National Catholic Register: Is hospice movement going beyond end-of-life care?
STEUBENVILLE, Ohio (National Catholic Register) – Families who have contacted the nonprofit Hospice Patients Alliance are raising important questions about hospice as a movement.
Although hospice’s stated mission remains that of providing compassionate and dignified care to people at the end of life, some are asking whether hospices are starting to go beyond that role by hastening death instead.
Since the first hospice program was started in the United States in 1974, hospice organizations have served more than 1 million patients at the end of life by providing a range of services dealing with management of pain and physical symptoms and psycho-social needs.
Many families who have had a hospice experience speak positively, even glowingly, of it, saying a hospice was able to help them at a difficult time in a way traditional health care could not.
But, especially since the March 2005, imposed-starving death of Terri Schiavo, reports of a dark side to the hospice movement are emerging.
In the state of Oregon, for instance, legalized assisted suicide takes place in some hospices, according to Rita Marker, executive director of the International Task Force on Euthanasia and Assisted Suicide in Steubenville, Ohio.
Even in cases where the hospice staff does nothing more than provide support to the family during an assisted suicide, allowing the suicide to occur can be seen as a form of participation in evil, Marker said.
Although such developments don’t necessarily mean that hospice as a movement has changed, Marker said consumers need to be cautious before turning themselves or a loved one over to hospice care.
“You need to know who is in charge, what the protocols are, what the philosophy of that hospice is, and where they stand on the issue of food and fluid,” she said.
A spokesman for the hospice movement said that hospices neither hasten nor prolong dying. Stephen Connor, vice president of research and international affairs for the National Hospice and Palliative Care Organization, added that the Alexandria, Va.-based group has a longstanding board resolution against assisted suicide.
Where assisted suicide is legal, Connor said, a hospice patient cannot legally be discharged because he or she wants to take a lethal prescription. In those cases, he said, the staff may be present to support the patient’s family.
Food and water
Connor said his group’s standard on medically administered food and hydration is that “people have a right to decide whether they want those interventions or not. And a decision about whether they should have them or not resides with the patient, usually made in the context of a family system. They ought to decide whether they want it or don’t want it, and those wishes should be respected.”
Connor said hospice does allow the withdrawal of food and hydration, even when the patient is not in immediate danger of death, although individual hospice programs vary in their policies on medical nutrition and hydration. Some do not allow patients to have intravenous fluids or feeding tubes, for example, while others may permit them.
Former hospice nurse Ron Panzer called hospice “a wonderful service if done with integrity and morality.” But, since founding the Hospice Patients Alliance in Rockford, Mich., in 1998, he has heard from patients, families and caregivers who have concerns about hospice care, ranging from overmedication to refusal of food and fluid.
Panzer, who now works in home health care, claims that some hospices eagerly hasten death and fight every attempt to prolong life.
“They interfere at every step in ordinary care,” he said. “They’ll pull the rug out from a patient by removing food, hydration and medications, and refusing to provide treatment for easily treated infections.”
Church teaching is clear on the subject. Even when death is thought to be imminent, the Catechism of the Catholic Church (No. 2279) states that “the ordinary care owed to a sick person cannot be legitimately interrupted.”
Richard Doerflinger, deputy director of the U.S. Conference of Catholic Bishops’ Secretariat for Pro-Life Activities, said even though a person is terminally ill, assisted feeding can still be a form of basic care that should be provided unless and until it is actually doing more harm than good to the patient.
Pope John Paul II, in an address to the international congress on “Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas” on March 20, 2004, said: “The administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act. Its use, furthermore, should be considered, in principle, ordinary and proportionate, and as such morally obligatory, insofar as and until it is seen to have attained its proper finality, which in the present case consists in providing nourishment to the patient and alleviation of his suffering.”
The church teaches that assisted feeding can be validly ...
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