Washblog

Booth Gardner's "Angel Of Death" Initiative

[Front paged: NM]

Genene Jones, Maria Gruber, Irene Leidolf, Stephanija Meyer, and Waltraud Wagner, Kristen Gilbert, Vickie Dawn Jackson, Harold Shipman, Orville Lynn Majors, Donald Harvey, Beverley Allitt, Charles Cullen, Christine Malevre, Elfren Saldivar -

What do all these people have in common? They are all convicted serial murderers, most of whom are thought to have taken the lives of more human beings than Ted Bundy. All were suspected well before their crimes were even investigated and all their murder sprees went on for multiple years without anything being done to stop them. Most were not even investigated even after being linked to one or more suspicious deaths they were known to have had the means and opportunity to have caused. Many were not even fired although they were widely reputed by their own co-workers to have done these murders in their own workplaces. Some recruited their co-workers to aid and abet their murder and some even recruited co-workers to murder along with them.

They are not just serial murderers, but the most murderous of all kinds of serial murderers. The other thing that ties them together? They were all healthcare workers treating the most vulnerable and helpless among us.

But it's not as if Initiative 100 encourages such maniacs to become healthcare workers - at least not deliberately. So let me rename it: "The Invisible Patient Initiative" Because for all of these murderers, the fact of incapacitation, a grim or termimal prognosis, "DNR" orders, helplessness or a complaining patient were "green lights" for them to do murder. And a patient who's actually is in the process of choosing "medical" suicide? How much more vulnerable is she? How much more invisible? And consider that all - ALL - of the serial killers I listed cited "mercy" as one of their many, many attempted excuses for murder. Some of these convicted villains even tried to become exponents for "death with dignity" as their trials came near - with little effect on their sentences, of course.

Journal of Forensic Sciences

"Serial Murder by Healthcare Professionals"

ABSTRACT: The prosecution of Charles Cullen, a nurse who killed at least 40 patients over a 16-year period, highlights the need to better understand the phenomenon of serial murder by healthcare professionals. The authors conducted a LexisNexis® search which yielded 90 criminal prosecutions of healthcare providers that met inclusion criteria for serial murder of patients. In addition we reviewed epidemiologic studies, toxicology evidence, and court transcripts, to provide data on healthcare professionals who have been prosecuted between 1970 and 2006. Fifty-four of the 90 have been convicted; 45 for serial murder, four for attempted murder, and five pled guilty to lesser charges. Twenty-four more have been indicted and are either awaiting trial or the outcome has not been published. The other 12 prosecutions had a variety of legal outcomes. Injection was the main method used by healthcare killers followed by suffocation, poisoning, and tampering with equipment. Prosecutions were reported from 20 countries with 40% taking place in the United States. Nursing personnel comprised 86% of the healthcare providers prosecuted; physicians 12%, and 2% were allied health professionals. The number of patient deaths that resulted in a murder conviction is 317 and the number of suspicious patient deaths attributed to the 54 convicted caregivers is 2113. These numbers are disturbing and demand that systemic changes in tracking adverse patient incidents associated with presence of a specific healthcare provider be implemented. Hiring practices must shift away from preventing wrongful discharge or denial of employment lawsuits to protecting patients from employees who kill.

And this

In an article for Forensic Nurse, Kelly Pyrek indicates that since the mid-1970s, there have been 36 cases of serial murder among nurses and other healthcare workers in the�U.S. � A survey shows that the incidences appear to be increasing, with 14 during the 1990s and already five since 2000. (The article was written before Cullen's atrocities came to light, so that makes at least six.)
"Many experts speculate," says Pyrek, "that healthcare has contributed more serial killers than all other professions combined and that the field attracts a disproportionately high number of people with a pathological interest in life and death."

Consider that these were outright, mass murderers and yet the evidence of their hideous crimes was invisible through the tangled weeds of hospital red-tape. We're not even talking about poor care or negligent care or medical mistakes. We're talking about deliberate murder. Hospitals didn't catch it for years, in part because of the power relationships within hospitals that attract some of these power-mad lunatics in the first place. It was covered up, shoved under the bureaucratic rug and institutions of healing became places where innocent people died at the hands of psychopaths. Again, all of these murderers chose victims about whom the system cared least and who were the most helpless.

And Washington state's latest "healthcare" priority is not cutting bureaucracy, not making information available so we can know what kind of treatment our sick and elderly are getting, not finding a way to finance life-sustaining and health-promoting measures more evenly and more effectively. No, we are now concerned with "death with dignity". The sanctimonious signature-gatherer I met today outside a Seattle QFC was doing very well. One after another self-satisfied person was signing away and everyone was all smiles.

In the ten or so years since it has been in effect, Oregon's physician-prescribed suicide law has allowed about 300 people to end their own lives by prescribed fatal overdoses of barbiturates.

If you think that's a good thing, I bid you temper your enthusiasm. In that same period about 10,000 people who very probably did not want to die were killed in Oregon by medical mistakes.  An unknown number died from lack of medical care. In every year since Oregon's "death with dignity" act has been in place between three and five times as many people have died of heroin overdose each year as have taken their own lives "with dignity" with prescribed barbiturates. And in that time how many have drunk themselves to death? Or overdosed on methamphetamine? Or died of hypothermia sleeping on the streets?

Three times as many elderly people in Oregon take their lives by suicide than "with dignity" - making Oregon's elder suicide rate about 50% above the national average. And remember, "death with dignity" by prescribed barbituates is not counted in suicide statistics because it's not really suicide, right?

Clearly, these numbers show that ten years ago the LAST public health priority on ANY Oregonian's mind should have been giving physicians the right to prescribe life-ending overdoses of barbiturates  - unless, of course, you happened to be an insurance company executive.

I'm not a person who believes in preserving a patient's life at any cost. I'm not religious. As a person who has cared for a relative who died mentally and physically incapacitated by Alzheimer's, I know the very difficult decisions that have to be made - balancing an understanding of the patient's wishes, different values among different family members, the limits and necessities of palliative care.

As the Oregon case shows, very few dying people choose a formal, medical suicide process. Rather, the onus is on caregivers to gradually choose palliative over life-sustaining measures. This is never an easy process, but it must be one done with respect and responsibility - preserving life but taking responsibility to make that life bearable even if it means making it shorter. But that is very different from simply giving a person a relatively peaceful-looking means of taking her own life. Instead, one has more often than not to look down at an incapacitated person who may have held you in her arms when you were a baby and ask yourself "What is right?" and "If something more needs to be done, can I do it?" But that's life and to pretend that there are simple answers is facetious and disrespectful.

What the real health numbers show us, of course, is that we have a mental and physical health system that is failing Americans at a tragic and preventable level. End-of-life issues are hard enough for people who have means and families to support them. I shudder to think what will happen when a "death with dignity", prescribed-suicide law gives the green light to those who would conveniently dispose of the anonymous and indigent - possibly for their own unsavory motives.

Because our healthcare system does not wait and help and care and ask questions about suffering and the value of life. Our healthcare system ignores, sedates (at best) and lets die with quite callous disregard for medical care let alone medical ethics. Once a patient even talks about getting a fatal prescription from a doctor, do you think the hospital or nursing home is really going to bother with all that paperwork and all those witnesses and forms? Think again. She'll be sedated "to make her more comfortable", she'll drop to the bottom of the list of people to look in on and care for (she's chosen to die anyway) and she'll just die a relatively short while later. How long? Who cares? As long as she doesn't make too much noise or cost too much money.

But now, in this moment, we are on the verge of making a change. We are recognizing our values, ending our self-deception and making the choice to care for each other. We are on the verge of electing a Democrat for President. And now our candidates running for that office are fighting to claim whose healthcare program will care for people best and most universally. And in this moment, after it looks like we just might turn around decades of Democrats' failing to give healthcare to our nation, Christian Sinderman, Blair Butterworth and Booth Gardner are gathering petitions to give Washington state residents the privilege of putting themselves to sleep like dogs.

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...in this story, i have to offer a few contradictory comments.

you discuss the relationships between hospitals and the "power-mad" who practice there...but then you report 85% of the deaths were at the hands of nurses.

power mad nurses, causing the hospitals to cower at their approach? a more likely scenario is that hospitals, for reasons related to liability, would prefer not to notice the relationships between these deaths and their staff.

perhaps a solution might be found in requiring outside investigators to look into hospital deaths...and as you mention, there could be a huge potential for not just ending the rash of murders, but even more importantly, you might begin to knock down the 100,000 + accidental deaths that occur in american medical facilities annually.

another point: the fact that more folks overdose, or that there are more deaths caused by other means than self-directed death seems to have no real bearing on the question of whether washington citizens should have the option to choose to end their own lives.

as to priorities: this is not the state saying this is its priority...it is instead a group of citizens who feel it is their priority. such is the nature of initiative campaigns...and if it passes, it suggests it is a priority of the vox populi as well.

by fake consultant on Mon Mar 03, 2008 at 02:42:14 PM PST

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   One of the more amazing things about this Initative and Governor Gardner, is that He may well not be eligible. Parkinsons isn't in anyway "immediately fatal".
   I've seen to many slow deaths. I don't want heroic measures if I'm not going to get back on my feet and whatever.
   I expect some more years before I would be in this position, but when I am, I want the option.

Dave Gibney Pullman

by gibney on Mon Mar 03, 2008 at 05:55:00 PM PST

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and update them regularly.  I don't know the political and religious subtext of the article you included really comes from.  Many nurses get charged with murder after pushing opiates to end of life patients.

But, with medical technology, many people who have lives bereft of medical care are then cared for more than they may even want.  Not for me to say.  It's for them to say.  And, for me to say for myself in explicit detail, updated frequently based on new medical technology.  I think that might include getting the barbs to end ones life.  

I appreciate the passion of this article, and I have many concerns.  I wonder if this proposal is a desperate attempt to deal with a sick over medicalized dying experience, or if there are truly bad effects.  I wonder if there are comparison statistics for before the Oregon law was passed versus after, not just what happened in the last ten years?  And, I do not see the point of how many medical mistakes kill people unless we have numbers from before the law and after the law to somehow prove that the law means no one cares.  But, I need the numbers from before and after the law passing, and comparison to national trends before I understand any impact of the law good or bad.

If we are saying the law has no impact, then that is fair. That it does not really address what we need to deal with.  You talk about murdering nurses.  You show no statistics that show more murdering nurses due to Oregon's law.  But, you may be saying that this proposal is misplaced?

I had an interesting conversation many years ago with a friend whose parents came to the US from India - he was raised here but visited there often.  I said, "I can't see myself being comfortable visiting India because I perceive there is a disregard for human life based on the belief of reincarnation."  He said, "I perceive that, in the US, we disregard human life except when one is in the hospital.  Then we use every means necessary to keep the body alive.  Even newborns, who would not survive in the past, now have heroic efforts to keep them alive and they often either die or are severely disabled for life."

So - My mother had a stroke in the night almost 20 years ago.  My father, because they had agreed (and this was before the State of MD emergency response would accept Advance Directives) went back to sleep to let her pass away if that was to be.  Yikes!  If he had called the ambulance right away, there are drugs they could have given, honestly not so much back then but really there are immediate meds now that mitigate stroke significantly.  But, you get the conundrum.  My mother told ALL of us early and often that she would NOT be hooked up to machines to live out her life.  She sat me down numerous times in my life and said - let me go if I have a heart attack or stroke.  My parents were staunch Catholics.

My Dad nursed my Mom for 10 years.  We had some great times and some really good recovery early on although she was paralyzed, had aphasia, and eventually lost the ability to swallow.  Still, after the initial depression when she was at the national rehab hospital and we really needed to convince her that LIFE was not over, she was able to see another daughter married, experience 4 more grandchildren, and continued to be my mommy who organized with the animators at Disney in the 40s, supported Henry Wallace in 1949, and Robert Kennedy in 1968 (even was up all night watching the returns in Cali where we lived so saw the assassination live), who would make me watch ANYTHING important in politics and civil rights as a child, who would make me watch C-SPAN as an adult, listen to NPR, play killer blackjack, and laugh at Monty Python reruns.  

Towards the end, her body finally broke down.  My Dad had a nurse who told him that it was time to bring all of us (by now I had moved to Seattle) now scattered children in to see her.  I read her a novel, Fanny Flagg, "Welcome to the World baby Girl". Even though she was passing in and out, she would not let me stop reading.  My mother died SIX MONTHS later. My Dad and my Mom's doctor called in the Hospice folks.  My youngest sister who lives nearby told me that I should not come out at that time; my visit six months earlier was qualitative.  Her body was nearly non-functional.  I, 3000 miles away knew the moment she died.  I know for a fact that she WAS pumped full of drugs "to make her comfortable".  Was THAT murder?

by ktkeller on Wed Mar 05, 2008 at 04:49:57 AM PST

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