Click here to sign the petition demanding the Attorney General drop this unjust case.
Yesterday, August 1, a Pennsylvania woman named Barbara Mancini endured the first of what may be many days in court, declaring her innocence and fighting for her liberty. An aggressive criminal prosecution by the office of Pennsylvania Attorney General Kathleen Kane’s office is underway, and she must respond to charges that acting out of love and compassion for her dying father was a crime.
Last February, 93-year-old Joe Yourshaw was under hospice care in his hometown of Pottsville, Pennsylvania. He was dying from multi-system failure, end-stage diabetes, extensive heart and vascular disease, stroke and kidney failure. He took morphine prescribed by his hospice physicians to relieve his pain. His daughter Barbara is a nurse, and she was helping to care for him.
The police report and criminal complaint make claims about a crime based on motives and intentions. But the undisputed facts are these: Barbara was at his bedside when he drank the partially filled bottle of morphine and lost consciousness. A hospice nurse arrived, and the hospice called 911. EMTs transported Joe to the hospital, over objections that he wanted to die at home. At the hospital they injected Narcan to counteract the morphine and he woke up, irate at finding himself hospitalized. Hospital staff provided extensive medical care, including morphine, until he died there four days later. A coroner declared Joe died from “morphine toxicity” and pronounced his death a homicide.
After the local district attorney recused himself because of a friendship with Barbara’s sister, the Pennsylvania Attorney General’s office took over the case and decided to throw the book at Barbara. At last week’s hearing the prosecutor pressed his arguments for felony charges and resisted a defense motion to reduce the charge to a misdemeanor.
So much is wrong in this story of a state’s overreaching police power; it’s hard to know where to start.
First, the state insists Joe wanted to commit suicide when he asked for his morphine. In the state’s thinking, Barbara committed the crime of causing or aiding a suicide, a second degree felony that carries a maximum penalty of 10 years in prison. But Joe was dying and he was in agony. If some part of him wished for his agony to be over, does that make him “suicidal” in the eyes of the law? Only in some rigid and dogma-ridden theocracy would that interpretation be defensible. Most Americans believe government should not be meddling in the deeply personal decisions of a dying man. Most Americans, and a growing number of mental health professionals, believe that even if Joe did have his death in mind when he asked for morphine, a rational intention to advance the time of death in terminal illness is fundamentally different from irrational suicidal ideation in mental illness. Joe was dying; his intention cannot be proven, and it’s none of government’s business anyway.
Second, irrespective of prosecutors’ personal moral beliefs, they serve the people. Applying the law of Pennsylvania to punish pain relief is just plain wrong. It undermines the public interest in promoting effective pain management at the end of life. Doctors are already reticent to prescribe enough medication to stay ahead of pain as it escalates during active dying. This is just the sort of case that scares doctors and nurses into letting their dying patients suffer rather than risk the scrutiny of an over-zealous prosecutor. Putting Barbara Mancini on trial is likely to increase the suffering of many — those dying in Pennsylvania and beyond.
Third, a criminal prosecution so unlikely to succeed qualifies as a waste of public resources. Long ago Hubert Humphrey observed, “There are not enough jails, not enough policemen, not enough courts to enforce a law not supported by people.” One need only look to the example of Michigan. Between 1994 and 1997 the state put an infinitely less sympathetic defendant, the grandstanding Jack Kevorkian, on trial four times for assisting suicides. Three acquittals and one mistrial later, Oakland County prosecutor Richard Thompson lost the primary election and attributed it in part to the lack of public support for the prosecution of Kevorkian and its associated cost. Barbara Mancini, a humble person, devoted daughter and skilled nurse, is as far from Jack Kevorkian as one can imagine. How likely is a jury to label her a felon and send her to jail?
Finally, the state must recognize that Joe Yourshaw should have had another alternative besides suffering his agony or searching for relief on his own. If he was yearning for a peaceful, pain-free end to his long life, he should have been able to speak frankly to his doctor and hospice nurses. Dying patients in every state should experience the same peace of mind as those in Oregon, Washington, Montana and Vermont. In those states patients can choose a peaceful passing as part of their end-of-life medical care. Those state governments acknowledge that freedom of conscience includes the freedom to die on one’s own terms, in the sanctity of the home and the arms of loving family. The police took this freedom from Joe Yourshaw and would put those who defended it in jail.
We at Compassion & Choices intend to put Mancini’s criminal prosecution in the public eye and hold it up for public dialogue. You can join our call to drop the “assisted suicide” charge against Barbara Mancini here. The Yourshaw family is suffering mightily at the state’s hands today. But perhaps their story can help change public policy and establish end-of-life liberty for those who follow.
Barbara Coombs Lee is president of Compassion & Choices, the nation’s oldest and largest nonprofit organization working to improve care and expand choice at the end of life. Before becoming an attorney advocate, she had a 25-year career as a nurse and physician assistant, and often cared for terminally ill patients.