Oncology RoundsWhat determines a patient's quality of life at the end of life?
A Pennsylvania judge on Tuesday dismissed charges against a nurse who was prosecuted for allegedly providing her terminally ill father with a lethal dose of morphine, the Associated Press reports.
Background on the case
The Philadelphia nurse, Barbara Mancini, was charged with felony assisted suicide after giving her 93-year-old father, Joe Yourshaw, a vial of morphine at his Pottsville, Pa., home. Yourshaw was suffering from end-stage diabetes, heart disease, kidney disease, and arthritis and was under the care of a hospice nurse when he took a lethal dose of morphine on Feb. 7.
The hospice nurse called 9-1-1 and told local authorities that Mancini had given Yourshaw morphine "at his request so that he could end his own suffering," according to police reports. Mancini allegedly told an officer that her father had requested enough morphine to commit suicide and she had provided it.
Yourshaw was revived at a local hospital, but died four days later after he was given more morphine for his pain. His death certificate listed the cause of death as "morphine toxicity" that complicated his heart disease and diabetes. The manner of death was listed as "homicide."
Mancini and her lawyers maintained that the nurse gave Yourshaw a vial of morphine to ease his pain, not to help him end his life, and that Yourshaw had a prescription for morphine.
Judge: Case based on 'hearsay,' little investigation
In a 47-page opinion issued Tuesday, Schuylkill County Judge Jacqueline Russell wrote that state prosecutors failed to prove that a crime had taken place. Specifically, there was little proof that Yourshaw had meant to take his own life, or that Mancini had enabled him to do so.
Dilemmas at end-of-life
"The commonwealth's case appears to have been based on little independent investigation, significant hearsay, including double hearsay received from third persons - speculation, guess, and defendant's alleged incriminating statements," Russell wrote.
At a news conference on Wednesday, Mancini said, "I'm relieved and I'm happy and that's something I haven't felt for over a year." She argued that the "unjust" prosecution violated her freedom and rights, as well as those of her father. His "end of life was nothing like he wanted it to be," she said.
Supporters from Compassion & Choices, a group that supports assisted suicide and other end-of-life decisions and contributed $20,000 to defray Mancini's $100,000 legal bill, also asked that Pennsylvania Attorney General Kathleen Kane (D) refrain from appealing the judge's decision to dismiss charges.
Mancini's prosecution "did more than torment and torture one family," said spokesperson Gwen Fitzgerald, adding, "The arrest of a family caregiver providing pain medication to a dying loved one has a chilling effect for families across the country" (Rubinkam, AP/Atlanta Journal-Constitution, 2/12; Vitez, Philadelphia Inquirer, 2/13).