In case anyone missed it, Frank Bruni’s column in the NY Times on Saturday, August 10 featured comments from yours truly. The subject was the possible prosecution of 57-year-old Barbara Mancini regarding her alleged assistance in her 93-year-old father’s suicide – although suicide attempt might be more accurate.
Here’s an excerpt from one of the most detailed accounts of the incident, from NPR:
Joseph Yourshaw was a hospice patient suffering from diabetes and frailty. According to an autopsy report filed by Dr. Rameen Starling-Roney, he stopped taking all medications in December 2011. “He drank regular soda, [and ate] two boxes of candy per week and multiple pastries,” the report notes — a diet that would be expected to worsen uncontrolled diabetes.
In January 2013, the autopsy report notes, an entry in Yourshaw’s hospice chart says he told his family “that he wants to die.” His wife, Marguerite, reportedly said, “Your daughter [apparently referring to Barbara Mancini] told you how to do that. Just stop drinking.”
Yourshaw became increasingly weak and short of breath. Hospice records show that Mancini called to request low-dose morphine for Yourshaw’s pain. On Feb. 6, he had a fall. The next day hospice nurse Barbara Cattermole paid a call to check on him at home and found Yourshaw unresponsive in bed.
Cattermole told authorities that Mancini said she had given an entire vial of morphine to her father to end his life, while Mancini says she was merely trying to relieve his pain.
The hospice nurse called 911 and reported an attempted suicide. Pottsville Police Capt. James K. Reiley, who responded to the call, wrote in a criminal complaint that Cattermole “told me that her client had taken an overdose of his morphine with the intent to commit suicide. Cattermole further stated that her client’s daughter was present and told her she gave him the morphine at his request so that he could end his own suffering.”
The only uncontested action on Barbara Mancini’s part is that she gave her father a vial of his own prescription medicine. She didn’t mix or prepare anything – or measure out any kind of dose. That has come to be seen as a low level of “assistance” and has failed to trigger any sort of criminal conviction in several cases (the definition of “assistance” is being fought out in several legal arenas right now). There’s more:
“It’s nonsense to assert that one can die from morphine toxicity from a dose taken four days earlier,” Fanelli tells Shots. “It’s unsupported medically, scientifically, and it just doesn’t make sense. The fact is, after he was given narcotic reversal agents in the hospital, Joe woke up and was raising hell with everyone, [saying], ‘Why did you revive me and why is everyone picking on Barbara?’ “
If this is true, it’s hard to see how one could prove to any jury that any medication dose involving Barbara Mancini could have actually caused her father’s death four days later.
This provides some context for my comments in Frank Bruni’s column Fatal Mercies:
And the lightness of this alleged assist, coupled with the ambiguity of its connection to his death after he’d rebounded from the overdose, has not only provoked outrage from Compassion and Choices, an organization that supports more options in end-of-life care.
It has also prompted befuddlement on the other side of the issue, with a leading opponent of assisted suicide scratching his head about the way the case is being handled. “It is odd to see one like this prosecuted,” Stephen Drake, the research analyst for the advocacy group Not Dead Yet, told me.
He added that the case worries him, because if it gets significant publicity and informs what many people believe assisted suicide is, they’ll see it as a more benign act than he believes they should. “It’s going to make it even harder to prosecute ones that really call out to be prosecuted,” he said.
Bottom line: It doesn’t help our side to see an ambiguous case that will elicit maximum public sympathy get prosecuted to the full extent of the law. And, in fact, before the advent of assisted suicide advocacy and even now, prosecutions of incidents like this were – and are – relatively rare. Prosecutorial discretion has always functioned to handle these cases flexibly – in many cases too flexibly, we’d argue; but that’s a discussion for another day. Heightened publicity for this case, along with the suggestion that Barbara Mancini could be prosecuted to the fullest extent of the law, plays right into the hands of Compassion and Choices. Get people pissed enough, make it politically disastrous enough, and no prosecutor will want to touch a case like this again in the state – even when factors such as coercion and/or financial motives are in evidence.
Anyway, what my brief appearance in the NY Times on Sunday has done is to draw the attention of the Diane Rehm Show. I’ll be on the show, representing Not Dead Yet, sometime between 10 am and 11:00 am ET on Aug. 13 on your local NPR station. You can read more about the show here.
Yes! Compassion and Choices loves this kind of publicity that supports their contention that The State is unreasonable not only in the prosecution of a “compassionate daughter” who happens to be a Nurse but equally unreasonable in denying citizens the right to “assisted suicide” on demand. I’m sure Compassion and Choices are delighted.
I would not be opposed to all of their recruiting and politicking if they were equally vigilant in protecting the autonomy of those patients who CHOOSE to live and NOT SHORTEN their lives by refusing life-extending care and/or committing suicide. —-and where DO they really get their money from????? Compassion and Choices must KNOW that unilateral DNR Code status is being misused to remove the autonomy for choice from the elderly but yet they do NOTHING to explain all of this to the public –and why not?
Of course this organization is supporting government policy as envisioned in the 1991 PSDA wherein those who elect to shorten their lives with an advanced directive — do save Medicare and the private insurers lots of money. Assisted Suicide, of course, is the cheapest and fastest and, therefore, the moist efficient method of shortening life that just coincidentally cuts the costs of end- of- life care for the suicide victim AND Medicare/Medicaid.
Can’t understand WHY the prosecutors would elect to file this case to begin with as there is no accounting for the HOSPCE drugs once they are delivered to the house of the Hospice Patient and it is generally the unprofessional primary care giver (usually a family member) who is responsible for administering the drugs as needed out of the residential refrigerator, There are no Charts maintained by HOSPICE on when drugs are administered. Until the last days, when death is imminent, there may be only a few one- hour visits a week to the patient from the Hospice Organization, Does the prosecutor have other fish to fry? Who knows? .