scope than circumstances where body systems are shutting down.  This expansive willingness to deny nutrition and hydration is further confirmed when the article suggests “bio-ethical support for withholding nutrition in those persons with advanced illness whose greatly impaired quality of life would not be improved, but only prolonged.”

“Greatly impaired quality of life” is a subjective criterion that can easily be abused in arbitrarily deciding to deny food and water to patients who are not dying.  Any hospice that follows the principles set forth by the Hospice Foundation of America  is certainly willing to cooperate with or even encourage actions that hasten death through denial of food and water.  They have clearly stated a standard of care that hastens death in their own literature.

HFA's push to hasten death gets worse.  Among conference materials was a 350-page book published by Hospice Foundation of America, entitled Living With Grief: Ethical Dilemmas at the End of Life.  Actions called ethical in this book are anything but ethical.  Buried in the middle of the book, in a chapter extolling the ethics of assisted suicide, are statements that reveal the intent and means used by hospice to hasten death.  Here is a telling sentence that summarizes the means used to hasten death: “It is well known that hastening death is practiced and approved in many ways in contemporary terminal care when suffering is extreme and irremediable – for example, by terminal sedation, by delivering pain relief sufficient to cause death by incidentally suppressing breathing, or by withdrawing nutrition and hydration.  Given the obligation to relieve suffering, such practices are not incompatible with the physicians’ oaths.”  (p. 192)

This quote appears in a chapter that encourages the use of physician-assisted suicide and praises Oregon for having a law to allow it.  The chapter expresses the ethics of assisted suicide.  The twisted thinking reflected in these so-called ethics is reflected in the following logic on why the physician is not responsible in any way for the death of the patient:  “Assisting suicide does not involve killing others or taking steps that cause or hasten their deaths.  Suicides kill themselves.  Assistance involves such things as giving would-be suicides information about how to kill themselves, enabling them to secure the means of doing so, giving them realistic options, interacting with them as they choose among their options, assuring them that their choice will be respected, supporting them emotionally once they have decided, and protecting them from unwanted intervention.  The would-be suicides themselves are entirely responsible for exercising the option and completing the act of killing themselves.”

If valid ethics have reached such a state, we need to inform the criminal courts that they can no longer prosecute the person who drove the bank robber to and from the bank that was robbed.  The driver had nothing to do with the bank robbery.  Clearly this example shows that what is being called ethical behavior to encourage patients to kill themselves does not pass the test of logic.  Hospice Foundation of America puts its name squarely behind faulty logic to justify behavior that is not ethical at all.  Their reference to these means to hasten death as “contemporary terminal care” warns us that these practices are also being used outside of hospice care.  We might be in danger in hospitals and nursing homes as well, but HFA is willing to document such practices as ethical end-of-life care.

This is certainly not death with dignity!  The author even uses the same false concepts of “choice” that we have heard for years to justify abortion.  If you do not accept these actions as ethical, do not commit suicide yourself or assist someone else, but do not try to prevent others from exercising their “right to die.”  They have the right to choose to end their life.  The author even goes so far as to claim that not referring patients to others who would be willing to assist them would be unethical.  That is what always happens when something truly unethical gets labeled as a right.  Wrong becomes right and right becomes wrong!

Beyond HFA among hospice associations, the National Hospice and Palliative Care Organization (NHPCO) accepts the use of “terminal sedation” for some patients.1  "Terminal sedation is deliberately inducing and maintaining deep sleep but not deliberately causing death in very specific circumstances."  Terminal sedation (also called total or palliative sedation) is a protocol actively promulgated by NHPCO.  Howard M. Ducharme, chair of the philosophy department at the University of Akron, expresses serious concerns about the use of terminal sedation.  He writes:

Terminal sedation (TS) is not limited to patients who are suffering from overwhelming physical pain from their terminal illness.  TS is deemed appropriate for intractable or refractory suffering due to "overwhelming physical, emotional, or spiritual distress that is poorly relieved by other means."2 NHPCO advises, "There are many cases in which patients experience refractory spiritual or emotional pain, often referred to as existential suffering."3 TS is deemed appropriate treatment for existential distress "that is not relieved by counseling from social workers and chaplains, psychotropic medications, and other interdisciplinary interventions."4 Thus, the criteria for rendering a patient totally unconscious can come down to the individual's own report of the existential distress he or she feels. Those suffering from chronic depression or severe depression (e.g., parents who have lost their only child in a car accident) would qualify for TS.
When patients are put in an unconscious state through terminal sedation, they will not be given food and water by hospices that practice this protocol.  Whether a feeding tube is removed or total sedation is used, the patients will die from starvation and dehydration.  In what way is this approach not hastening death?

In summary, there is clear evidence that the hospice principle to avoid hastening death is seriously threatened.  Whether the method used is a high dosage of painkillers such as morphine (justified as pain control), terminal sedation, denial of food and water, or a combination of these methods, the arguments to justify these actions are well established as "ethical" in the view of some medical ethicists.  Next time, we will review some examples of how hospice care has failed to "improve the quality of a patient's last days by offering comfort and dignity."

1 Perry G. Fine, "Total Sedation: Management Issues," Total Sedation: Ethical Foundations and Pharmacotherapy Review, National Hospice and Palliative Care Organization, Telephone Seminar (June 14, 2001), p. 1.   The NHPCO total sedation policy draft being available at this time (November 2001) is evaluated as the NHPCO TS policy in this article.

2 Ibid.

3 Jamie Goldstein-Shirley and Perry Fine, "Ethics of Total Sedation," Total Sedation Educational Resources Draft, Prepared by a Task Force of the NHPCO Ethics Committee (Session 8A, March 25, 2001), p. 3.

4 Ibid., p. 9.

The above column was first posted on RFFM.org in September of 2006.

Illinois Right to Life Committee's (IRLC) website http://www.illinoisrighttolife.org

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Part IV Research on "brain dead" and "almost dead" patients declared "ethical"

by Bill Beckman, Executive Director, Illinois Right to Life Committee

Editor's Note: This is the fourth in a series of columns first posted on the Illinois Right to Life Committee's (IRLC) website [http://www.illinoisrighttolife.org/] written by Bill Beckman, IRLC's executive director. The column discusses research on "brain dead" and "almost dead" patients. This series warns readers about end of life issues and the need to monitor the care given to loved ones. The IRLC director also describes what readers can do to protect themselves from the looming culture of death which permeates the thinking of many medical facilities in our nation.

The following was written by Bill Beckman

Life is precious, and it is certainly fragile for those burdened with a serious disease or injury. In today's health care arena, the certainty of care seems to evaporate when the patient's "quality of life" is deemed too low. This can lead to a battle with hospital ethics committees on whether patient care should be continued [see previous article in this series on RFFM.org, titled "Futile Care--What is it? Knowing May Save Your Life Or The Life Of A Loved One" *]. Ultimately, for some patients, recovery will not be possible--even with the best efforts of relatives to protect the patient's right to care and with the best efforts of medical staffs to provide that care. The right answers on reducing or ending treatment are often difficult and are rarely made with complete confidence.

When hope of recovery is gone, new threats to a natural end to this earthly life now present themselves. If the patient is declared "brain dead", is he/she really dead? Should the patient's organs be donated? If the organs are not usable, should the patient be allowed to have medical research conducted on their bodies--either after declaration of "brain death", or while unconscious, but not yet declared "brain dead"? Relatives are now being asked to make such decisions.

You should be especially concerned if your relative is diagnosed as “brain dead”. “Brain death” is not a definitive means to establish that a person is dead. For this reason, IRLC has already been recommending not to choose organ donation because it could lead to your premature death. IRLC has presented informed concerns from medical doctors about the tentative nature of this diagnosis. For example, see Ethical Dilemmas Defining Death (www.illinoisrighttolife.org/EthicalDilemmasDefiningDeath.htm) and "Brain Death" is Not Death! (http://www.chninternational.com/brain_death_is_not_death_paul_md.html)

For patients who are declared "brain dead", medical personnel might push for approval of organ donations. If the patient’s organs are not considered usable, you may now encounter requests to allow medical research on your dying relative. Some medical researchers have decided it is ethical to perform research on “brain dead” patients. A very outrageous article on this new abuse of disabled patients appeared in the Chicago Sun-Times on January 3, 2006 http://www.illinoisrighttolife.org/EthicalFrontier_ResearchOnTheDead.htm

Researchers can use these "brain dead" patients to test new drugs for effectiveness in stabilizing irregular heartbeats, test new alternatives to respirators, etc.

Of course, as soon as this new utilitarian perspective is put into action, further abuses immediately occur. The Chicago Sun-Times article discussed one patient at M.D. Anderson Cancer Center in Texas who was alive, but unconscious, and so sick due to complications from cancer, his family was about to take him off life support. [Translated, that means the family was going to allow removal of the patient's respirator so death would occur--even though the patient was not declared “brain dead”.] Instead, the family was convinced to leave their relative on the respirator, so medical research could be performed on his body before he died.

According to the Chicago Sun-Times, "M.D. Anderson researcher Dr. Wadih Arap said that in research projects, the soon-to-be-dead can ethically be treated the same way as the recently dead...Arap used (Mr.) Minatra in a study on targeting drugs to specific sites in the body. Arap injected genetically modified viruses that had identification tags and moved through the body like drugs."

Family members allowed this research after receiving assurances their relative would feel no pain. Would you trust such assurances? You should not, given these assurances may be as inaccurate as claims made that no pain is felt during starvation and dehydration after feeding tube removals, or ridiculous assertions which state unborn babies feel no pain during abortions. However, whether there is pain or no pain, allowing medical research on unconscious patients continues to expand morally unacceptable "quality of life" criteria used in making decisions that can deny care to patients and, ultimately, justify euthanasia. Do not allow the dignity of your dying relative to be violated by agreeing to medical research that may cause pain on even hasten the death of your still living relative.

Apparently, hospital ethics committees will allow the continued use of the respirator for patients on whom research will be performed, but have no problem removing the respirator from non-research patients deemed to have a low "quality of life", even when relatives consider that step premature. Early in 2006, I was informed a physician at a California hospital, contrary to the expressed request of family members, removed a respirator from a heart attack victim, who then died. The doctor took this action when no family members were present, even though they indicated they would be back shortly. The victim’s son lives in Chicago. He mentioned his family's distress over the incident to a friend who is a Chicago policeman. The officer said removing respirators happens at hospitals in Chicago all the time.

A family member called a supervisor at St. Mary of Nazareth Hospital in Chicago inquiring about their policy in such cases. The caller was informed the hospital would remove the respirator in similar cases. The supervisor emphasized the point by adding the hospital is not concerned about lawsuits from family members because the hospital always wins in court. If you have a relative placed on a respirator, be aware that someone must remain with the patient constantly to protect them from overzealous medical personnel who find their quality of life too low even to give them a fair chance to recover.

This column was first posted on RFFM.org in August of 2006.

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Part III Futile Care--Knowing What It Is May Save Your Life Or The Life Of A Loved One

by Bill Beckman, Executive Director, Illinois Right to Life Committee 

Editor's Note: This is the third in a series of seven columns first posted on the Illinois Right to Life Committee's (IRLC) website [http://www.illinoisrighttolife.org/

The following was written by Bill Beckman

You are preparing to take or have already enacted a life-affirming advance directive such as Illinois Right to Life Committee's Patient Self-Protection Document. Now you are fully protected, right? Unfortunately, in some cases, even this step may not be sufficient to protect your life in all cases. The following circumstances occurred in Texas, but some hospitals around the nation are forming ethics committees. These committees are making decisions about denial of patient care that, in some situations, can override a patient's advance directive, with, or even without, support of a state law. The only way to reduce the nightmare of encountering these circumstances is to verify that you are working with Pro-Life doctors and medical facilities.

What a change a few days can make! No, I am not talking about the weather. I am referring to the case of Andrea Clark, a patient at St. Luke's Episcopal Hospital in Houston, Texas. On April 19, 2006 the hospital ethics committee decided that attempting to save Andrea’s life was futile, she should be removed from a respirator and all medical treatments should be stopped.

Even though Andrea is mentally alert, communicates by moving her lips and blinking her eyes, wants to live, and has the full support of her family, the hospital ethics committee decided further care for her was futile. Andrea, 54, developed bleeding on her brain after open-heart surgery and needed a respirator to breath. Although she suffered damage to her motor functions, her mental capacity was not affected.

As of May 2nd 2006, Andrea has a new doctor who is not planning to give up on her medical care and treatment, reported her sister Melanie Childers. “Not only is my sister not going to be put to death by St. Luke's Episcopal Hospital, but it also looks like she is recovering from her heart surgery, finally,” Melanie said. Melanie also mentioned Dr. Matthew Lentz has told the family Andrea will be able to get off of the blood pressure raising drugs she has been on for months, and he is cutting in half the amount of pain medications she was taking. That will allow Andrea to better interact with her family.

Jerri Ward, the attorney for Andrea's family, stated, “St. Luke's is doing the right thing in this case now. The physician team met with the new attending [physician] and it went well. The team is on board and the medical futility procedure has been stopped.” This change in direction was certainly vital for Andrea! It is most fortunate Andrea's family was fighting for her right to life and found a physician who was willing to make another assessment of her case.

But why should patients’ lives be threatened by a medical facility that is supposed to provide them a means for recovery? Unfortunately, a Texas law gives hospitals the power to decide if a patient’s life is “worth” maintaining so officials at St. Luke’s Hospital are legally able to remove Andrea’s respirator against the expressed wishes of herself and her family. If the hospital ethics committee decides to withdraw care, the family has just 10 days to find another treatment center. It is not known how many patients have already died through lack of support from family members or from having no opportunity to get the opinion of another physician?

Bob Kafka, a disability rights activist with Not Dead Yet, stated, “I have come to the conclusion that the essence of any futility law embraces involuntary euthanasia. The ability of a doctor to overrule both the patient and their surrogate in withdrawing life-sustaining treatment is in violation of the principle of patient autonomy.” Kafka says the Texas law can not be improved, but should be thrown out entirely.

How far are the peddlers of death, labeling themselves the “right to die” movement, willing to go? Here is some evidence that the so-called "right to die" will eventually be deemed a "duty to die." This intent was made visible in a 1997 article written by philosopher John Hardwig which appeared in the Hastings Center Report, a prestigious bioethics journal. Hardwig argued that there is not only a right, but also a duty to die, including this frightening statement: “A duty to die becomes greater as you grow older. As we age, we will be giving up less by giving up our lives . . . To have reached the age of say, seventy-five or eighty years without being ready to die is itself a moral failing, the sign of a life out of touch with life's basic realities.” Here we go again -- more bait and switch, with semantics that promise one thing and deliver something else.

[Author's note: Unfortunately, Andrea contracted a sepsis infection that caused her death on May 7, 2006. At least she was given a chance to live rather than being prematurely euthanized. The ethics committee that Andrea's family had to overcome was empowered by a Texas state law, but ethics committees are being formed at many hospitals across America, and taking similar actions to deny "futile care" -- even without any state laws to give them cover.]

This column was first posted on RFFM.org in August of 2006.

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Part II How a Living Will can bring about your premature death

Precautions and Alternatives by Bill Beckman

From the Editor:

This is the second in a series of columns first posted on the Illinois Right to Life Committee's (IRLC) website [http://www.illinoisrighttolife.org/] written by Bill Beckman, IRLC's executive director. The RFFM.org re-posting of the column discusses how living wills can cancel out the wishes of patients and loved ones regarding end of life issues. Also, readers can learn how to seek out alternatives to living wills and find ways to ensure their end of life issues are respected and adhered to. Included are examples of how living wills have been used to disregard patients rights.

The following was written by Bill Beckman:

We knew the push for living wills based on the Terri Schiavo case would be dangerous to people who took the bait. Recently, some cases are coming to light that confirm our fears about the dangers of such documents. A living will has nothing to do with living, but everything to do with dying.

A living will is claimed to be a mechanism for preventing unwanted medical treatment, including so-called heroic medical measures or resuscitation in the event of a healthcare catastrophe. No one wants to consider their perspective might change after they experience a healthcare catastrophe. The will to live is strong, regardless of what someone else perceives our quality of life to be. The organization Not Dead Yet understands this fact. They are fighting to maintain respect for the rights of disabled people and recognize the threat to these rights from a “quality of life” mindset that decides to deny medical services based on the futile care theory [see: http://www.illinoisrighttolife.org/newsline.htm#2006050201]

An example of a case out of Florida should establish the serious risk that living wills and futile care theory have on disabled patients. Late in 2004, Hanford Pinette was admitted through emergency to a hospital in Orlando, Florida after suffering congestive heart failure. He was placed on a ventilator and a dialysis machine. Doctors informed his wife Alice that his condition was “not likely to improve”. Then, she was informed the doctors intended to “follow his living will” and remove the provisions of ventilation and dialysis. Mrs. Pinette objected because her husband 'Hank' was alert and oriented, there was no prognosis tendered that could determine his death was eminent, he spoke (sporadically, but he managed) and he responded physically to her directions and touch. He was fighting for his life. By Mrs. Pinette's accounts, Hanford Pinette simply wasn’t ready to die.

The hospital actually petitioned the circuit courts for the authority to remove Hanford Pinette’s provisions of ventilation and dialysis, over the objections of his named surrogate (his wife Alice) and as a means of “enforcing his living will”. They won, and those medically necessary treatments were taken away from him. After two hours of struggling for air, Hanford Pinette – a nondying, cognizant and alert man - succumbed and was pronounced dead. The hospital’s deadly application of his living will overcame even Hank’s stated intention to have his own wife make his medical decisions.

Supporters of the living will claim that modern technology has allowed the artificial extension of life--in violation of human dignity. Is the artificial extension of life through modern technology really the issue? Then why is it that the issue is almost always feeding tubes and ventilators? Why are organ transplants and cancer treatments never the focus of these debates? Judgments are made about when it is appropriate to use modern technology, such as organ transplants--apparently with very limited controversy. Removal of feeding tubes and ventilators is the agenda of the “right to die” movement. Their claims of oppressive technology do not stand up to scrutiny.

Action Point: Medical institutions are required by Federal law to ask patients if they have completed an advance directive. "Advance directive" is a generic term that covers both Living Wills and Durable Power of Attorney for Health Care documents.

If you have not signed a Living Will, don't! If you have signed a Living Will, the Illinois Right to Life Committee (IRLC) urges you revoke it by locating the copies and destroying them. [The same advice applies to a poorly-worded Durable Power of Attorney for Health Care.]

As an advance directive, IRLC urges you to sign only a life-affirming version of the Durable Power of Attorney for Health Care. The IRLC's Patient Self-Protection Document [available for review at: http://www.illinoisrighttolife.org/pspdoc.htm] provides such a life-affirming Durable Power of Attorney for Health Care. Obtain it by calling Illinois Right to Life at (312) 422-9300. Protect yourself now from those who see death as the solution for difficult health care decisions.

RFFM.org Editor's Note:

If you already have a living will, rip up all copies--held by yourself or family members. Then contact every medical agency who may have made a copy of your living will and advise them the document is no longer valid. Finally, access the IRLC's Patient Self-Protection Document or find a similar life-affirming organization in your city or town which provides like-minded documents. If you have further questions, seek the advice of a trusted lawyer or call the IRLC at the above number.

This column was first posted on RFFM.org in August of 2006.

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Part I The Myth Of Living Wills

You Are Actually Signing Your Life Away by Bill Beckman

Through the next seven days, RFFM.org will publish a series of columns which first appeared on the Illinois Right to Life Committee's web site. The articles, edited and written by IRLC's executive director Bill Beckman, will address issues which include the dangers associated with living wills, hospice care and issues dealing with patient's rights. This highly important series will provide readers with information a family must have, in order to make educated decisions regarding the medical care of their loved ones. It is a must read. For more information on alternatives to living wills and other life-affirming issues, go to http://www.illinoisrighttolife.org

The following was edited + written by Bill Beckman:

The “Living Will” - a document by which a person can give, in advance, a directive to have life-sustaining medical treatment withheld or discontinued at the time of future serious illness or injury - should be avoided by anyone who respects the sanctity of human life.

Why? Because “Living Wills” were conceived and designed by “right-to-die” (pro-euthanasia) organizations and have more to do with dying than living. Signing a “Living Will” allows decisions about a patient's health care to be made by unknown medical personnel when the patient is not able to make these decisions.

If these medical personnel believe the patient’s potential for recovery or "quality of life" is too low to warrant life saving measures, they may interpret the “Living Will” to mean whatever they consider appropriate to justify denial of treatments such as a ventilator or feeding tube.

Indeed, according to Dr. Brian Clowes, author of The Facts of Life (HLI), there are several problems with “Living Wills,” as follows:

1) The person usually signs it long before he knows if or when he will be incapacitated, or what the circumstances of that incapacitation will be. This means that the person cannot specify the desired details of his treatment for future medical conditions.

2) Changes to or revocation of a “Living Will” depend upon an individual’s condition. If that the person should experience a change of heart, after they are incapable of communicating, they're out of luck.

3) If a person would like to change or revoke his “Living Will,” they may find it is very difficult to locate all original and duplicated copies of the document. [To revoke your “Living Will,” make sure that you destroy all the original copies, and as many duplicated copies as you can locate with relatives, medical personnel and medical facilities.]

4) The wording of the original “Living Will” may remain the same, but the law governing its application may change. For example, Florida “Living Wills” now presume that patients refuse food and water - unless otherwise specified - a fundamental change from the law’s original meaning (p. 115).

The Patient Self-Protection Document (available from IRLC) is an important alternative to the pro-euthanasia “Living Will.” It is a durable power of attorney for health care that: counters the nationwide push to remove food and fluids from dying (and non-dying) patients; opposes euthanasia either by omission or commission; allows the appointment of a trusted agent to carry out one's Judeo-Christian beliefs regarding treatment/non-treatment if one is unable to do so.

Is the Patient Self-Protection necessary? Yes, and for two reasons:

1) There is an Illinois law entitled the Health Care Surrogate Act (also known as Life Sustaining Decisions Act), which allows for the removal of food and water from a terminal or non-terminal patient by directive of a surrogate designated by law.

2) The 1990 federal law, the Patient Self-Determination Act, requires any medical institution accepting Medicare and Medicaid funding to ask entering patients if they have an advance directive. If the patient's answer is “no”, an option to complete an advance directive is offered, usually a “Living Will” in standardized format. The patient is not obligated to complete an advance directive, but may feel pressured under such circumstances. If the patient accepts the offer, the medical institution will record any advance directive signed by the patient.

To obtain printed copies of the Patient Self-Protection Document, or for additional information on the dangers of the “Living Will”, please contact Illinois Right to Life Committee at (312) 422-9300 or by e-mail at [email protected]  

NOTE: Part 2 in this series will bring to light nightmarish examples of how "Living Wills" have trumped the wishes of signees and spouses regarding continued medical care. The column addresses why and how "Living Wills" have been used to assign rights concerning one's life to a medical facility against the wishes of signees and family members who believed such a document would protect their rights to life.

Editor’s note: This series was first posted on RFFM.org in August of 2006.

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