Assisted-suicide charge strains Phila. nurse and her family

Joe Mancini shows photographs of his 93-year old ather-in-law Joseph Yourshaw in his younger days (left, in 2009) and more recently (right, last fall, with his wife, Marge). TOM GRALISH / Staff Photographer
Joe Mancini shows photographs of his 93-year old ather-in-law Joseph Yourshaw in his younger days (left, in 2009) and more recently (right, last fall, with his wife, Marge). TOM GRALISH / Staff Photographer
Posted: October 01, 2013

The Philadelphia nurse charged with assisted suicide for giving morphine to her terminally ill, 93-year-old father has been suspended from her job without pay, run up legal fees of $90,000, and often can't sleep because she feels so angry and hurt, her husband said in an interview.

"It is at times, for all of us, unbearable," Joe Mancini said, at times breaking into tears himself.

Barbara Mancini, 57, was charged with aiding a suicide, a felony, on Feb. 7 in Pottsville. Her case erupted into worldwide news after her preliminary hearing on Aug. 1. She could face up to 10 years in prison. No trial date has been set.

"How do you put into words [how] someone you truly love is being so wronged? And has been so unfairly and unjustly prosecuted and persecuted by the state Attorney General's Office?" asked Joe Mancini, a paramedic with the city.

Ever since medicine has gotten so good at keeping people alive, the nation and its courts have tried to balance the individual's right to die with dignity with the state's responsibility to protect its most vulnerable citizens.

This case takes that tension right to the bedside of a terminally ill man in hospice care being cared for by his daughter, a situation in which many Americans find themselves.

According to a Feb. 7 police report and testimony at her hearing, no one disputes that Barbara Mancini handed an unknown quantity of legally prescribed morphine to her father, Joseph Yourshaw, who had asked her for it.

Yourshaw, an Army veteran of the Battle of the Bulge, suffered from diabetes, heart disease, end-stage renal disease, and the effects of a stroke. He had an advance directive stating his wish to die at home without extraordinary measures.

He designated Barbara Mancini to have medical decision-making authority if he could not speak. He had a do-not-resuscitate order, and had told family and hospice workers he had accepted his death and was ready.

Barbara Mancini, who lives with her family in Roxborough, often drove the 200-mile round-trip to Pottsville to care for her father.

On Feb. 7, soon after Yourshaw took the morphine, a hospice nurse arrived. After a conversation with Barbara Mancini, and despite Mancini's objection, the nurse called 911.

"I responded on a report of an attempted suicide by drug overdose," police Capt. Steve Durkin wrote in his report. "I was met . . . by Barbara Lattermole, a nurse with Hospice of Central Pa., who told me that her client had taken an overdose of his morphine with the intent to commit suicide.

"Lattermole further stated that her client's daughter was present and told her she gave him the morphine at his request so he could end his suffering."

Durkin also said he spoke with Barbara Mancini: "She told me that her father had asked for all his morphine so he could commit suicide and she provided it."

When the ambulance arrived, Durkin continued, Barbara Mancini "told them not to take or treat her father." But the officer said he told Mancini "that she no longer had any say in the matter and her father was going to the hospital."

Her father was revived at the hospital with the drug Narcan. He was given a urinary catheter and breathing mask, among other treatments, according to Joe Mancini   .

Barbara Mancini wife was arrested and released on $100,000 bail. Yourshaw died four days later in the hospital - after receiving morphine to ease his pain.

Joe Mancini said the police report and trial testimony contained misinformation, and noted that his wife had not yet publicly given her side of the story.

At the preliminary hearing, District Justice James K. Reiley ordered all parties not to discuss the facts in public. Joe Mancini,  who spoke at a meeting last week of the advocacy group Compassion & Choices in Philadelphia  , was careful not to discuss events leading to his wife's arrest. He mostly talked about the case's impact on his family.

He said his wife, an emergency room nurse, was put on personal leave without pay after the Aug. 1 hearing. He would not disclose the name of hospital because his wife hopes to return to her job,  working weekends  , once she is vindicated. The couple live with their two teen daughters.

 Joe Mancini said he was working extra shifts to try to make up for his wife's lost income. He said his wife worries about her mother, 84, who has been stressed by the arrest and who went to a hospital last week with chest pains.  

For a while, the Mancinis also retained a lawyer in St. Louis. "We can no longer afford two attorneys," Joe Mancini said. "Remember, lawyers charge for every phone call, letter, etc. It quickly adds up."

Barbara Mancini's local attorney, Fred Fanelli, filed a motion last week to dismiss the case. It argues that Mancini did not open any bottle, or mix any ingredients, or encourage her father in any way.

"According to the testimony," the motion states, "Ms. Mancini did nothing more than hand her father the bottle so that he could ameliorate his pain. As recognized in [U.S. Supreme Court cases] Glucksberg and Quill, Joe Yourshaw had the right to self-administer as much of the morphine as was necessary to get relief, even if it hastened his death."

The brief also says a hospice nurse at the hearing testified that Yourshaw had once before tried to drink a bottle of morphine.

"Joe wanted to die; he had unfettered access to the morphine; he could open the morphine and administer it to himself."

Because the local prosecutor was a friend of Barbara Mancini's sister, the case went to the attorney general to prosecute.

"She is a registered nurse," Senior Deputy Attorney General Anthony Forray said at the hearing. "She knows the effect of morphine. We believe the evidence is overwhelming."

In August, state Attorney General Kathleen Kane told the Harrisburg Patriot News: "We will be prosecuting that case because it is a violation of our state laws."

On Thursday, Kane's spokesman, Joe Peters, said: "Clearly, it's a tragedy all the way around. We are not unmindful of the emotion and difficulty."

He added: "The facts met the statute and we had no choice but to bring this charge. We are simply doing our jobs."

  One group that typically supports assisted-suicide prosecutions is concerned the case may discourage other prosecutors from pursuing more viable and heinous cases.

"Never mind public sentiment," said Stephen Drake, a research analyst and spokesman for Not Dead Yet, a disability rights group. "You've got big evidentiary problems . . .. All she did was hand her father his own prescription medication, which was meant for pain relief, and he was entitled to take what he wanted."

In another unusual element to this case, the hospice nurse was the one who called 911, leading to Mancini's arrest.

"I'm really worried about how this might impact the way people use hospice," said David Casarett, medical director of the Penn Wissahickon Hospice.

"One is people will say, 'Yeah, I don't want a stool pigeon in our home. I don't want to be turned in.' I can imagine patients saying, 'I don't want to take a drug like an opioid and get my family in trouble.' And I can imagine a family member saying, 'I don't want to get involved in the care, because we could get in trouble.'

At the same time, he said, "I don't think it's the hospice nurse to blame. If there's a problem here, it's that this became a criminal prosecution.

"It shouldn't be a crime for a daughter to help her father take a dose of morphine that was prescribed legally for a legitimate purpose," added Casarett, who is also head of hospice care at the University of Pennsylvania. "Where it gets more complex is if someone wants to take the medication for the express purpose of ending their life. Like it or not, in the Commonwealth of Pennsylvania, legally you can't do that."



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