By Ron Panzer, Executive Director, Hospice Patients Alliance
The following is part 2 of a 3 part series on the history, state and future of hospice.
For someone who cares about hospice's original pro-life mission, what the hospice industry, for the most part, has become is a painful topic to address. Listening to people from all over the United States and other nations who have had traumatic experiences with hospice is also painful, yet that is what I've done for the past two decades.
At the very start of this article, it is important to clarify that Hospice Patients Alliance enthusiastically supports the original pro-life mission of hospice—to maintain dignity, to increase quality of life, and to provide comfort and pain control. Through our work, we help promote that mission and foster the provision of needed services. All healthcare MUST be pro-life, otherwise it is not health CARE!
If healthcare is not pro-life, it would be better for us to avoid entering into the healthcare system at all.
While we condemn actions that do harm to patients, we are not saying we should hate those who serve in hospice and other healthcare settings. We do not support "hospice haters" whose sole focus is to tear down and attack the industry for crimes committed against their loved ones, but we do not shy away from telling the truth about what has happened to the industry and its victims. The solution—and an essential part of our mission—is to promote reverence for God and for the life He has given, and to serve those in need with a love that manifests His face in the world.
The “Sacred Cow” of Healthcare is Actually a “Cash Cow”
For promoting reverence for life, we are attacked by those who have joined the hospice cult, who tell us that hospice can do no wrong at all. Without a doubt, hospice is the "sacred cow" of healthcare. Criticizing hospice, to put it mildly, is not politically correct.
Hospice is being promoted by our federal and state government bureaucracies as THE place where they prefer everyone to die. Billions of dollars are saved when hospice is utilized instead of acute hospital care. Hospice, as it has become, often eliminates those who are deemed “unworthy of life.” Our healthcare system in general and hospice in particular has an agenda to end the lives of those who require extensive and costly services.
There was a time when all physicians were required to take the Hippocratic Oath by which they promised never to give a lethal medication or anything that would cause an abortion. It was understood that these were evil acts. However, many physicians today do not promise to protect life and to never act to cause death.
Secular humanist, utilitarian "ethicists" have defined as "good" actions that are completely alien to the principles of the Hippocratic Oath. These “ethicists” believe that ending the lives of people who are suffering is good because it ends their suffering permanently. They also believe it is good to end the lives of those who enter acute hospital settings "too frequently" and whose care is costly, so they send patients with treatable conditions into hospice to be made dead.
These utilitarian “ethicists” have discarded the traditional moral compass that many of us expect healthcare professionals to have. If people only knew what their “principles” actually are and how their deadly “ethics” are being implemented, they would prepare to do battle before entering any healthcare setting!i
When the Healthcare Environment Becomes Hostile to Life …
Why should pro-life medical professionals bother to serve as physicians, nurses, and other healthcare providers when it is made difficult, if not impossible in some settings, to provide life-preserving care? Why should pro-life patients bother entering a healthcare setting if they can’t trust that they will get the care they need and want? In fact, many of our finest medical professionals are leaving and some people are avoiding healthcare settings entirely if they can.
People call us to ask questions and to learn about the services hospice may provide, but our most common call is from a person whose loved one is not receiving the care that is needed and is required by the standards of care. It is troubling enough to know that a loved one is facing death in the near future, but it is truly distressing to have to argue with hospice staff to obtain basic care that was promised by an agency, but is not being delivered.
Even more troubling is having to fight with the hospice to stop unwanted interventions such as the removal of the patient’s essential medications while they still provide benefits, the administration of unwanted medications that sedate and may cause death, and various decisions made by staff that are intended to cause harm to one's loved one! How terrifying it is for patients to realize that the staff are denying them helpful, life-preserving medications while forcing unwanted and unnecessary sedatives or opioids on them. On the other hand, some patients cry out for pain relief and do not get it.
We allow our loved ones to enter hospice programs and healthcare facilities so they will be given excellent care, and we expect such care to be delivered. However, when the healthcare environment becomes hostile to life—rather than life-affirming—it becomes a nightmare. That is the reality for many families and patients today.
We have heard just about every complaint you can imagine. Virtually every service that you would expect to be delivered has at some point been denied to a patient somewhere. Though hospice agencies advertise that they provide the "full range of services" required, they often only provide a few services. Access to required services—such as nutritional counseling by dietitians, speech therapy, occupational therapy and physical therapy—are promised, but rarely delivered. How do we know this? Not only do the families call us to complain, but therapists who have been signed on as "the hospice therapist” report to us that their agencies won't allow them to provide services!
What about imposing death? Do they really do that? Absolutely! And, they do it in many ways. One of the most common methods is the misuse of "terminal sedation" to sedate the patient permanently so they dehydrate, their blood circulation collapses, and they die. Another method for imposing death is intentionally overdosing the patient with various opioids (e.g., fentanyl and morphine). Often hospice staff will administer psychotropic medications (with names such as Haldol, Risperdal, and Ativan) that are medically contraindicated and unneeded. These medications disorient patients, leading to justifications for more sedation!
Rather than affirming the lives of their patients, hospice staff who are not pro-life actively encourage patients to stop eating and drinking, promising them that they will be kept “comfortable” as they starve and dehydrate to death. It's a method that's been popularized as VSED ("voluntary stopping eating and drinking"). This is suicide. Of course, as patients truly approach death, they begin to eat and drink less until they don't need food and fluids at all. However, VSED means stopping eating and drinking long before the patient is near the natural end of life.
If you wish to know what is really going on in hospice today, the Hospice Patients Alliance has provided dozens of accounts reported by surviving family members.ii
iDianne N Irving, M.A., Ph.D., What is "Bioethics"? June 3, 2000, LifeIssues.net
iiStealth Euthanasia: Health Care Tyranny in America, especially Chapter 12, “How Things Work: Typical Hospice Scenarios for Hastening Death
"Four Part Explanation about Hospice and Its Tainting by Secular Humanists like Ira Byock, MD"
"Main Topics," Section 10: “Tragic Lessons From Patients Mistreated
by Hospices (and other facilities)”