Fighting Doctor-Prescribed Suicide: A Nurse's Perspective

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On Saturday, Sept. 23, 2017, Nancy Valko, R.N. spoke at MCFL-sponsored events in Fall River and Sandwich. Valko recounted her personal experiences of a nearly 50-year career in healthcare as an advocate for her most vulnerable patients.

Valko’s writings are frequently seen on this web site and she was also the keynote speaker at the 2015 MCFL Convention. She blogs at NancyValko.com. The following article is from the Summer 2015 MCFL Magazine.

In her 45-year career in oncology, trauma, ICU, and hospice nursing, Nancy Valko experienced how changing attitudes about death, suicide, disability, and human dignity impacted health care. 

Valko didn't believe pro-life predictions that the legalization of abortion would lead to infanticide and euthanasia. "When I started nursing in 1969, everybody was on the same page ethically, but I saw tremendous difference after abortion was legalized," Valko said. "But, I thought doctors and nurses could never look someone in the eye and kill them."

Her beliefs soon began to change. In 1982 the parents of a Down's syndrome newborn known as Baby Doe rejected life-saving surgery to fix a correctible esophageal defect leaving their son to die from starvation and dehydration. "I was really upset. I thought that they should operate. A pro-choice friend told me I had never been there and couldn't know what baby Doe's parents were going through," Valko said.

However, six months later, Valko did know. Her daughter Karen was born with Down syndrome and a severe heart defect. Valko learned firsthand the discrimination against children born with handicaps. "The cardiologist said he would support my decision either way in choosing surgery for my daughter's heart problem," she said. "In those days it was hard for parents with Down children to get good treatment in hospitals. They told me they overheard a doctor referring to Down kids as 'mongoloids.' I was outraged."

Valko found her advocacy for her daughter changing hearts and minds. She became involved with disability groups and developed programs to help parents of disabled newborns in the St. Louis area. "Dr. Arnie Strauss, chairman of the Cardiology Department went on to form one of the first Down syndrome clinics at Children's Hospital in St. Louis," Valko said. "I lost Karen at six months of age to pneumonia. The care for special medical needs of children with Down syndrome is my daughter's legacy," she said. "My daughter's life changed a lot of people, but she changed me the most as I began to see abortion, infanticide and euthanasia as part of a whole piece."

Valko began to warn about the use of 'living wills' as the first step towards acceptance of euthanasia. "St. Louis had several cases of water being withdrawn in order to hasten death in cases where 'quality of life' was an issue," she said. "The Nancy Cruzan case involved the removal of a feeding tube for a patient in a persistent vegetative state. I was a nurse before 'vegetable' was a diagnosis. I had to struggle to get patients such as Cruzan accepted as disabled." 

Valko's personal life continued to parallel significant pro-life issues. "My husband had a breakdown and abandoned the family just as my mother suffered with Alzheimer's disease and inoperable cancer," Valko said. "This was when Jack Kevorkian was gaining national notoriety after he killed his first victim, a woman with mild Alzheimer's. At that time, Alzheimer's was lumped in with vegetative state. I had someone ask me if I was going to continue to feed my mother.

"In my career as an oncology and hospice nurse the idea was to never hasten or prolong dying. But now with emphasis on 'patient's wishes,' there's this idea we have to do what the patient wants. I'll do anything for my patients except kill them or help them kill themselves."

During this time Valko's older daughter endured a long battle with drug addiction. When her daughter became pregnant at eighteen she encouraged her to consider adoption. "Eventually, she slipped back into drug use and became suicidal." Said Valko, "In my career I've worked with many suicidal people, but I never lost anyone until my daughter.

"Our young people are getting caught up in this. They have suicide websites like they have anorexia websites. A detective told me that the medical examiner called my daughter's suicide 'Textbook Final Exit.'" Valko's daughter learned online how to kill herself using a technique described by suicide advocate Derek Humphry, founder of the Hemlock Society, now known as Compassion and Choices. "That was devastating," Valko remembered.

Valko sees a danger for young people in the campaign for doctor-prescribed suicide. "The media is normalizing and glamorizing suicide. They exploited the case of Brittany Maynard, the young woman suffering from brain cancer who is my daughter's age who moved to Oregon to take a legal overdose to end her life. She's a spokesperson for Compassion and Choices; the Brittany Maynard Fund raises money to go and advocate for suicide in every state. They put her on the cover of People Magazine with a countdown until her announced suicide date of November 1. Maynard is standing on a virtual window ledge and the media is saying 'jump.'

Doctor-prescribed suicide is being sold as only for people in intractable pain, but that's a big lie.

The top reasons for choosing a legal overdose in Oregon is not pain, it's fear of being a burden, loss of autonomy and loss of ability to enjoy certain activities. In Holland people who are depressed or just tired of life can be euthanized. Suicide groups think this should be a legal right for anyone.

End of life issues are being sold to the public through television programs. They are subversive and effective. Medical and legal dramas portray the subject as 'sometimes it's just better if people die.' I say suicide is a tragedy to be prevented; they say it's a civil right. All this has tremendous impact in the hospitals.

Valko almost lost her job as an ICU nurse by challenging the care given to a 72-year-old patient who remained unconscious after routine surgery and required a ventilator. The patient was pronounced brain dead by a neurologist. Valko found a doctor's order to increase morphine until the patient stopped breathing. "The man wasn't in any pain. I turned off the morphine drip and started some oxygen. I said to another nurse don't tell me this is 'comfort care.' I went up the nursing administration chain of command saying 'I can't do this.' Some nurses agreed with me others didn't. I had three children to support and I expected to be fired, but I had to stand up for principle." Valko continued, "Then the most amazing thing happened. Things started to change. That kind of incident only happened one other time, and then it stopped. In a similar case nurses recognized and refused to go along with overdosing a patient with morphine telling me 'you opened our eyes.'"

Valko finished her nursing career as a consultant helping to draft protective laws in several states. "My pro-life work is a legacy from my daughter. The media is trying to make suicide look pretty, but suicide is an atom bomb dropped on a family. It's a tremendously horrible thing. The fight against doctor-prescribed suicide is about principles, not feelings. It's worth standing up for your principles."

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Following her talk, Valko posted the following public message:

I gave a talk In Massachusetts Saturday about how abortion logically led to the increasing acceptance of euthanasia. (Massachusetts is facing a revival of a physician-assisted suicide bill that was thought to be dead in committee. Prayers needed for new testimony schedule for Tuesday.)

I used stories from my own life and one, of course, was about the medical discrimination my daughter Karen, who had Down Syndrome) and I faced.

After the talk, a young mom came up with her beautiful little boy who had Down Syndrome. Tears were streaming down her face. I was worried that what I said had upset her but instead, she told me that she was crying because Karen’s story was so beautiful and inspiring!

I almost cried myself.

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