How End-of-Life Care Is Undermined: A Podcast Conversation with the Pennsylvania Nurse Prosecuted for Aiding Her Father’s Death

Podcast Episode 111: End of Life Planning – The Story of Barbara Mancini, RN, MSN (Part 1)

In February 2013, Barbara Mancini was arrested in Pottsville, Pennsylvania, and charged with aiding the attempted suicide of her dying 93-year-old father, Joseph Yourshaw.  Barbara had handed him his prescribed morphine at his request.  A hospice nurse called 911 after Mr. Yourshaw took the morphine. The hospice nurse and the police ignored Mr. Yourshaw’s written advanced directives, and he was hospitalized and treated in defiance of his end-of-life wishes. Joseph Yourshaw died at a hospital four days later.

 Barbara’s prosecution lasted a year, during which it garnered national attention and was roundly criticized throughout the media. The charges against Barbara were dismissed when the judge ruled that there was insufficient evidence to send the case to jurors.

Barbara was interviewed about her case on 60 Minutes, and National Public Radio, and has spoken to diverse audiences about her experience. She has become a vocal advocate for improved end-of-life care and for increased options at the end of life, including medical aid-in-dying. 

In the compelling 25-minute podcast interview with ElderLawAnswers National Director Rebecca A. Hobbs, Barbara explains the four factors that she believes undermine end-of-life planning:

         1. The imperative of our health care system to “save” lives; 

         2. People who disagree with the dying person’s values and wishes, and who hold positions that cause them to disregard or override the patient’s careful planning;

         3. Incompetent or inadequate hospice care; and 

         4. Politics surrounding when and how individuals are allowed to die.

As Barbara makes clear, Joseph Yourshaw did everything right. He had an advanced directive and he discussed his end-of-life wishes with his family. Despite this, at the end of his life his wishes were not followed. Barbara believes that a few elements contributed to the ordeal that her father had to endure in his final days, one being the failure of his hospice to provide the care he was entitled to. Barbara also explains that most state laws make no distinction between, on the one hand, the desire of the dying to have a comfortable and peaceful end on their own terms and, on the other, a mental health crisis that leads to suicide. Other contributing elements include local politics and a U.S. criminal justice system in which, once you are accused of a crime, it becomes very difficult to stop a prosecution.

To listen to the full podcast episode, click here.

To read Part 2 of this two-part series, click here.