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WHAT ABOUT VENTILATORS AND “PULLING THE PLUG”?

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WHAT ABOUT VENTILATORS AND “PULLING THE PLUG”?

By Nancy Valko, RN
Reprinted with the author’s permission from her blog: https://nancyvalko.com/2019/03/08/what-about-ventilators-and-pulling-the-plug/
When I first became a registered nurse in 1969, ICUs (intensive care units) were still new. The first one I worked was set up in the former visitors’ lounge. We learned how to read EKGs (heart tracings) by using a book. By the early 1970s, I worked in a surgical/trauma ICU where we used sophisticated ventilators. We were able to get almost all our patients off ventilators by weaning—the process of gradually lowering ventilator support until the patient can breathe on his or her own.
However, in 1976, I was shocked by the Karen Quinlan case. It changed everything. Karen, 21- years old, had suffered brain damage after apparently taking drugs at a party. She was hospitalized and placed on a ventilator. Thought to be in a “persistent vegetative state”, her adoptive parents asked that her ventilator be removed. The doctors disagreed. Eventually the New Jersey Supreme Court allowed removal of the ventilator on the grounds of an individual’s right to privacy. Shortly afterward, California passed the first “living will”, an advance directive law that permits refusal of “life support” in the event the signer is incapacitated.
Ironically, Karen lived 10 more years because, as some ethicists criticized, she was weaned off the ventilator instead of it being abruptly stopped.
My experience with ventilators became personal in 1983 when my baby daughter, Karen, died on a ventilator before she could get open-heart surgery. One young doctor had offered to take her off the ventilator to “get this over with.” I reported him to the chief of cardiology who was furious with him.
In the 1990s, I returned to working in an ICU and was shocked by the development of the “terminal wean” for some patients on ventilators. Often the families were told that there was no hope of a “meaningful” life. The terminal wean involved abruptly disconnecting the ventilator and “allowing” the patient to die. I brought up at least trying gradual weaning and oxygen as we did for the other patients on ventilators, but I was ignored.
After retiring from bedside nursing, I was asked to be with an elderly man on a ventilator who had suffered a massive stroke. The family was told that he would never have any quality of life and would die soon. I tried to bring up gradual weaning. but some members of the family were adamantly opposed. When the ventilator was stopped, I held the man’s hand and prayed while he gasped for air and turned blue. I asked the nurse to at least giving him oxygen for comfort, but she ignored me. Instead, she gave frequent doses of morphine intravenously until the man’s heart stopped after 20 minutes.
I’m still haunted by this man’s death.
INFORMED CONSENT?
The medical definition of informed consent requires understanding “the purpose, benefits, and potential risks of a medical or surgical intervention….” But most people, when they sign a medical advance directive, have only a vague understanding of the ventilator and very little information about this often life-saving medical intervention.
As a nurse, I found that most people—especially the elderly—tend to automatically check off ventilators without understanding that a sudden problem with breathing can come from treatable conditions that don’t require long-term use of a ventilator, such as asthma, drug overdose, pneumonia, and some brain injuries.
In some circumstances, such as certain spinal cord injuries and late-stage neurodegenerative diseases like amyotrophic lateral sclerosis, the ventilator is necessary long-term to live. People like Christopher Reeve and Stephen Hawking have used portable ventilators to continue with their lives. Some people with disabilities use small ventilators only at night.
It is important to know that ventilators move air in and out of the lungs but do not cause respiration—the exchange of oxygen and carbon dioxide that occurs in lungs and body tissues. Respiration can occur only when the body’s respiratory and circulatory systems are intact. A ventilator cannot keep a corpse alive.
It’s also important to know that not all machines that assist breathing require the insertion of a tube into the windpipe. Non-invasive positive-pressure ventilation (like the BiPap) allowed my elderly friend Melissa to use a face mask to assist her breathing until antibiotics cured her pneumonia.
WEANING FROM A VENTILATOR
Many patients are easy to wean from a ventilator, but some are more difficult.
Years ago, I cared for an elderly woman with Alzheimer’s who needed a ventilator when she developed pneumonia. She had made her son and daughter her medical decision makers in her advance directive. When the woman improved, the doctors found it very difficult to wean her from the ventilator. They spoke to the family about removing the ventilator and letting her die. The daughter agreed but the son was adamantly against this.
The woman was totally awake after the sedation to keep her comfortable on the ventilator was stopped. She was cooperative and made no effort to pull out the tube in her windpipe. She just smiled when asked if she wanted the ventilator stopped.
I knew some great respiratory therapists in the past who were able to successfully wean difficult patients from ventilators. At my suggestion, she was transferred and a week later we were told that she was successfully weaned. About a year later, I encountered the woman again when she was recuperating after routine surgery. Although her Alzheimer’s disease was unchanged, she was doing well in an assisted living residence.
THERE ARE NO GUARANTEES
As a student nurse, I was initially intimidated by ventilators. As I learned how to use them and saw the constant improvements, not only in the technology but also in our care of patients on ventilators, I came to see ventilators as a great blessing when needed.
While we are never required to accept treatment that is medically futile or excessively burdensome to us, sometimes this can be hard to determine in a crisis. Most of my patients on ventilators recovered, but some could not be saved. We were surprised and humbled when patients with poor prognoses recovered while others who seemed to have a better chance died unexpectedly. There are no guarantees in life or death.
That is why my husband and I wrote advance directives that designate each other as our decision maker with the right to have all current options, risks and benefits of treatment fully explained.
We don’t want an advance directive that could be hazardous to our health!
Note: To learn more about medical advance directives or to download HALO’s LAMP (Life-Affirming Medical Proxy) document, visit our website at www.HALOrganization.com.

CULTURE OF LIFE STUDIES PROGRAM

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CULTURE OF LIFE STUDIES PROGRAM

A Life-Affirming K-12 Educational Program
By Mary Flores
The threats to our children’s future are devastating. Today’s young people are not receiving a solid education in the basic understanding of the dignity and value of human life. We see this in what one teen from a Catholic school wrote to us about the threat of euthanasia:
Another big thing is euthanasia or mercy killing—killing someone if he is dying. To me it is not that bad if someone is old and suffering and he wants to die and you take him off life support. I don’t see that as bad. What is bad is when he doesn’t want to die and you do it anyway.
The sad thing is, this student isn’t alone. Many young people today, even those who have grown up in good Christian homes, believe the lies that our twisted culture spouts at them.
There is a dire need to educate students on the dignity of persons at the end of life; to teach them the truth about the value of all human beings, the sacredness of the sacrament of marriage, and the necessity of the family as the building block of society.
The good news is that such a program exists. The Culture of Life Studies Program does all of that and more!
The CLSP is a K-12 program that provides teachers and parents with the tools they need to help their students become evangelists of the culture of life—a culture that respects the dignity of every human being from creation to death regardless of age, appearance, or ability. The program has been endorsed by Cardinal Raymond Burke and Fr. Frank Pavone (founder and president of Priests for Life). Every CLSP lesson is created with the help of pro-life leaders and subject-matter experts such as Dr. Dianne Irving, Bobby Schindler, the members of the Healthcare Advocacy and Leadership Organization, Philip Lawler, attorneys from the Thomas More Law Center, Coleen Kelly Mast, and a host of other priests, doctors, lawyers, and educators.
CLSP materials are positive, engaging, and flexible. Unit studies can be easily integrated into an existing curriculum, and the materials are appropriate for even the youngest students.
For the past several years, the CLSP has been a program of American Life League. During that time, God has blessed this program with many successes. Here are some highlights:
  • Since 2015, the CLSP has released a full line of pro-life educational materials for students in preschool through 12th grade.
  • Over 175 schools across the US and Canada teach CLSP lessons, including the entire Diocese of Wilmington, Delaware, where the program received its first diocesan-wide endorsement.
  • CLSP materials were granted an imprimatur and nihil obstat by the Most Reverend Michael F. Burbidge, bishop of the Diocese of Arlington.
  • In 2017, the Culture of Life Studies Program shared its Who Was the Real Margaret Sanger? video and discussion guide with 14,000 pilgrims (mostly young people) travelling to the March for Life. Who Was the Real Margaret Sanger? has also aired repeatedly on EWTN, sharing the truth about Planned Parenthood with an even wider audience.
Given the success the Culture of Life Studies Program has enjoyed and the team’s reliance on God, the program recently took a huge leap of faith. We have now officially separated from American Life League to form a new organization—Light and Shield Ministries!
Under this new ministry, the Culture of Life Studies Program will continue its important work of serving parents and teachers. Light and Shield Ministries will include more much-needed programs, like Life Defenders (a youth outreach program) and other life-affirming initiatives.
Leaving American Life League presents us with both opportunities and, obviously, challenges. This next year we are poised to triple the number of schools teaching CLSP materials, we’re working with several dioceses to secure diocesan-wide endorsements, we have multiple lessons in the pipeline (including a revision of our euthanasia lesson for high school students!), and we have plans to attend several pro-life and educator conferences, which will provide an essential opportunity to spread the word about our program. But to continue our important work, we need your help!
I hope you will take the time to learn about this important life-affirming program. Truly our future depends upon it! Visit the CLSP website atcultureoflifestudies.com, click on the yellow “store” button in the upper right-hand corner to be directed to the CLSP store, and peruse the incredible life-affirming, educational materials we have created for students of all ages.
Would you like to ensure that the next generation is equipped to take up the fight to defend preborn children, respect all human beings from creation until death, and speak the truth with confidence in defense of the innocent?
I invite you to join our team of ambassadors for life by committing to pray for our efforts, offer your financial support, or by working with me to introduce your local schools to the CLSP.

Please e-mail me at MFlores@CultureOfLifeStudies.com or call my direct line at 540-907-9648 to learn how you can support this crucial life-affirming educational program. And watch the next HALO newsletter for an article on our newly revised edition of Euthanasia: An Introduction! We have expanded this lesson to include three classes, which examine the complex topic of euthanasia by peeling back the layers of rhetoric to show students what is really at the heart of end-of-life issues. Using Church documents, this supplement provides students with a basic understanding of the Catholic Church’s teachings on euthanasia and gives students the tools they need for defending those teachings against cultural attitudes and pro-euthanasia arguments.

DEATH IN NEW BRAUNFELS, TEXAS

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By Gloria Hartman

My husband, Tony, was 80. He did not have cancer, heart disease, or any terminal illness. He had moderate dementia and was disabled from a stroke suffered on August 2, 2017. After the stroke, he needed a wheelchair to get around. Although he continued to have mini-strokes, Tony did not complain of pain or headaches. He was able to converse, answer questions, smile, and pray his Rosary. He said “I love you” often. We rolled his wheelchair up to the table and he fed himself.
After spending a couple of months in two different facilities for rehabilitation, Tony moved home under my care and the care of paid caregivers. On November 1, 2017, I signed him up for hospice care, as I thought hospice was compassionate and would provide the supplies and nursing care he needed. On her first visit, the hospice nurse brought a bag full of the “end-of-life” drugs they planned to use. I did not understand why I needed these drugs, but dutifully put the bag in the back of my refrigerator as advised. I have since learned that most hospices today do provide several drugs to have on hand and use according to standing orders.
Unwanted sedation and shocking neglect
On January 15, 2018, hospice offered to give me a “caregiver’s respite” for five days, as I was having health problems. Tony was admitted to the respite care wing of a nursing home where I visited him every day. Arriving about noon on January 16, I found Tony unable to sit up in his wheelchair. When I sought an explanation, a nurse told me that he had been given the sedative Ativan (brand name for lorazepam). I was livid. I had previously made it clear that no sedatives should be given to Tony because he was highly sensitive to any drugs affecting the brain. I called the hospice nurse and told her to stop this drug immediately and that he was never to be given it again.
It was difficult to care for Tony at home because I was suffering from angina and stress-related high blood pressure, so he was moved to another wing of the nursing home on January 20. This began four months of a shocking lack of care despite my frequent complaints and visits with the administrator. Because it was extremely understaffed, the nursing home was neglecting Tony. He fell on the floor several times while trying to take himself to the bathroom. I decided it was time to move him home.
Looking back, I feel I should have seen a red flag the first time he was given a sedative in violation of my explicit instructions.
Home again and happy, but not for long
Tony came home on May 1. Getting lots of hugs and attention, my husband was happy at home. He loved feeding the deer off the back porch and watching old classic movies. The hospice nurses presented a professional appearance. They arranged for aides to give him showers at home, and a nurse came once a week to take his vital signs. I made special foods for him and gave him nutritional supplements. We were grateful we had bought long-term care insurance because it meant he was able to have a steady stream of caregivers throughout the day. Everything went very well for about two weeks. Then Tony had symptoms of a urinary tract infection (UTI).
The hospice nurse brought in Levaquin, an antibiotic frequently used to treat UTIs and other infections. Tony soon developed tendonitis in his left shoulder, painful abdominal cramps, and extreme weakness, as well as nausea and vomiting. Some of those symptoms may have been caused by the liquid Tylenol used to reduce his fever and pain, but tendonitis is a side effect of Levaquin. The hospice nurse said that, since he was in pain, she should give Tony Ativan to calm him down. Tony wasn’t agitated in the least, but I wanted him to be comfortable and, unfortunately, did not question her. Later I would realize that the Levaquin should have been stopped when the tendonitis developed, it should have been replaced with a different antibiotic, and Ativan should not have been given. But, at the time, I trusted the hospice nurse.
After seven days on Levaquin and with the addition of Ativan, he became so weak that he could not sit up in his wheelchair and soon became bedridden. The hospice nurse gave us a book to read about the symptoms of dying, so I was encouraged to view his symptoms as part of “the death process.”
A deadly combination
I could see that Tony was becoming dehydrated and was desperate to get fluids into him. Though bedridden, at first Tony could still feed himself. The hospice nurse coached us to give him more Ativan. Caregivers helped feed and hydrate him, but he was soon unable to swallow. Hospice provided thickener for his juice, but I asked for IV hydration. The hospice nurse refused. She responded, “He doesn’t need that!”[1]
On June 5, my daughter moved in to give me support. We were told Tony was dying and to just keep him comfortable, which seemed to mean we were to give him steady doses of Ativan and morphine, closer and closer together, and more and more. Tony was sleeping all the time. At night he went into periods of delirium. At some point, the nurse also gave him Haldol, an antipsychotic drug. I can’t imagine why this drug was given. I believe now that Tony was a victim of stealth euthanasia.[2]
Tony had never complained of pain until he was given Levaquin. While in hospice, a doctor signed the nurse’s orders electronically without seeing Tony. Tony’s vitals had been very good until hospice introduced one drug after another: Levaquin, Ativan, Haldol, and morphine. If Tony had been given hydration, nutrition, and appropriate care for his UTI, I believe he would be alive today. The omission of appropriate care and medical treatment, and a lethal combination of drugs sealed his fate. On June 10, 2018, my husband died. I miss him.
Tony’s death certificate is a complete fraud. It says the cause of death was “coronary heart disease,” but he had a strong heart. He had been thoroughly examined by doctors prior to his admission to hospice and had no history of heart disease. The hospice nurses handled the whole thing. No hospice doctor ever examined Tony.
About a week after Tony’s death, I awoke from a sound sleep in the middle of the night with a startling realization. I never should have trusted the hospice. Since I gave him the drugs and didn’t insist on getting him real medical care when he needed it the most, I failed him and myself. I felt like I had killed him. It was all my fault. He was clearly dehydrated to death, and the use of constant sedation was an attempt to mask his agony. I will carry this pain for the rest of my life.
Note from HALO: Some of us have had experiences like Gloria’s. We suspect or know that a loved one’s death was deliberately caused by healthcare providers we thought we could trust. We understand the pain and guilt Gloria expresses. When a loved one is sick, family members often are very vulnerable due to anxiety, stress, and exhaustion. We cannot blame ourselves for trusting and being deceived by charlatans who practice stealth euthanasia. However, we can do something very important to help others avoid being victims of such crimes.
We can use what we’ve learned from Gloria’s and our own experiences to educate our relatives, friends, and others about the dangers they or their loved ones may face in the healthcare system. We can also tell them that HALO is here to help them with immediate assistance when it’s needed to save a life. Simply email feedback@halovoice.org.
Another resource is the Hospice Patients Alliance. There is a great deal of valuable information on its website (www.hospicepatients.org) about what should be done and should not be done in hospice. All the information is there so people can make sure that these killings are not allowed to happen.
Some hospices provide excellent end-of-life care. Nevertheless, people need to be warned that many hospices today practice stealth euthanasia. Forewarned is forearmed.
[1] Ron Panzer, LPN, BSN, the president of Hospice Patients Alliance, told the editor of HALO Monthly, “This is part of the death protocol, to sedate the patient so they cannot eat or drink. Tony certainly should not have been given more Ativan! The solution was not IV hydration. The solution was to stop the Ativan. And with any antibiotic, it is important that the patient get more fluids (as Gloria wanted to do), not less (which would occur with sedation). Giving antibiotics—or any other medication that requires the kidneys to flush it out—without fluids is a method of stealth euthanasia because it kills the kidneys.”
[2] “Stealth euthanasia” means deliberately hastening a patient’s death while pretending to provide appropriate treatment and care. Actions and omissions intended to cause death are disguised or hidden from those who may object, such as concerned family members.