Have you heard the principle expressed that hospice care neither artificially prolongs life nor hastens death?  This concept of hospice care is prominently stated on the Hospice Foundation of America web site.  It turns out that this phrase amounts to nothing more than bait and switch advertising.  Practicing “buyer beware” is strongly advised.

Hospice Foundation of America has published a book entitled Living With Grief: Ethical Dilemmas at the End of Life.   Actions called ethical in this book are anything but ethical.  Buried in the middle of the book, in a chapter extolling the ethics of assisted suicide, are statements that reveal typical hospice care often hastens death.

Here is a telling sentence that summarizes the means used to hasten death: “It is well known that hastening death is practiced and approved in many ways in contemporary terminal care when suffering is extreme and irremediable – for example, by terminal sedation, by delivering pain relief sufficient to cause death by incidentally suppressing breathing, or by withdrawing nutrition and hydration. Given the obligation to relieve suffering, such practices are not incompatible with the physicians’ oaths.”

“Extreme and irremediable” suffering turns out to be nothing more than patient (or caregivers) concerns about “quality of life” and “dying with dignity.”  Under the “principle of autonomy” patients should have the opportunity to choose suicide when they are “rational” in making that choice.

The chapter on assisted suicide presents the so-called ethics of assisting the “would-be suicide” with the following logic on why the caregiver is not responsible in any way for the death of the patient: “Assisting suicide does not involve killing others or taking steps that cause or hasten their deaths.  Suicides kill themselves.  Assistance involves such things as giving would-be suicides information about how to kill themselves, enabling them to secure the means of doing so, giving them realistic options, interacting with them as they choose among their options, assuring them that their choice will be respected, supporting them emotionally once they have decided, and protecting them from unwanted intervention.  The would-be suicides themselves are entirely responsible for exercising the option and completing the act of killing themselves.”

Doesn't that sound like the same thing as being an accomplice to a crime?  If valid ethics have reached such a state, we need to inform the criminal courts that they can no longer prosecute the person who drove the bank robber to and from the bank that was robbed.  Clearly, this parallel example shows that what is being called ethical behavior to encourage patients to kill themselves does not pass the test of either logic or ethics.

Hospice Foundation of America puts its name squarely behind this faulty logic to justify behavior that is not ethical at all.  Their reference to these means to hasten death as “contemporary terminal care” warns us that these practices might also be found outside of hospice care.   We might be in danger in hospitals and nursing homes as well, but Hospice Foundation of America is willing to document such practices as ethical end-of-life care.   Beware of the philosophy of care provided by any hospice, but especially of those associated with this foundation.

Whether death is hastened by actions of caregivers or the patient, this is certainly not death with dignity!  The author suggests the same false concepts of “choice” that we have heard for years to justify abortion.  If you do not accept these actions as ethical, do not commit suicide yourself or assist someone else, but do not try to prevent others from exercising their “right to die.”  The author even goes so far as to claim that not referring “would-be suicides” to others who would be willing to assist them would be unethical.  That is what always happens when something truly unethical gets labeled as a right.  Wrong becomes right and right becomes wrong!

Bill Beckman