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Matt C. Abbott
Is Hospice Care Safe?
By Matt C. Abbott www.MichNews.com  
Mar 30, 2005

I received the following e-mail from Ron Panzer, president of Hospice Patients Alliance (hospicepatients.org/euth-center.html):



Right to life organizations have been out-maneuvered by the so-called right to die organizations.  How did this occur?  We have to look at the history of the right to die organizations and then the answer will be clear.

Before the Third Reich, before World War II, the eugenics and euthanasia advocates were quite active in the U.S.  The Euthanasia Society of America, formed in 1938 in New York, having failed in getting passage of laws legalizing euthanasia, changed its tactics.  Realizing that the sanctity of life ethic was alive and well in the U.S., they sought a way to chip away at the bedrock blocking their way.  Commissioning research to learn what phrases their dark agenda could be palatably sold to the American public, they came up with terms such as ‘choice in dying,’ ‘dying well,’ ‘the right to die’ and ‘patient choice.’

In the 1960s they changed their name to Choice in Dying, choosing to focus on incrementally advancing the euthanasia agenda.  Living wills, advanced directives, and do not resuscitate orders were successfully sold to the U.S. and accepted by the mainstream health care industry policymakers.

Simultaneous with the introduction of the living will and the advanced directives initiative, hospice care arrived on the scene, suggesting that we avoid aggressive acute hospital care when such interventions may be burdensome and intrusive for patients who are truly dying.  Providing compassionate care to the terminally ill, relieving their suffering while allowing a natural death in its own timing ... who could object?

What the public did not know is that the first hospice in our nation, the Connecticut Hospice, was founded by a major representative of the euthanasia movement, Florence Wald, MSN, who stated that assisted suicide should be available for just about any reason at all:

‘I'll tell you the way I see it, and I know that I differ from Cicely Saunders, who is very much against assisted suicide. I disagree with her view on the basis that there are cases in which either the pain or the debilitation the patient is experiencing is more than can be borne, whether it be economically, physically, emotionally, or socially. For this reason, I feel a range of options should be available to the patient, and this should include assisted suicide.’  (JAMA. 281; 1683-1685, May 12, 1999, Hospice Care in the United States: A Conversation with Florence S. Wald, M. J. Friedrich)

While many in hospice assert that they will neither hasten death nor prolong death, hospice staff around the country may misuse common end of life interventions to hasten death.  Terminal sedation, a common intervention to relieve severe agitation at the end of life, can be misapplied to place patients into a medically-induced coma from which they are not allowed to recover.  They die of dehydration while sleeping, thereby allowing for a ‘pretty’ and ‘peaceful,’ but unnatural death, i.e., murder.

Right to life organizations have traditionally viewed hospice as the rightful alternative to euthanasia and have ardently supported hospice services, and so they should, IF hospices remain loyal to the original hospice mission of the London-based Dame Cicely Saunders, the founder of the modern hospice movement.  But the euthanasia advocates have always known that hospice could be used as the back door to legalization of euthanasia and/or physician-assisted suicide.

And that is what has been occurring throughout the U.S.  We have families reporting their loved one was killed off outright within hospices, through inappropriate use of medications when there was no clinical need, resulting in the death of an otherwise non-dying patient.

…The euthanasia advocates have taken over the national policymaking circles of the entire hospice industry.  Doubt it?  Well, remember the Euthanasia Society of America?  It changed its name to Choice in Dying, which sounds great, but was clearly an early indication that the choice they really wanted to promote was the choice to have physician-assisted suicide and/or euthanasia.

Choice in Dying completed its mission, the nationwide acceptance of incremental changes in our attitude toward life, substituting a ‘quality of life’ ethic for the ‘sanctity of life’ ethic.  Having done its job, it looked forward to the next step: the direct control of the hospice industry.  Choice in Dying merged with the hospice industry coalition, Partnership for Caring, whose goal was the changing of state and federal laws to favor utilization of hospice.  Partnership for Caring merged with Last Acts, one of the largest hospice coalitions in the world, funded by the Robert Woods Johnson Foundation, to become Last Acts Partnership.  Many who have served as Last Acts Partnership's directors also serve on the National Hospice & Palliative Care Organization board.

For example, Mary Labyak, C.E.O. of the Hospice of the Florida Suncoast, served as secretary at the Partnership for Caring and is a prominent leader in the hospice industry, having served on the boards of Last Acts and the National Hospice & Palliative Care Organization.  It is Labyak's hospice, Hospice of the Florida Suncoast, which has actively participated in accepting a non-terminal patient, Terri Schiavo, into the hospice, for the express purpose of euthanizing the ‘unworthy of life’ victim, Terri Schiavo.

Those who think hospice is the safe alternative to open euthanasia have been outfoxed. The euthanasia society has run circles around the well-meaning but naive right to lifers. So whether euthanasia is legalized openly or ‘back-doored’ through hospice, euthanasia is here, and it has been here for a long time.  The National Right to Life Committee has known about the hospice killings for years, yet has refused to expose these killings.

Is the right-to-life groups' stance on hospice consistent with its professed opposition to euthanasia?  Only if it admits that the realities in hospice are mixed, and citizens of our nation need to remain vigilant in determining whether their loved one is receiving end of life care, or is receiving care that leads to the end of life at will, i.e., euthanasia.



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Matt C. Abbott is the former executive director of the Illinois Right to Life Committee and the former director of public affairs for the Chicago-based Pro-Life Action League. He is a Catholic journalist and commentator. He can be reached at mattcabbott@hotmail.com.

Copyright © MichNews.com. All Rights Reserved.

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Woman, 81, at center of feeding tube feud

Kenneth Mullinax, the patient’s nephew in Birmingham, Ala., said a hospice nurse told him that Magouirk had not received substantial nourishment since March 28. He wants a temporary feeding tube inserted until she can be evaluated for treatment at the University of Alabama Medical Center. A living will states that nourishment should be withheld only if she were in a coma or vegetative state with no hope of recovery.

Mullinax and the patient’s brother and sister – Lonnie Ruth Mullinax of Birmingham and A.B. McLeod of Anniston, Ala. – came here last Friday to arrange for a feeding tube and take her to the Birmingham hospital. That same day Gaddy received emergency guardianship in Troup County Probate Court.

At a follow-up hearing Monday, the parties reached a settlement that awarded guardianship to Gaddy provided three cardiologists – James Brennan and Thomas Gore, both of LaGrange, and Raed Aquel of Birmingham – evaluate the patient, who would receive whatever treatment two of the three recommended. A final decision had not yet been reached.

“They were all hugging necks when they left court,” said Probate Judge Donald Boyd. “I don’t know what happened.”

Boyd said Gaddy testified at the hearing that she feeds her grandmother Jello, chips of ice and “anything else she’d be willing to eat.”

“I think all of Mrs. Magouirk’s family has her genuine best interests at heart, but unfortunately they disagree on what they believe would be best for her,” said Jack Kirby of LaGrange, attorney for the patient’s brother and sister.

“She (Gaddy) said, ‘I think it’s time she (her grandmother) goes home to Jesus, that’s she’s too sick and would not have a good quality of life,” Kenneth Mullinax said.
His complaints have been posted on Internet Web logs that have been in overdrive since the Terri Schiavo case.

“All of the Terri Schiavo people have come to our rescue,” Mullinax said. “This thing’s going national.”

On Thursday, the Probate Office, West Georgia Health System and attorneys in the case were inundated with phone calls and e-mails.

“We need people surrounding that place (hospice), we need some activity,” one caller from Oregon told the Daily News, adding that she had called the governor’s office and attorneys in the case.
The probate office got an estimated 50 calls from people saying things like, “I understand y’all are murdering people in Troup County” and “You’re euthanizing people.”

“We’re taking the posture of refusing to deal with those people because they’re not representing the responsible parties,” said West Georgia Health System President Jerry Fulks. “We’re focusing on taking care of the patient and her family.”

Fulks said he could not comment on an individual patient, but the health system’s policy calls for nourishment and hydration for hospice patients, sometimes through a feeding tube because of throat cancer or some other condition that prevents the patient from swallowing.

He said there is a “reverence for life that our staff and our physicians and our volunteers all adhere to in doing the jobs they do.”

Mullinax said his aunt does not have a terminal condition, which is a requirement for admission to hospice.

Danny Daniel of LaGrange, the attorney for Gaddy and another grandchild, said doctors made the decision to admit Magourik into hospice.

Gaddy has been taking care of her grandmother for 10 years, he said.
“They’re following the doctors’ recommendations and they want to do what’s in the best interests of their grandmother,” Daniel said, adding that hospice is providing “excellent care” for Magourik, a widow with no children.

Gaddy could not be reached for comment.

“The doctors can make her very comfortable again and give her a normal life,” Mullinax said. “That’s all we want for Aunt Mae ... My aunt can’t live much longer without substantial fluids or nourishment.
“I want the world to know that at Hospice LaGrange you have people who are not terminal being denied nourishment as a matter of course. This national debate has reared its head in Troup County, Georgia. It’s the damndest thing I’ve ever seen.”

He said he will “pursue every available avenue” to get treatment for his aunt.
Joel Martin can be reached at jmartin@lagrangenews.
com or (706) 884-7311 ext. 235.

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When her siblings and nephew lodged a complaint with the hospice’s in-house attorney, Carol Todd on March 31, Todd checked Magouirk’s case file and discovered that Gaddy did not have the durable medical power of attorney required to make the decision to end her grandmother’s life. The attorney also ascertained that according to the woman’s living will, fluids and nourishment were only to be withheld if she was either comatose or vegetative. She is neither.

After learning that Magouirk was being starved to death and being told by attorney Todd that Gaddy did not have the proper legal authority and her act was against the living will in place, her family ordered that nutrition and hydration be restored to the woman as the law provided that her sister and brother were legally entitled to make all decisions. Todd was instructed by Mrs. Mullinax to insert fluids via an IV and insert a feeding tube via her nose.

The attorney had the IV fluids started that evening but told the family they would have to come to Hospice LaGrange to sign papers to have the feeding tube inserted because once it was done, she believed that Magouirk would no longer be a candidate for the hospice. However, she was not terminal initially and did not legally qualify for hospice admission.

Todd allegedly stated that the only reason that the woman was at the hospice was that LaGrange Hospital administration had failed to exercise due diligence in closely examining the power of attorney which Gaddy misrepresented that she had, as well as executing provisions of Mae’s living will to her preordained stipulations. Gaddy had only a financial power of attorney.

Georgia law requires that a hearing be held for emergency guardianship within three days of a request. While Magouirk’s family was detained at the hospice in a meeting with hospice attorney Todd April 4 to arrange for emergency air transport of Mae to the University of Alabama-Birmingham Medical Center, Gaddy was appearing before Troup County, Ga., Probate Judge Boyd who granted Gaddy emergency guardianship, giving her complete authority. Once empowered by the court to continue the killing of her grandmother, Gaddy ordered that Mae’s IV fluid tube be removed.

The judge reportedly favors granting Gaddy permanent guardianship which will allow her to starve her grandmother to death despite the wishes of her living will and the fact that she is not terminal, not comatose and not PVS.

According to Mullinex, Boyd would not allow the family attorney, Jack Kirby, to cross examine Magouirk’s attending physician to ask if he would agree that there are alternative treatments. Boyd reportedly called Mullinax’s charges false and said that all relatives agreed to let three doctors decide the fate of Magouirk.

Interested persons may contact hospice attorney Carol Todd at 706-882-1411; Probate Judge Donald Boyd at 706-883-1690, court case number Estate 138-05.

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I would also be surprised if the judge's ruling in the second case was not influenced by the decisions in the first case and the fact that no court, including the Superior, overturned them.

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Juju - 1.) a magic charm or fetish 2.)Magic 3.)A taboo connected woth the use of magic

The dictionary never lies.... I am magical (;

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I concur in the denial of rehearing en banc in this case because any further action by our court or the district court, would be improper, as I explain below.

An axiom in the study of law is that “hard facts make bad law.” The tragic events that have afflicted Mrs. Schiavo and that have been compounded by the resulting passionate inter-family struggle and media focus certainly qualify as “hard facts.” And, while the members of her family and the members of Congress have acted in a way that is both fervent and sincere, the time has come for dispassionate discharge of duty.

A popular epithet directed by some members of society, including some members of Congress, toward the judiciary involves the denunciation of “activist judges.” Generally, the definition of an “activist judge” is one who decides the outcome of a controversy before him according to personal conviction, even one sincerely held, as opposed to the dictates of the law as constrained by legal precedent and, ultimately, our Constitution. In resolving the Schiavo controversy it is my judgment that, despite sincere and altruistic motivation, the legislative and executive branches of our government have acted in a manner demonstrably at odds with our Founding Fathers’ blueprint for the governance of a free people — our Constitution. Since I have sworn, as have they, to uphold and defend that Covenant, I must respectfully concur in the denial of the request for rehearing en banc. I conclude that Pub. L.109-3 (“the Act”) is unconstitutional and, therefore, this court and the district court are without jurisdiction in this case [FOOTNOTE 1] under that special Act and should refuse to exercise any jurisdiction that we may otherwise have in this case. Under the first amended complaint in this case (the initial complaint was improperly grounded on habeas corpus) a basis for jurisdiction was Pub. L. 109-3.[FOOTNOTE 2] The second amended complaint adopted other, independent grounds for jurisdiction, including the Americans With Disabilities Act (“ADA”), The Civil Rights Act (42 U.S.C. § 1983) and The Rehabilitation Act of 1973. We have held that the Rooker-Feldman [FOOTNOTE 3] doctrine is jurisdictional. Clearly, application of that doctrine should have been made in this case, the effect of which would have been to decline to exercise any jurisdiction that we or the district court did have under the ADA, the Civil Rights Act or the Rehabilitation Act of 1973.

(emphasis mine)

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It is axiomatic that the Framers established a constitutional design based on the principles of separation of powers. See Marbury v. Madison, 5 U.S. 137, 176 (1803) (noting that separation of powers is one of the governmental principles “on which the whole American fabric has been erected”). The Framers established three coequal but separate branches of government, each with the ability to exercise checks and balances on the two others. And to preserve this dynamic, the “Constitution mandates that ‘each of the three general departments of government [must remain] entirely free from the control or coercive influence, direct or indirect, of either of the others.’” Mistretta v. United States, 488 U.S. 361, 380, 109 S. Ct. 647, 659 (1989) (quoting Humphrey’s Executor v. United States, 295 U.S. 602, 629, 55 S. Ct. 869, 874 (1935)). Because of the important constitutional role assigned to the judiciary by the Framers in safeguarding the Constitution and the rights of individuals, see Federalist No. 78 (A. Hamilton), the execution of this constitutional mandate is particularly important when legislative acts encroach upon the independence of the judiciary. See INS v. Chadha, 462 U.S. 919, 961, 103 S. Ct. 2764, 2789 (1983) (Powell, J. concurring) (citing Federalist No. 48 for the proposition that the Framers enshrined in the Constitution separation of powers principles because of past legislative interference with the judiciary); Northern Pipeline Co. v. Marathon Pipeline Co., 458 U.S. 50, 60, 102 S. Ct. 2858, 2866 (1982) (“[T]he independence of the judiciary [must] be jealously guarded.”). Accordingly, we risk imperiling our constitutional design if we do not inquire as to whether Pub. L. 109-3 infringes on the independence of the judiciary guaranteed by Article III of the United States Constitution.

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Against these most elementary of constitutional principles, Section 1 of Pub. L. 109-3—which states that the United States District Court for the Middle District of Florida shall have jurisdiction to hear a suit regarding alleged violations of rights held by Mrs. Schiavo “under the Constitution or laws of the United States”—is not facially unconstitutional. If the Act only provided for jurisdiction consistent with Article III and 28 U.S.C. § 1331, the Act would not be in violation of the principles of separation of powers. The Act, however, goes further. Section 2 of the Act provides that the district court: (1) shall engage in “de novo” review of Mrs. Schiavo’s constitutional and federal claims; (2) shall not consider whether these claims were previously “raised, considered, or decided in State court proceedings”; (3) shall not engage in “abstention in favor of State court proceedings”; and (4) shall not decide the case on the basis of “whether remedies available in the State courts have been exhausted.” Pub. L. 109-3, § 2. Because these provisions constitute legislative dictation of how a federal court should exercise its judicial functions (known as a “rule of decision”), the Act invades the province of the judiciary and violates the separation of powers principle.

(emphasis mine)

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The separation of powers implicit in our constitutional design was created “to assure, as nearly as possible, that each branch of government would confine itself to its assigned responsibility.” INS, 462 U.S. at 951, 103 S. Ct. at 2784. But when the fervor of political passions moves the Executive and the Legislative branches to act in ways inimical to basic constitutional principles, it is the duty of the judiciary to intervene. If sacrifices to the independence of the judiciary are permitted today, precedent is established for the constitutional transgressions of tomorrow. See New York, 505 U.S. at 187, 112 S. Ct. at 2434. Accordingly, we must conscientiously guard the independence of our judiciary and safeguard the Constitution, even in the face of the unfathomable human tragedy that has befallen Mrs. Schiavo and her family and the recent events related to her plight which have troubled the consciences of many. Realizing this duty, I conclude that Pub. L. 109-3 is an unconstitutional infringement on core tenets underlying our constitutional system. Had Congress or the Florida legislature, in their legislative capacities, been able to constitutionally amend applicable law, we would have been constrained to apply that law. See Robertson v. Seattle Audobon Soc’y, 503 U.S. 429, 441, 112 S. Ct. 1407, 1414 (1992). By opting to pass Pub. L. 109-3 instead, however, Congress chose to overstep constitutional boundaries into the province of the judiciary. Such an Act cannot be countenanced. Moreover, we are bound by the Rooker-Feldman doctrine not to exercise any other jurisdictional bases to override a final state judgment. Should the citizens of Florida determine that its law should be changed, it should be done legislatively. Were the courts to change the law, as the petitioners and Congress invite us to do, an “activist judge” criticism would be valid.

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Love's a lovely lad
His bringing up is beauty
Who loves him not is mad
For I must pay him duty
-Anonymous

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The congress could have passed laws regarding evidence -- they could have put an automatic stay into the law to require all feeding tubes to be kept in any incapacitated patient where family members disagreed on treatment until final law could have been worked out -- or they could have simply granted jurisdiction without dictating to the courts what they had to do -- but, they had to grandstand and grab for power.

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