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Another case for nursing reform

Count the sad case of Wendy Melcher as further evidence that the Oregon nursing board is in need of reform. Melcher’s death may have been hastened two years ago by two nurses who apparently ignored provisions of Oregon’s physician-assisted suicide law by administering massive doses of drugs to Melcher — a Hillsboro software engineer who was in the late stages of throat and neck cancer. The state nursing board, which is supposed to provide oversight of the nursing profession, knew about these alleged misdeeds many months ago, but never told law enforcement officials. The board didn’t even interview family members as part of its investigation. And even though the board came to the conclusion that the nurses had acted outside the law, it didn’t revoke their licenses. The nurses are belatedly coming under criminal investigation now because a former employee of the nursing board provided information about the case to Gov. Ted Kulongoski. We’re pleased to see this inquiry by the state attorney general and the Oregon State Police. And we hope that the investigation will be vigorous not only in determining whether the nurses broke any laws, but also in reviewing the actions and procedures of a nursing board that has a track record of protecting nurses before patients. Nurses ignored the law The Melcher case, as reported in Friday’s Portland Tribune, is filled with twists, turns, conflicting memories and interpretations. But amid the ambiguities, one plain fact emerges: There would be no dispute now about Melcher’s death if the law had been followed. Oregon’s one-of-a-kind assisted suicide law didn’t forsake Melcher and her family. That accountability must fall to the two nurses — Rebecca Cain and Diana Corson — who admitted to participating in a suicide plan for Melcher. In saying this, we recognize that Cain and Corson might very well have acted out of compassion and under Melcher’s direction — although at least one member of Melcher’s family hotly challenges even those assumptions. But it doesn’t fall within the professional duties of a nurse to assist a patient’s death. It is called “physician-assisted suicide” for a reason: A physician must be involved. And until a Tribune reporter called in June, Melcher’s family was never told that Melcher’s death might have been due to anything other than cancer. Suicide law not to blame In addition to underscoring the need for better nursing oversight, this case raises other concerns. Most notably, it provides fodder for critics of Oregon’s assisted-suicide law. Since the beginning, some have argued that assisting suicide is just a step away from encouraging it. But we believe the Melcher case has more to do with human flaws than with faulty laws. If nurses — or anyone else — are willing to go outside the law, then all the protections built into the Death With Dignity Act are for naught. With or without the assisted-suicide law, end-of-life decisions always will be difficult, painful and emotional. That’s why families depend on health professionals to be not only compassionate, but also clear-headed when caring for gravely ill people. And while personal philosophies about assisted suicide vary greatly, a few things must be universally accepted: It’s wrong to break the law. It’s wrong to withhold information about a patient’s death from family members. And just as important: Oversight boards actually have an obligation to provide meaningful oversight.