Nurse charged in father's death hopes for dismissal

Joseph Yourshaw died Feb. 7, 2013, at a hospice after taking morphine. He had said he wanted to die.
Joseph Yourshaw died Feb. 7, 2013, at a hospice after taking morphine. He had said he wanted to die.
Posted: January 16, 2014

The clock ticks on in the Barbara Mancini case.

As her husband e-mailed last week, "Eleven months of pure hell!" And yet the prosecutors are equally adamant that a crime occurred.

The Philadelphia nurse was charged with aiding a suicide, a felony, on Feb. 7, 2013, when she handed a bottle of prescribed morphine to her 93-year-old, terminally ill father, Joseph Yourshaw of Pottsville, who had said repeatedly that he wanted to die.

Mancini, 57, is not only awaiting trial, but also a ruling on a motion Oct. 10 by her lawyer to dismiss the charge - a ruling expected any day now from Schuylkill County Court Judge Jacqueline L. Russell.

 The case has received worldwide coverage. Rarely does an arm of the state reach the bedside of a terminally ill man and prosecute a daughter caring for him. Millions of Americans have found and will find themselves in similar situations.

In briefs filed over the Christmas holidays, the defense argued that without the testimony of hospice nurses - who recited incriminating conversations they allegedly had with Mancini - the state would have no case.

The prosecution in its brief said there is plenty of other evidence, namely a prescription for morphine that Mancini requested for her father. The prosecution says this request shows an intent by the daughter to get morphine and give it to her father, who had refused all drugs, with the express intention of helping him die.

The defense says this is nonsense. It contends morphine was prescribed by a physician the day her father was admitted to hospice, but never filled, so all Mancini was doing two weeks later by calling the hospice and asking for a prescription was trying to relieve her father's pain.

When Yourshaw was admitted to hospice Jan. 17, 2013, the admitting doctor wrote in his order that he "refuses all meds and has disengaged himself from any medical suggestions for his care. He continually states that he wants to die so he is self-restricting his food intake. He sleeps frequently. He says he has pain across his chest all the time but refuses any treatment."

In the patient plan of care, created the day of admission to hospice, many prescriptions were given for symptom management but never filled. Included was "Morphine Sulphate 20/mg/ml for moderate/severe pain."

 The order also said, "The patient may self-administer medications."

On Feb. 1, Mancini called the hospice and asked for a prescription for a five-milligram dose of morphine, according to the prosecution. A hospice nurse said the patient was "opiate-naive" and "other medications should be used prior to morphine," according to hearing testimony by a hospice nurse.

Mancini, according to testimony of hospice nurses, said she understood. She is a career ER nurse. But her father needed morphine, she said. He was in extreme pain. The hospice nurse testified that she was comfortable asking the doctor for a 2.5-milligram dose, and on Feb. 1, Yourshaw was prescribed 2.5 milligrams every four hours, up to 15 milligrams in 24 hours.

The liquid medication arrived on Feb. 2, enough for 40 days, a total of 600 milligrams.

The prosecution, led by Senior Deputy Attorney General Anthony W. Forray, alleges that Mancini gave her father a nearly full bottle Feb. 7, intending and knowing that if he drank it all, he would die.

When the hospice nurse showed up unexpectedly Feb. 7, because Yourshaw had fallen the day before, Mancini, according to the state, told her how she had honored her father's wish.

Since Yourshaw was still breathing when the nurse arrived, Mancini, according to the state, asked the hospice nurse to supply more morphine. The state alleges that when the hospice nurse, Barbara Cattermole, got alarmed and felt a law might have been broken, that a suicide had been attempted and assisted, Mancini asked the hospice worker to forget everything she had said, and eventually threw the hospice nurse's phone against the wall in frustration.

Mancini has yet to give her side of the story. She has had no opportunity to testify and has been barred by court order from speaking with reporters.

Joe Mancini said his wife has been enormously frustrated about being unable to present her side while living with these allegations.

Barbara Mancini has worked as an emergency room nurse all her adult life - that is where she met her husband, a paramedic.

She has been suspended without pay from her job at a local hospital since the preliminary hearing Aug. 1 and has incurred $100,000 in legal fees, her husband said.

Stephen Goldfine, chief medical officer for Samaritan Healthcare and Hospice in South Jersey, asked to comment about the case, said that in his experience, when dying patients refuse medications, they are typically refusing life-sustaining medications, but welcome medications to relieve pain.

Goldfine also said that even for an opiate-naive patient, a five-milligram dose - the amount requested by Mancini for her father - is reasonable and common.

Defense lawyer Fred Fanelli contends that all Mancini did was hand her father medication that he requested, that was legally prescribed, and that he easily could have gotten up and reached himself.

The state does not dispute that Yourshaw asked his daughter for the medication and that he drank it willingly.



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