Combining personal experience with a passionate plea for social action, Barbara Mancini addressed the audience of “Death with Dignity: Rights and Choice,” the fourth of a series of health forums on the problems of aging. Approximately 60 people attended the forum on March 26 at First United Methodist Church of Germantown, sponsored by Weavers Way, Northwest Village Network, East Falls Village, Mt. Airy USA and Ralston My Way.

Barbara, an emergency-room nurse with 30 years’ experience, was charged in 2013 with assisting an attempted suicide by her father. Barbara explained that she had handed her father, who was 93 and in hospice care in Pottsville, PA, his prescribed morphine, which he took in one gulp. When she reported this to a hospice attendant, this attendant called the police. Barbara’s father was rushed to the hospital and given a painful antidote. He died five days later later of pneumonia. The Schuylkill County coroner declared the incident a homicide; the prosecution for assisting attempted suicide was handled by the office of the Pennsylvania attorney general.

Barbara described how she was pushed very hard to accept a plea bargain. She refused and insisted on a trial, which took place in February 2014. Here she was able to show that the hospice workers had ignored an earlier doctor’s prescription for morphine, that her father suffered terribly because of the side effects of the antidote, that the hospital ignored the advance directives supplied by her father, that the homicide charge was so ridiculous that the prosecutor did not even brother to bring it to court, and finally that the prosecutor had not even bothered to read all the files relating to her father. At the end, Common Pleas Judge Jacqueline L. Russell dismissed the case with a blistering criticism of the prosecution.

Barbara didn’t work for a year, incurred enormous legal expenses and risked having her reputation ruined. Since then, she has turned into an advocate for right-to-die laws and has become a speaker for Compassion & Choices, an organization devoted to death with dignity for long-suffering individuals.

After relating her story, Barbara talked about several items relating to our political and social systems. There was, first of all, tremendous pressure by the prosecutor to get her to accept a plea bargain. It seems that over 90 percent of criminal cases are settled by plea-bargaining, a system that gives prosecutors an enormous advantage. A plea bargain is a successful conviction, and prosecutors love to boast of their “success rate.”

Barbara emphasized the need to have a written advance directive, but even with such a document there may be problems. Something that spoke to the audience on a personal level was the difficulty that she had with the hospice organization. Many people in the audience were under the impression that there are few choices for hospices, and that all of them provide wonderful support for patients approaching end of life. However, in urban areas, reimbursement patterns by Medicare have resulted in the rise of many for-profit hospice organizations. One must be very careful in interviewing such organizations and learning about their policies. Personal recommendations are very useful in this regard. It is also very important to know if such organizations or hospitals have a religious orientation that would prevent them from carrying out the wishes of the patient.

She also reviewed the state of end-of-life legislation in various states. Oregon has led the way in permitting suicide at the end of life, under very strict conditions, but several states have now instituted such legislation; six others have approved it; and others are considering it. Although such legislation has been introduced several times in Pennsylvania, it is far from being approved. Barbara went on to talk about the importance of personal contact, either in person or by letter, in convincing legislators of the importance of this issue.