Sunday, August 25, 2013

Case Watch: Pennsylvania Daughter/Nurse Charged with Unlawful Assisted Suicide in Elderly Father's Death

Pennsylvania's Attorney General  has taken over prosecution of Barbara Mancini, a Pennsylvania woman in her fifties, for allegedly providing a vial of morphine to assist her 93-year-old father's suicide.  The AG's role was prompted by a conflict for the local District Attorney.

According to news accounts, the father, Joe Yourshaw, was on hospice with severe complications from multiple conditions, including diabetes, kidney failure and heart problems.   In Pennsylvania, "hospice" status is  limited to "terminally ill" patients, requiring a medical opinion that the patient's "life expectancy is 6 months or less." 55 Pa. Code Section 1130.3

The daughter, who is a nurse, is alleged to have made self-incriminating statements to a hospice nurse, who in turn called 911.  A central issue is whether the daughter's February 2013 actions were intended merely to relieve her father's pain or end his life as he requested. 

While Oregon, Washington, Montana and Vermont permit some types of assisted suicide, Pennsylvania does not, and in fact Pennsylvania was among the last of the states to enact laws  permitting individuals to adopt "advance" directives for end-of-life treatment decisions such as whether to continue hydration and nutrition.   Assisted suicide is, of course, even more controversial. 

Pennsylvania law states that "a person who intentionally aids or solicits another to commit suicide is guilty of a felony of the second degree if his conduct causes such suicide or an attempted suicide, and otherwise of a misdemeanor of the second degree." 18 Pa.C.S.A. Section 2505(b).

To complicate the Mancini case history, according to news accounts Yourshaw was transported by emergency personnel from his home to a hospital, where he was administered an antidote to the morphine, even though he reportedly had a "Do Not Resuscitate" directive in place.  Yourshaw reportedly  survived four days before dying.

Daughter Barbara Mancini's case is now awaiting a trial date in Schuylkill County's Court of Common Pleas.  The case is attracting national attention, with recent editorials opposing prosecution appearing in Harrisburg's Patriot News and the New York Times.

The nonprofit organization Compassion & Choices has initiated a campaign calling for the AG to drop the case and it describes the prosecution as an example of "a state's overreaching police power."  However, in 1997, in Washington v. Glucksberg, 521 U.S. 702, the U.S. Supreme Court declined to recognize a constitutional right to assisted suicide, thereby upholding the rights of states to bar assisted suicide even if performed by physicians. 

In Glucksberg, the Supreme Court observed that "Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide," while concluding that the court's own decision "permits this debate to continue."   

The Mancini case appears to place the issue of "elder" assisted suicide on center stage, while at the same time shining a light on an important sub-set of the issue, the "morality, legality and practicality" of potential roles played by family members in an elder's decision-making and actions.

News stories on the Mancini case often include a poignant photograph, of the daughter on her wedding day, dancing with her father.

Advance Directives/End-of-Life, Ethical Issues, Health Care/Long Term Care | Permalink

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