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Note to HALO Monthly recipientsWhether or not you are able to make a donation to HALO, you will continue to receive the newsletter. However, there are expenses involved in producing a quality newsletter. Therefore, we suggest an annual donation of $25.00 for HALO membership, which includes our newsletter. Of course, donations in any amount to support the work of HALO will be gratefully accepted. Please send checks only to: HALO, P.O. Box 324, Chisago City, MN 55013.
Welcome to this edition of the HALO Monthly. This e-newsletter provides opportunities for HALO to share information about current healthcare issues, events, contributions from members, answers to prayer, and other relevant information. Please share your ideas and suggestions with us.

  Contact Us at: 
feedback@HALOrganization.com

HALO MISSION STATEMENT

The mission of the Healthcare Advocacy and Leadership Organization is to promote, protect, and advocate for the rights of the medically vulnerable through direct patient and family interactions; through community education and awareness programs; and through promotion and development of concrete *"life-affirming healthcare"* alternatives for those facing the grave consequences of healthcare rationing and unethical practices, especially those at risk of euthanasia and assisted suicide.

*"Life-affirming healthcare" is defined as medical care in which the paramount principle is the sanctity of life, which means that the life and safety of each person come first and each person receives medical care across their lifespan based on their need for care and never with an intention to hasten death, regardless of their abilities or perceived "quality of life."

ELECTIONS HAVE CONSEQUENCES


The elections are both good news and bad news. We don’t have to do a rundown of the results here; we’ll just acknowledge that elections have consequences. One consequence of the Democrats taking control of the House is that any more whittling away at Obamacare probably will not happen. This election indicates that most Americans want government-run healthcare. This is bad. I would even say this is very, very bad.
Bruce Frohnen, in Crisis Magazine, explains why:
A majority of Americans are more attracted by the idea of government funded healthcare than they are to job creation, local liberties, and the traditional American commitment to voluntary action. This is troubling, not because affordable healthcare is not important, but because societies that seek to provide it for free through government programs undermine crucial religious values. Government programs like healthcare crowd out more local, subsidiary institutions and associations (charity hospitals, for example—a high percentage of which were once run by Catholic organizations). They make us look to the government instead of to one another in our local institutions for help in time of need. They also bankrupt the nation, and in the process devalue human life. Whether in Great Britain, the Netherlands, or Canada, government-run health services have brought the rationing of care, followed by grisly death panels that decide who should be given treatment and who should be allowed to die, and, all too soon, euthanasia. (“No Blue Wave, Yet Troubles Are Ahead,” Crisis Magazine, November 7, 2018.)
Judie Brown, President of American Life League and a member of the HALO Advisory Board, laments, “Sadly, folks do not see that the more government controls the lives of the vulnerable, the less valuable each individual human being becomes.”
HALO has a lot of work ahead and our job just got tougher.
Julie Grimstad, President
HALO Board of Directors

ANNOUNCEMENT: OUR WEBSITE IS NOW LAUNCHED!

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Check out the Healthcare Advocacy and Leadership Organization website which we just launched at www.HALOrganization.com. We are thankful and blessed to have this tool to help us set our course. The HALO website will be continually updated with vitally important information to help you educate yourself and others. So please visit it often.
Much has fallen into place since September, when we began this undertaking to serve others (see our mission statement). If you need to contact a patient advocate for advice or help or just someone to listen to your concerns, email feedback@halorganization.com and we will respond ASAP. We also welcome any ideas or suggestions to improve our outreach to you.
Plans for HALO include setting up a hotline and staffing it with volunteer patient advocates who will answer callers’ questions and make referrals when necessary to protect patients’ lives. Next month, Julie Grimstad will share information about our patient advocate training program. We have taken the first step by producing a video on patient advocacy that will be posted to HALO’s YouTube channel soon. Stay tuned for that.
I call your attention to two important articles in this edition of the HALO Monthly. Julie explains the problems with POLST, a dangerous advance directive that is little known to the public. And Lucy Karen Clay, a HALO advisor, warns us about Senate Bill 693, the Palliative Care and Hospice Education Training Act, which is currently in committee but already has been passed by the House. Why is this important? It is evident that you are reading this newsletter because you care for others and want to learn more and do more to help others. Read Lucy’s article and find out how you can take a strong and effective stand against the increasing dangers in end-of-life care.
The entire HALO Board of Directors wishes you a wonderful Thanksgiving. Please join us in saying a prayer of thanksgiving to God for His many blessings and answered prayers.

ADVANCE DIRECTIVES FOR HEALTHCARE

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PART TWO: THE DANGEROUS POLST FORM

By Julie Grimstad

Physician Orders for Life-Sustaining Treatment (POLST) is an advance directive form used extensively throughout the United States. POLST has many different names and acronyms, such as Medical Orders for Scope of Treatment (MOST), Clinician Orders for Life-Sustaining Treatment (COLST), and Transportable Physician Orders for Patient Preferences (TPOPP). These forms differ, and some are worse than others, but all of them can be used to encourage refusal of life-saving and life-preserving treatment and care, resulting in avoidable deaths.




A brightly colored (usually neon pink, green or yellow) form that is very visible in a patient’s medical chart, POLST reduces complicated medical decisions to a “check the box” format. Trained “facilitators” (sometimes with little or no medical expertise) ask patients questions and check boxes indicating whether they do or do not want cardiopulmonary resuscitation (CPR), a ventilator, antibiotics, IV fluids, tube-feeding, and various other medical interventions. After filling out a POLST with a patient, the facilitator presents it to a doctor or nurse practitioner (NP) for a signature. Once signed, this unusual advance directive becomes medical orders that can go into effect even when a patient is fully capable of making his or her own medical decisions and/or does not have a terminal condition.

POLST medical orders travel with the patient from one healthcare setting to the next, and even home to be followed by EMTs in an emergency. Using medical orders that were written weeks, months or years earlier is not sound medical practice.

Tilted toward refusal of treatment

POLST facilitators follow a script according to which they present treatment and care options as if all medical decisions are morally neutral.

The Respecting Choices program distributes fact sheets for POLST facilitators to use to educate patients. The “Long-Term Tube Feeding Facts” sheet concludes, “Whatever you decide, plans can be made to follow your wishes.”[1] It does not explain what those ”plans” might include, so I will. When tube-feeding is withheld from patients who are not otherwise dying (hence the word “long-term”), they will be given “comfort care” which often involves sedating patients to unconsciousness to prevent them from experiencing the pains of thirst and hunger as they die of dehydration. This is a form of euthanasia, which is both unethical and immoral.

Patients answering POLST questions may not be aware that, even if they could recover, treatments they refuse will not be provided and they could die as a result. What if an elderly person is in an accident? Will he be given the life-saving treatment he would probably want in this situation? Or will he be denied it because of some boxes checked by a POLST facilitator?

The way questions are phrased can manipulate patients’ responses. For example, a facilitator may ask, “Do you want comfort care? Do you want us to focus on keeping you comfortable?” The patient says, “Yes of course,” not realizing that this answer will be interpreted to mean, “Stop efforts to treat my illness and only provide comfort measures.”

The POLST form is designed for only one thing—refusal of treatment. A typical POLST form states, “Any section not completed implies full treatment for that section.” Therefore, if a person wants full treatment, a POLST is pointless.

A cost-saving strategy

John M. Haas, president of the National Catholic Bioethics Center (NCCB), in a letter to the Secretaries of Health and Human Services and the Veterans Administration regarding POLST, dated June 7, 2017, noted that “evidence suggests that such approaches have more to do with cost saving than the protection of informed consent. In fact, the very means by which costs will be saved is the premature death of a patient through the denial of basic care.”[2]

Listening to POLST’s advocates leads to the conclusion that POLST is indeed a strategy to cut spending on medical care for the most vulnerable patients. For example:

  • Dr. Robert L. Fine, Director, Office of Clinical Ethics and Palliative Care, Baylor Health Care System (Texas), addressed “Why should we support POST?” One of several reasons he listed was “High costs in the last year of life with 28% of Medicare dollars spent in the last year and 14% spent in the last 2 months of life.”[3]
  • The Gundersen Health Systems, La Crosse, WI, has been promoting a model for advance health care planning—the Respecting Choices program—since 1991. The program promotes POLST and trains POLST facilitators. An article advertising Respecting Choices stated, "Partly due to Gundersen's Respecting Choices program, end-of-life medical costs in La Crosse are nearly half the national average."[4]

POLST’s reach is expanding

According to the National POLST Paradigm website (polst.org), “The POLST form is for seriously ill patients for whom their physicians would not be surprised if they died in the next year, not for all patients.” Despite this qualification, POLST’s reach is expanding.

Case in Point: Jo Tolck, Vice President of the HALO Board of Directors, received a call from a woman in Minnesota who had been given a POLST form at her doctor's office when she was there for a procedure necessary to have a prescription renewed. She reported being strongly encouraged to sign the POLST form. However, having read Informed: A guide for critical medical decisions[5], she knew this was not a good idea and was incensed at the pressure being put on her to sign the POLST. The staff member finally asked her to take it home and think about it.

Case in Point: An attorney in Wisconsin, who has “heard many stories like this,” reported: A woman in her forties came to the Emergency Department at a local hospital. She was in such respiratory distress that she could not talk. While waiting for a doctor, she was approached by the unit clerk who wanted to complete a POLST with her. The nurse, who had brought the woman to the hospital, intervened and stopped the POLST process. The ward clerk said it was their policy to do a POLST on any one with respiratory problems. The woman’s problem was an allergic reaction to a new medication. An Epi-Pen injection completely restored her to health.

I have also received reports from credible sources that some nursing homes require every resident to have a POLST, even though many people live in nursing homes for several years or more.

POLST is a uniquely dangerous advance directive

No other type of advance directive requires a healthcare provider’s signature. Every other advance directive requires the signatures of the person making the directive and witnesses, yet many POLST forms do not require either. For instance, the La Crosse Area (Wisconsin) POST merely recommends the signature of the patient or surrogate and no witnesses are required. Incredibly, this POST form permits a physician or NP to initial a box “to verify that the patient or surrogate consent to these orders but was unwilling or unable to sign.” If a person was unwilling to sign a document, it is doubtful that the person consented to it. Without witnesses, how can we prevent fraud and protect patients from being coached or coerced to refuse treatment?

As a routine part of a visit to the doctor, Medicare started paying for conversations about “advance care planning” in January 2016. The goal to is get patients to fill out advance directives such as a POLST.

Advice: According to the National POLST website, completing a POLST form is always voluntary. Do not allow anyone to push you into it. When approached with a POLST form, firmly state, “I have a Medical Power of Attorney for Health Care[6] which will go into effect if ever I need my agent to make decisions for me. Until such time, I want to discuss my condition and treatment options with my attending physician as needed. Please respect my wishes.”


[1] http://www.northtexasrespectingchoices.com/wp-content/uploads/MC760-E-TubeFeedFacts_v9-15.pdf
[2] https://www.ncbcenter.org/files/4715/0896/0198/HaasPolst.pdf
[3] "A POLST form for Texas: What is it and why is it important?" A presentation to GETAC Medical Directors, Robert L. Fine, MD, FACP,https://www.dshs.texas.gov/emstraumasystems/POLST.pdf
[4] Modern Healthcare, 6/11/2015, "'Revolutionary' change for life's final choices would reduce unwanted care," by Andis Robeznieks]
[5] 
https://resources.humanlife.org/pdf/informed.pdf
[6] See “Advance Directives for Healthcare – Part One: The Best Advance Directive is a Medical Power of Attorney,” https://newsletter.halorganization.com/search/label/Advance%20Directives%20For%20Healthcare

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@HALOrganization.com.
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.

OPPOSE SENATE BILL 693 NOW, BEFORE IT’S TOO LATE!


By Lucy Karen Clay
Let’s get rid of the fraud and waste and abuse in the Medicare system and in the federal hospice program before we put …good money after bad.
--Joni Eareckson Tada
Months ago, when I read the ALERT about Senate Bill 693—the Palliative Care and Hospice Education Training Act—from Ron Panzer (President of Hospice Patients Alliance) and Nancy Valko (a spokesperson for the National Association of Prolife Nurses), my immediate reaction was to look the other way. It was too much…too heavy...too impossible. The weight of it was far beyond anything my mind could comprehend. I do not have the expertise to begin to understand the ramifications of it all, yet my spirit was and still is screaming that this bill is potentially one of the worst threats to the lives of medically vulnerable patients that our country has faced to date. 
I found it even more challenging that those whom I assumed would be willing to speak out about it were nowhere to be found! AT LAST, Joni Eareckson Tada (Founder and CEO of Joni and Friends International Disability Center) stepped out to plead for immediate OPPOSITION while this bill, which already has been passed by the House, is still in the hands of the 23 Senators who sit on the Health, Education, Labor, and Pensions (HELP) Committee.
Joni points out that S. 693 will do two things.
  • Pour a massive amount of taxpayer dollars into hospice programs.
  • Fund new and much more liberal palliative care and hospice education.
Opposition to this bill is not opposition to good pain management and care provided by reputable, life-affirming healthcare professionals. However, palliative care and hospice programs often are not as advertised.
Most existing hospice programs are plagued by tremendous fraud, a gross waste of taxpayer dollars, poor quality care, rampant abuse and, according to many reports, even murder. Furthermore, this bill is supported by Compassion & Choices, an organization whose mission is to legalize assisted suicide. We definitely do not want C&C and its allies to be involved in designing the curriculum for palliative care and hospice education.
Time is running out to stop S. 693. Write to all the members of the Senate HELP Committee (https://www.help.senate.gov/about/members) as well as your state senators (https://www.senate.gov/general/contact_information/senators_cfm.cfm).
Urge them to VOTE NO on S. 693. A sample letter to senators is available at https://www.thesimplicityproject.org/thesimplicityproject/sample-letter-for-senators-to-oppose-senate-bill-693/ Scroll down to find the letter.
MORE INFORMATION ABOUT S. 693
Concerns:
  • S. 693 does not define what palliative care or hospice are and what they are not.
  • S. 693 does not define what abuse of palliative care or hospice is and what penalties will be applied when it occurs.
  • S. 693 does not prohibit medical killing (i.e., “medical aid in dying,” “physician-assisted suicide,” “terminal sedation” and/or dehydration to cause death, etc.).
  • S. 693 does not set penalties for violations of the law.
Additional messages confirming that this is a dangerous bill:



About the author: Lucy Karen Clay is the founder of The Simplicity Project Wellness Initiative (www.TheSimplicityProject.org) and the newest member of the HALO Board of Advisors. Among her many titles and talents, Lucy is a life advocate, educator, speaker, event coordinator and author who provides awareness of end-of-life issues.


Monthly Quiz

  1. What does Senate Bill 693 address?
  2. What does the term "terminal sedation" mean?
  3. What is POLST?
  4. What is the topic of HALO's upcoming video?
  5. What is the meaning of "stealth euthanasia?"
Hint: answers can be found in the articles in this newsletter and on our website (www.HALOrganization.com).
Email feedback@halorganization.com with any questions you have after reading the articles in this newsletter or with suggestions for issues you would like to have addressed in future editions of the HALO Monthly.


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