End-of-Life Choice, Palliative Care and Counseling

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Compassion & Choices Action Network Legal Defense Fund

By now you know the plight of Barbara Mancini, the Pennsylvania woman who stands accused of “assisted suicide” in the death of her terminally ill 93-year-old father, Joe Yourshaw.

Despite months of public outrage and near-universal local condemnation, Pennsylvania Attorney General Kathleen Kane refuses to back down on her unjust prosecution of Barbara. As the case heads for trial, Barbara faces up to 10 years in prison.

As you can imagine, this harrowing ordeal is a tremendous emotional burden on the Mancini family — Barbara, her husband Joe, their children, and her widowed mother.

Yet the family also bears an enormous financial burden. Barbara has been placed on unpaid leave from her job as an ER nurse. Her husband, a Philadelphia paramedic, must work overtime as the family’s legal bills mount.

Compassion & Choices has long provided legal support in cases where our justice system is at odds with the reality of compassionate end-of-life care. Now, to help families like the Mancinis, we have a Legal Defense Fund as part of our Compassion & Choices Action Network.

Please make a gift to the Compassion & Choices
Action Network’s Legal Defense Fund today.

Gifts to the Legal Defense Fund will defray legal fees and associated expenses of people and organizations facing civil, criminal or disciplinary legal action. Because of its express purpose, contributions to the Fund are not tax deductible.

Barbara Mancini is like thousands of other daughters and sons caring for aging and dying parents. She sat by her father’s bedside as he suffered a painful litany of ailments, including end-stage diabetes, heart and cardiovascular disease, stroke, kidney disease and arthritis. Enrolled in hospice, he yearned to die peacefully, at home. He gave Barbara medical power of attorney to carry out his end-of-life wishes.

Authorities allege that Barbara handed her dying father a partially filled bottle of morphine at his request — an act they construe as “assisted suicide.” A hospice nurse who arrived shortly after Joe ingested the medication called 911. Revived at the hospital, he was furious to learn that his daughter was under arrest. He died with that anguish — after the hospital gave him still more morphine — four days later.

Families suffer when loved ones die. The pain of that loss is unimaginable. And when a good death — at home, surrounded by family — goes awry, it’s doubly painful. Add to that the strain of criminal charges, lengthy legal proceedings and soaring costs … well, it’s more than anyone should have to bear.

You can help Compassion & Choices Action Network
fight legal battles like this.
Contribute to our Legal Defense Fund today.

Thank you for your generous support.

P.S. If you have not yet done so, I urge you to read Joe Mancini’s moving essay, which so beautifully captures his wife’s generous and giving nature. Read it here. Your gift to the Compassion & Choices Action Network Legal Defense Fund can have a profound impact on good people like the Mancinis who are caught in a legal nightmare.

DNR: A Supporter’s Story


Mr. Demarest powerfully exposes how the medical system  disregards the most thorough end-of-life plans with  its default mode to provide treatment – no matter the  patient’s circumstances and wishes.

The stories Mr. Demarest and others shared complement our national campaign to stop this tragedy and raise awareness to ensure that someday we’ll all be allowed to die with peace and dignity.

My father prided himself on doing everything right, by planning everything in advance. By the time he was in his 70s and I was in my 30s, he had shown me where he kept the key to his filing cabinet and where I could find his stash of silver coins. He told me about his will. And his living will.

I watched as Pop declined from a spry 85-year old who won sailing races on Glen Wild Lake and traveled to China and all over the United States to run his business, to a 95-year old who hobbled around, first with a couple of canes, then a walker, and finally in a wheelchair, while his wife Eileen ran the business.

During this decline, we discussed his living will more than once. When the time came, there were to be no heroic measures. There were to be no feeding tubes and no respirators, no CPR and no defibrillation. We neglected to discuss the most important part of his living will. Under just what circumstances were there to be no heroic measures? Did he believe at the age of 95, that he had reached that point? I didn’t ask, nor did I look at a copy of the living will. Everything seemed to be far off in the future, and I lived 3,000 miles away. His end-of-life plans were the responsibility of his wife, Eileen.

A few days before Pop’s 96th birthday, he and Eileen planned to go out to dinner with friends. Two of the friends, Jane and Angie, wheeled Pop out of the house and transferred him into the car. Almost immediately, he said, “I want to go home,” started to get out of the car, and slumped back into the seat, not moving. Angie interpreted his statement to mean I want to go to Heaven, and said to Pop, “it’s all right, you can go.”

Jane called 911. Pop’s house was on a long, hilly, twisty one-lane road,. and there was no expectation that emergency personnel would arrive quickly, A few neighbors came over until there were a half dozen people standing in the driveway while the minutes ticked by with Pop, or rather his dead body, sitting in the front seat of the car. During these ten minutes waiting for help, any possibility that Pop, not breathing, could survive slipped away

When the policeman arrived, he moved the body from the car to the driveway and began administering CPR. The ambulance arrived with the EMT, who continued the CPR and then used the defibrillator, applying the paddles and the electric shock to Pop’s chest. They loaded Pop’s body into the ambulance, still doing CPR, and everybody followed to the hospital where he was officially pronounced dead.

I can’t blame Eileen or Pop’s friends and neighbors for not attempting CPR, because I don’t know the wording of Pop’s living will. I’m sure that the police and the EMT followed the rules by attempting CPR and defibrillation. I’m also sure that my father never would have wanted people pounding on his dead body for more than a half hour, and that’s what happened.

At the hospital, Jane asked the EMT about the CPR and defibrillation. “Why did you do this?”

“It’s for the widow.”

– Harry Demarest

Talking Turkey Over Turkey

The holiday season is coming, and with it dinners and get-togethers with family and loved ones. Yes, you guessed it: It’s the perfect time to sit down and talk about your end-of-life wishes.

Seriously. With siblings and multiple generations united, conditions are ideal to talk turkey about an important issue we all will face. Need to get Mom or Dad to discuss their end-of-life preferences? Trying to get your adult children to listen to your thoughts about dying? You’ll find that they are surprisingly receptive at family gatherings. How do you get the conversation started?

After many attempts to get family members engaged, one Compassion & Choices client set her Thanksgiving table with advance directive forms at every place setting and announced, “Nobody gets dinner until these Are filled out.” Now that’s some tough turkey. Your best approach is the one that suits you and those around you. And while the paperwork is important, the essential thing is to get the conversation going!

1.  How do you feel about life support if:

  • you have a terminal illness?
  • you’re in a permanent coma?
  • you have an irreversible chronic illness like Alzheimer’s disease?

2.  Do you always want to know the truth, the whole truth, and nothing but the truth? About your condition? About treatment options and their odds of success? And what success means for quality of life?

3.  What will be important to you when you are dying? No pain? Hold on as long as possible? Family members present? What are your priorities?

4.  Would you want to be placed in a nursing home if your condition warranted?

Are you good to go?

We have the tools you need to guide your conversation and document the results. They’re all in our Good-to-Go Toolkit, and they’re all free:

  • A values worksheet to structure your decision-making.
  • Advance directive forms for every state.
  • An optional dementia provision – that only Compassion & Choices offers.
  • Contract rider for assisted-living facilities contracts. Use this to ensure your new home intends respects your choices.
  • Visit tiny.cc./advance-directive
  • Call 800.247.7421 to get info by mail or to speak to one of our consultants.

Conversation Starters

Here are some ways to get the conversation going.

“I want to be certain you guys know what I would want if I ever get seriously ill or can’t speak for myself. What do you think I would want? What would you say to the doctors for me? What would you want me to say for you?”

“My doctor/attorney/pastor says I need to go over my advance directive with you.”

“If one of us ever had to make decisions about your treatment because you couldn’t, it would be much easier if we knew what you really want.”

Download and Print These Valuable Tools

Talking Turkey Conversation Starter

This one-page conversation starter will help you get the ball rolling at your next family gathering.


Fall Magazine and Annual Report

Download the full Fall Magazine and Annual Report here for the full text of Talking Turkey and much more.


Compassion Is Not a Crime

By Barbara Coombs Lee
Compassion & Choices
Aug 2, 2013

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. More

Nurse Charged With Assisting In Her Father’s Death

By Richard Knox
NPR News
July 31, 2013

A Philadelphia nurse has been charged with assisted suicide for allegedly providing her 93-year-old father with a lethal dose of morphine.

Authorities say Barbara Mancini, 57, told a hospice nurse and a police officer on Feb. 7 that she provided a vial of morphine to her father, Joe Yourshaw, to hasten his death.

Mancini and her attorneys acknowledge she handed the medication to her father, but maintain she never said she intended to help him end his life and was only trying to help her father ease his pain — an act they say is legally protected, even if it causes death.

“Barbara did not, would not, would never hand medicine to her father with the sole purpose — or with even a remote purpose — that he was going to intentionally end his life on her watch,” Mancini’s lawyer, Frederic Fanelli, told reporters during a teleconference Wednesday. “It’s ridiculous, it’s abhorrent that they would even say that.” More