Nancy Valko

Nancy Valko, RN ALNC, a contributing editor for Voices and long-time advocate of ethical and patient-safe health care, writes the regular “Bioethics Watch” column for Voices. A registered nurse since 1969, she is a spokesman for the National Association of Prolife Nurses (www.nursesforlife.org), past President of Missouri Nurses for Life and past co-chair of the St. Louis Archdiocesan Respect Life Committee.

After working in critical care, hospice, home health, oncology, dialysis and other specialties, Ms. Valko is currently working as a legal nurse consultant (www.valkogroupalnc.com).

Ms. Valko has served on medical and nursing ethics committee and has given speeches and workshops around the country on medical ethics issues. She has also served on the board and the Saint Louis Down Syndrome Association and is active in the field of disability advocacy. She has worked as a volunteer for children with disabilities, people with severe brain injuries, and bereaved parents.

She has appeared on many radio and television shows on various medical, ethical and pro-life topics; and she has written on these topics for The National Catholic Register, The National Catholic Bioethics Center, the St. Louis Post-Dispatch, First Things magazine and other publications.

"I have personally cared for many relatives with a variety of physical or mental disabilities, including my mother with Alzheimer's and terminal cancer and a daughter, Karen, who was born with Down Syndrome and a severe heart defect. Although both are now deceased, the influence of my mother and daughter has positively motivated my activities in medical ethics and working for greater support for people and families dealing with disabilities, chronic illness and terminal conditions", she writes.

Nancy married Kevin Scannell in June, 2008 and they live in St. Louis, Mo. Together, they have 4 mostly wonderful children and 3 wonderful grandchildren.

Catholic San Fransisco article on the End of Life Conference. Nancy was one of the three speakers.

Nancy Valko, one of three speakers at the Sept. 13 End - of - Life Issues Conference held at St. Mary's Cathedral in San Francisco, came to the field of bioethics through deep personal tragedy. In 1982, Valko gave birth to her daughter Karen, born with Down syndrome and a rare heart defect.

Valko's doctor gave the child only two months to live, saying the defect was so severe it seemed inoperable. She refused to accept the prognosis, and decided to use her training as a nurse to research other alternatives. She found a surgery that could correct the defect that had a 90 percent chance of success.

Reviewing the surgery, the doctor agreed, but made it clear to Valko he would support her either way.

"Either way for what?" Valko asked. She then realized the doctor would approve of withholding treatment, not because it had no potential for success, but because her child had Down syndrome.

Bioethics Watch: Should a Pro-Life Person Become a Nurse? — Nancy Valko, RN, Vol. XXIX, No. 2., 30th Anniversary Issue

Brain Death and Catholic Teaching -- by Nancy Valko, RN, Vol. XXIX, Pentecost Season 2014

Bioethics Watch: What Do Pro-lifers Really Do?, Vol. XXVIII, No. 4, Christmastide 2013-2014

Kermit Gosnell: Truths and Repercussions - Michaelmas 2013

Bioethics Watch: The “Helpful” Doctor and the Power of the Pro-life Message — Pentecost 2013

When Children Die, Where is God? — Lent Easter 2013

Open Adoption: A Love Story -- Advent Christmas 2012

Right to Health Care, Duty to Die? -- Michaelmas 2012

Bioethics Watch: Then and Now: The Descent of Ethics -- Pentecost 2012

Bioethics Watch: Special Needs, Special Gifts -- Lent-Eastertide 2012

Bioethics Watch: Organ Donation: Crossing the Line: Linking the "right to die" with organ donation has opened a terrible Pandora's Box — Advent-Christmas 2011

Bioethics Watch: The Trouble with “Free” Birth Control — Michaelmas 2011

Bioethics Watch -- The Dark Heart of Euthanasia: Selling Death -- Pentecost 2011

Bioethics Watch: Saving Catholic Health Care Ethics — Eastertide 2011

Bioethics Watch: The Most Amazing Recovery -- Michaelmas 2010

Bioethics Watch: Suicide — Prevention or Assistance? — Pentecost 2010

Bioethics Watch: Ethics Committees: Are “Death Panels” Already Here? — Eastertide 2010

Mary, Marie, and a Mother’s Love — Advent-Christmas 2009

Bioethics Watch: A Nurse’s View of Ethics and Health-Care Legislation — Vol. XXIV, No. 3, Michaelmas 2009

Bioethics Watch: War Against Conscience Right — Vol. XXIV, No. 2, Pentecost 2009

Bioethics Watch: Death and the Organ Donor -- Eastertide 2009

The Sarah Palin Effect: The Power of a Mother's Example, Advent-Christmas 2008

Bioethics Watch, Whatever Happened to Common Sense at the End of Life? "Withdrawal of treatment, “living wills”, terminal sedation, assisted suicide, organ donation, etc. Currently, it’s virtually impossible to escape all the death talk in the media and elsewhere...." -- Nancy Valko, RN -- Michaelmas 2007, Vol. XXII, No. 3

Bioethics Watch - Love, Health and Homosexuality - Although self-proclaimed experts in our society tend to characterize any concerns about homosexuality as homophobia and even hate, real love does not require approval of everything a person does but rather a commitment to the true well-being of that person.
by Nancy Valko, RN Eastertide 2004 Vol XIX, No. 1

No Blank Bullets -- [published on Lifeissues.net]-- The excuse that the only real issue is the patient's choice would be cold comfort to us doctors and nurses when we have to go home and face the fact that we helped kill another human being or had to remain silently powerless while some of us legally participated. 3/13/ 2002

Wednesday, January 25, 1995, Section: EDITORIAL, St. Louis Post-Dispatch
OREGON VOTES FOR DEATH LEGALITY CANNOT SUBSTITUTE FOR MORALITY

Have polls replaced consciences? Can right and wrong be put to a vote? On Nov. 8, Oregon voters approved, by a margin of 51 percent to 49 percent, the legalization of lethal overdoses for the terminally ill. Ballot Measure 16 (or M-16 as some in Oregon are beginning to call it) immunizes doctors from prosecution if they prescribe lethal overdoses for people expected to live six months or less.

Immediately, a state task force was formed to devise regulations to make the new law work. According to Jono Hildner, acting administrator of the state health division, members of the task force are state bureaucrats, hospital representatives, lawyers and doctors who were chosen to avoid debate about the ultimate wisdom or morality of the law. "It's not our purpose to debate whether it's good law or bad law," he said. "It is the law."

But substituting legalities for ethics does not necessarily make things simpler. Already, some disturbing facts are beginning to emerge. Cheryl K. Smith, an attorney who helped draft Measure 16, has admitted that "in about 20 percent of cases deaths will take up to four days to occur. Most of the time it will work, but the death won't be spontaneous. It will be long and drawn out, which means families will have to be educated about this. Otherwise, they'll have some emotional trauma watching loved ones take two, three and four days to die."

Derek Humphry, founder of the Hemlock Society, which proposed this measure, is already dissatisfied with the law and has written: "The new Oregon way to die will only work if, in every instance, a doctor is standing by to administer the coup de grace (lethal injection) if necessary."

Already, some euthanasia supporters are using the same arguments used in the Nancy Cruzan case to argue that the suicide "benefit" must necessarily be extended to people who cannot speak for themselves. Others point to the suffering of the chronically disabled as equivalent to the suffering of the terminally ill in an attempt to include that group in so-called death-with-dignity laws.

Also alarming is the fact that, earlier this year, Oregon obtained a waiver from the Clinton administration to begin rationing health care for the poor under Medicaid, but ironically, lethal overdoses would now be covered by the state health-care plan under "comfort care" according to the chairman of the Oregon Health Services Commission.

Therefore, you could be denied treatment you might want under Medicaid if you were terminally ill, but you would have your medicalized suicide covered by Medicaid!

Even the supposed safeguards are causing consternation in many quarters as common sense collides with Measure 16. For example, even though studies have shown that 95 percent of all suicide victims have a diagnosable mental disorder at the time of their suicide, psychological examinations are not mandatory. That is left up to the doctor's discretion even though disorders such as depression are notoriously underdiagnosed, especially in the elderly and terminally ill.

Also, according to Measure 16, families need not be notified of the death decision of a loved one until after death has occurred. Can you imagine how you would feel if you were denied even a final moment with your mother (much less a chance to convince her of the folly of suicide) by being purposely left in the dark?

Actually, the only real safeguard in Measure 16 turns out to be not for the patient, but instead for health-care providers who will be, in the words of the measure, "immune from civil, criminal liability for good-faith compliance." And, as one doctor has said, if doctors are allowed to kill their patients, "who will care about a little paperwork?"

A medical person is really not required for suicide. For example, a running car and a closed garage are notoriously "successful" in causing death. Medical people are only necessary to add a patina of respectability.

Euthanasia supporters attempt to reassure the public that very few people would take advantage of legalized suicide. If that is true, then why should we change our laws, our standards for health-care professionals, even our suicide prevention programs to accommodate these few people who insist that we approve their actions? Must we now accommodate every person's desires no matter what the consequences might be for society?

As a full-time cancer nurse, I know how vulnerable people with terminal illnesses can be. I know how cancer patients worry about the cost of their care and about being a burden to their families. But I also know that a dignified and meaningful death cannot be achieved by doctors and nurses killing their patients.

There really is a difference between allowing inevitable death and actually causing death. It is ironic that when we have so many ways to help and support the terminally ill and their families, euthanasia supporters insist that only a lethal overdose at the hands of a doctor will satisfy their desire for a "good death."

Thankfully, the Oregon law is on hold as judges determine its constitutionality. But the larger question remains: Can a society dispense with its most basic principle that innocent people cannot be legally and privately killed without dissolving into a kind of moral anarchy on life and death issues?

Unfortunately, if some of us are willing to risk legalizing euthanasia and the rest of us are intimidated into a silent "tolerance," we all will have to live (or die) with the answer to that question.

Op-Ed in the St. Louis Post-Dispatch (no longer online)
Friday, August 12, 1988
FEEDING IS NOT EXTRAORDINARY CARE-- DECISION IN THE NANCY CRUZAN CASE ADDS TO THE LIST OF EXPENDABLE PEOPLE

By Susan Harvath and Nancy Guilfoy Valko

Just a few years ago the Missouri Legislature passed a ''living will'' law that specifically excluded food and water from the kinds of care that may be withdrawn from a patient. In 1984, the National Conference of Catholic Bishops stated that legislation should ''recognize the presumption that certain basic measures such as nursing care, hydration, nourishment and the like must be maintained out of respect for the human dignity of every patient.''

Therefore, it is hoped that the Missouri Court of Appeals will overturn the recent Circuit Court decision that would deny tube feedings for Nancy Cruzan, a severely disabled woman cared for at the Missouri Rehabilitation Center. The anguish felt by the Cruzan family, which initiated the suit, is understandable. However, directly causing the death of an innocent person - even for reasons of mercy - violates that person's basic human rights.

The Cruzan case is perceived by many to be an issue of allowing a person to die. Cruzan has been categorized by some experts as being in a ''persistent vegetative state,'' an unfortunate and imprecise term at best. However, she is not dying or brain-dead. Rather, she is severely disabled from brain damage and needs no special technology to survive. Withdrawing her feeding tube would not ''allow'' her to die - it would ''force'' her to die. She would not die from her injuries, but rather from starvation and dehydration.

Also, starvation and dehydration cause a protracted, agonizing death in a fully conscious person. Some experts have stated that Cruzan would feel no pain if her feedings were stopped. Yet Cruzan's nurses have testified that she has cried, smiled and even laughed in response to stimuli.

The possibility of pain during the length of time before death occurs has led some to propose lethal injections as a more ''humane'' way to cause death than starvation. The passive euthanasia of withdrawing feeding logically leads to active euthanasia by injection or other means. Both are unacceptable.

A recent trend has been to classify tube feedings as medical treatment. However, unlike other medical treatments, denial of food from any person (sick or healthy, in or out of coma) will always result in that person's death.

Ethically, treatments may be withdrawn if they are useless or burdensome to the patient. However, tube feedings are not excessively expensive or burdensome to the patient and do maintain life and prevent the discomfort of hunger and thirst. In deciding what treatment may ethically be withdrawn one must be careful to judge the treatment itself, not the ''quality'' of the patient's life. A person's limitations do not decrease a person's humanity or worth.

In the past few years we have seen many court cases similar to Cruzan's in other states. Some have involved people less severely disabled than Cruzan. A recent case in North Dakota resulted in a judgment that even feedings by mouth may be stopped. In most cases it is not the patient who requests that feedings be stopped but rather a third party, usually a family member. Often, as in the Nancy Cruzan case, there is no clear and convincing evidence that the patient would even want the feedings stopped.

Some courts have gone even further and have stated that third parties do not need the approval of a court before a patient's food and water is withdrawn unless there is disagreement, for example, among family members. This trend has unfortunate implications for all people with mental impairments.

There is a vast difference between not prolonging dying and causing death. In the last two decades we have seen killing promoted as a humane and compassionate response to unwanted unborn children, newborns with handicaps and the terminally ill. Let us not add a new category of people (the non-dying, severely disabled) to the list of expendable human lives.

Nancy Guilfoy Valko, R.N., is co-chairperson and Sue Harvath is program director of the St. Louis Archdiocesan Pro-Life Committee.