Hawaii’s Assisted Suicide Bill and My Testimony Against It

While groups like Compassion and Choices and a mostly sympathetic mainstream media continue to tout allegedly strong “safeguards” in assisted suicide laws that allegedly prevent abuse, these “safeguards” already have been mostly eliminated in countries like Canada and Holland–and are now beginning to fall here in the US and other countries.


A case in point is Hawaii, whose legislature rejected assisted suicide just last year. Hawaii has a new bill this year, HB 2739. Called the “Our Care, Our Choices Act,” this bill was recently fast-tracked in the legislature with testimony scheduled for February 27, 2018.


HB 2739 (before amendments) would allow advanced practice registered nurses as well as doctors to be the “attending provider” for assisted suicide. Despite the ubiquitous problems with assisted suicide, which I have written about previously [1], the Hawaii legislators claimed “robust safeguards” such as “if appropriate,” the doctor can refer the terminally ill patient for “counseling” to be performed by “a state-licensed psychiatrist or psychologist” but just for the purpose of “determining that the patient is capable of making medical decisions and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.” [Emphasis added.] This is not the same as the usual psychiatric/psychological evaluation required for other suicidal people.


After “an emotional 5-hour hearing” [2] on February 27th, a joint House panel voted in favor of an amended version of HB 2739 that will head to a vote of the full House in the near future. The amended bill includes the welcome removal of advanced practiced registered nurses as “attending providers” but added social workers to the psychiatrists or psychologists designated as the counselors to determine the patient’s “capability” and allows “counseling” by telehealth instead of in person. Finally, the new bill would also lengthen the time between oral requests for assisted suicide from 15 to 20 days.


As usual, Compassion and Choices continues to describe HB 2739 deceptively:

“Medical aid in dying is an end-of-life medical practice in which a terminally ill, mentally capable individual who has a prognosis of six months or less to live requests, obtains and-if his or her suffering becomes unbearable-self-ingests medication to die peacefully in their sleep.” [3]


We all need to know that we are being lied to about assisted suicide and fight against such laws!

My Testimony on Hawaii’s HB 2739

February 26, 2018

Please Do Not Approve HB 2739, From a Mother and a Nurse


As the mother of a suicide victim who used an assisted suicide technique and as a registered nurse who has cared for suicidal people both personally and professionally for over 40 years, I implore you not to approve the dangerous HB 2739, the “Our Care, Our Choice Act.” This bill puts both desperate people and our health care system in danger. I want to address both issues.


My Daughter Marie Killed Herself Using an Assisted Suicide Technique


In 2009, I lost a beautiful, physically well, 30-year-old daughter, Marie, to suicide after a 16-year battle with substance abuse and other issues. Her suicide was like an atom bomb dropped on our family, friends and even her therapists.


Despite all of our efforts to save her, my Marie told me that she learned how to kill herself from visiting suicide/assisted suicide websites and reading Derek Humphry’s book Final Exit. The medical examiner called Marie’s suicide technique “textbook final exit,” but her death was neither dignified nor peaceful. Marie was a victim of the physician-assisted suicide movement, seduced by the rhetoric of a painless exit from what she believed was a hopeless life of suffering.


Suicide Contagion


Adding to our family’s pain, at least two people close to Marie became suicidal not long after her suicide. Luckily, these two young people received help and were saved, but suicide contagion, better known as “copycat suicide,” is a well-documented phenomenon. [4] After Oregon’s physician-assisted suicide law took effect in 1997, the rate of suicide increased. [5] In 2015, the state’s health department said “The rate of suicide among Oregonians has been increasing since 2000” and as of 2012 was “42% higher than the national average”; suicide had become “the second leading cause of death among Oregonians aged 15 to 34 years.” [6] These figures are in addition to deaths under the Oregon assisted suicide law, which legally are not counted as suicides.


My Marie was one of the almost 37,000 reported US suicides in 2009. According to the Centers for Disease Control and Prevention, suicide is the 10th leading cause of death among Americans with more than 44,000 people dying by suicide in 2015, more than 1.4 million people reported making a suicide attempt in the past year and almost 10 million adults reported thinking about suicide in the past year. [7]


Our urgent health care crisis is the staggering and increasing number of suicides, not the lack of enough medically assisted suicides.


My Story


Several years after Oregon’s law was passed, I was threatened with termination from my job as an intensive care unit nurse after I refused to participate in a deliberate overdose of morphine which neither the patient nor his family had requested. He was an older patient who had experienced a crisis after a routine surgery.


The patient had improved but did not wake up within 24 hours after sedatives used with a ventilator were stopped. It was assumed that severe brain damage had occurred and doctors recommended removing the ventilator and letting the patient die. However, when the ventilator was removed, the patient unexpectedly continued to breathe even without oxygen support. A morphine drip was started and rapidly increased, yet the patient continued to breathe.


When I refused to participate in this, I found no support in my hospital’s “chain of command.” I could not pass off this patient to another nurse so I basically stopped the morphine drip myself, technically following the order to “titrate morphine for comfort, no limit.” The patient eventually died after I left. Ironically, a later autopsy requested by the family showed no lethal condition or brain injury as suspected. The physician who authorized the morphine demanded that I be fired.


The Effect of Medically Assisted Suicide on Our Health Care System


I’ve known other doctors, nurses and therapists who have put their jobs on the line to protect their patients. Unfortunately, we are fast becoming pariahs in the face of medically assisted suicide legalization.


For thousands of years, doctors (and nurses) have embraced the Hippocratic standard that “I will give no deadly medicine to anyone, nor suggest any such counsel.” Should the bright line doctors and nurses themselves drew to separate killing from caring now be erased by legislation?


As a nurse, I am willing to do anything for my patients–except kill them. Working with the terminally ill, I have been struck by how rarely these people say something like, “I want to end my life.” The few who do express such thoughts are visibly relieved when their concerns and fears are addressed and dealt with instead of finding support for the suicide option. I have yet to see such a patient go on to commit suicide.


In 2015, the Canadian Supreme Court approved MAID (medical aid in dying, a.k.a. medically assisted suicide) and lethal injection suicides began in Quebec, one of Canada’s largest provinces. Now, MAID is practiced throughout Canada and “only 5 of more than 2,000 Canadian patients who used medical aid in dying self-ingested the lethal medication.” [8]


A December 2017 Canadian medical journal (Le Specialiste) contains a fascinating but disturbing English language article, “First Results from a Unique Study,” on pages 36-40. The study, done in Laval, Canada, showed that, prior to the law, 48% of doctors said they would participate, 30% with conditions, and only 28% said they would never participate. Afterwards, 77% of the physicians getting MAID requests refused to actively participate, using the conscientious objection clause, even though the study claimed the majority (72%) were in favor of MAID with only 13% of the doctors being neutral or ambivalent. The most common reason given for refusal was “too much of an emotional burden to bear.”


Do assisted suicide supporters really expect us doctors and nurses to be able to assist the suicide of one patient, then go on to care for a similar patient who wants to live, without this having an effect on our ethics or our empathy? Do they realize that this can reduce the second patient’s will-to-live request to a mere personal whim-perhaps, ultimately, one that society will see as selfish and too costly? How does this serve optimal health care, let alone the integrity of doctors and nurses who have to face the fact that we helped other human beings kill themselves?




Medically assisted suicide is a dangerous and slippery proposition. As noted, the vast majority of MAID deaths in Canada have been accomplished by lethal injections, not self-ingestion of the lethal prescription. Other countries have gone farther to include chronic psychiatric conditions, birth defects and even just old age.


We must not discriminate on the basis of health and choice when it comes to desperate people seeking suicide. We must treat all of our citizens with equal concern.


Note: This article was adapted from the original, available at https://nancyvalko.com/2018/03/01/they-are-lying-to-us/ . Nancy Valko’s testimony has been condensed.


About the author: I have been a registered nurse since 1969 and currently I am a spokesperson for the National Association of Prolife Nurses (www.nursesforlife.org). I have also been a past President of Missouri Nurses for Life and past co-chair of the St. Louis Archdiocesan Respect Life Committee. In 2015, I was honored to receive the People of Life award from the US Catholic Conference of Bishops. After working in critical care, hospice, home health, oncology, dialysis and other specialties for 45 years, I am currently working as a legal nurse consultant (www.valkogroupalnc.com) and volunteer.


[1] https://nancyvalko.com/2017/12/27/six-things-you-need-to-know-about-physician-assisted-suicide/

[2] http://www.civilbeat.org/2018/02/medical-aid-in-dying-bill-generates-an-emotional-5-hour-hearing/

[3] https://www.compassionandchoices.org/hawaii-house-health-human-services-and-judiciary-committees-approve-medical-aid-in-dying-bill/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384446/


[6] https://digital.osl.state.or.us/islandora/object/osl%3A94197/datastream/OBJ/view

[7] https://www.cdc.gov/violenceprevention/suicide/consequences.html

[8] https://www.canada.ca/content/dam/hc-sc/documents/services/publications/health-system-services/medical-assistance-dying-interim-report-sep-2017/medical-assistance-dying-interim-report-sep-2017-eng.pdf