The Dangers of Hospice

Hospice has developed a good reputation for providing compassionate care for dying patients.  A key principle is that hospice care neither artificially prolongs life nor hastens death.  Unfortunately, this principle is no longer consistently followed in hospice care.  This lack of consistency requires a “buyer beware” attitude when evaluating which hospice might be appropriate to provide truly compassionate end-of-life care.

Illinois Right to Life offers a Hospice Checklist to help evaluate the underlying philosophy of care practiced by any specific hospice.  Seeking answers to the questions on this checklist should be helpful in that evaluation.

As with any new information, I was initially skeptical that hospice could be killing people.  Calls from two nurses no more than one week apart informed me that morphine overdoses are being used to kill hospice patients.  Once I started to investigate on my own, I was helped by receiving a copy of a book published by Hospice Foundation of America, 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.”  Tragically, abuses of patient rights are becoming more common at those hospices controlled by “right to die” leadership.  Actions may be taken to hasten death either against the wishes of relatives or of patients themselves.

I have received phone calls and emails from a number of people who witnessed occurrences of this practice.  In one case the wife made a decision to get hospice involved in her husband’s care during his recovery from both surgery and another medical procedure to remove a brain tumor.  Even though the brain tumor was declared to be in total remission by the surgeon and the patient was not in pain, pain medications were forced on the patient.  This was the initial stage of the process that too often leads to an eventual overdose on morphine.  I was asked for advice by the patient’s niece who witnessed the mistreatment of her uncle that was occurring. 

In another case, a mother was on a feeding tube and being cared for by one of the younger sons among her eight children.  The oldest daughter arrived one day to take their mother to hospice “because she would not want to live this way.”  Most of the siblings, who opposed this move to hospice, needed to get an attorney involved even to get the opportunity to learn where their mother was taken so they could visit her.  They learned that their mother was no longer being given food through her feeding tube.  Even though she had not been taking pain medication at home, she was now being given pain medication under hospice care.

Whether death is hastened by denial of food and water or suppression of breathing using overdoses of morphine, this is certainly not death with dignity!  

William Beckman