Hospice Care May Extend Life
This study demonstrates an important point: Hospice care can extend life because, relieved of much suffering by proper care, patients can actually live longer than if they were not receiving such treatment. From the story:
"This [the study's results] should be reassuring to those faced with life-threatening illness and their families who are considering hospice care," Dr. Stephen R. Connor of the National Hospice and Palliative Care Organization based in Alexandria, Virginia, told Reuters Health. Hospice care is not "giving up." It is choosing to live life fully to the end, he said.
Connor and colleagues analyzed the survival of 4,493 terminally ill patients who died within a 3-year period. A total of 2,095 of them received hospice care. Survival was measured as the time to death after a defined "indicative date" of the beginning of the terminal stage of illness. The team reports in the Journal of Pain and Symptom Management that hospice patients lived an average of 29 days longer than non-hospice patients.
Yes, yes, I have heard the stories of hastened deaths occurring in hospices. But I remain convinced that while there are a few bad eggs, most hospices are dedicated to the proper care of their patients until natural death.
And this seems a good time to point out something about assisted suicide and hospice: If hospice is indeed "choosing to live life fully to the end," then when a doctor assists the suicide of a hospice patient, he or she is in complete violation of the hospice medical philosophy. Thus, when Oregon advocates for assisted suicide claim that patients were in hospice when committing assisted suicide, what they are really saying is that the facilitators of these suicides interfered with the proper application of hospice medicine--which explicitly includes suicide prevention in cases where patients become suicidal. But suicide prevention is not a required part of the Oregon law.
Labels: Hospice. Assisted Suicide.
posted by Wesley J. Smith @ 10:08 AM
7 Comments
7 Comments:
Patients who request assisted suicide and are denied access almost invariably kill themselves. That shortens life.
In Oregon, about 40% of those who get a lethal dose don't use it. So you see, Wesley, choice is life. By denying choice, you are encouraging suicide. Suffering is not just about physical pain. Existential distress cannot simply be "palliated away".
Tony: Again, your facts are bogus. In hospice, people who are suicidal and properly treated, rarely do the deed. Moreover, repeated studies show that suicidal terminally ill people often are very glad a few weeks later they didn't do the deed.
The Oregon statistics are virtually meaningless, as I have mentioned in repeated columns. But that some people ask for assisted suicide and don't do it, doesn't mean anything with regard to this post.
"Treatment" for depression in hospices often involves physically restraining them. Most terminally ill suicides occur before going into a hospice.
In Australia, at least, people over 75 commit suicide at a rate of three a week. Perhaps you would understand why once you reach that age.
I am a hospice nurse, and I have never seen anyone physically restrained. In fact, at our inpatient center, we recently received new beds so sensitive that they alert us when someone so much as moves a leg towards the edge of the bed to get out.
Treatment for depression in hospices is the same as treatment for depression anywhere else, except that if a person is not expected to live until the time the depression drug starts working, they will simultaneously prescribe a short-acting and long-acting antidepressant.
Thank you for your wonderful work, Heather, and for visiting Secondhand Smoke.
For several years, I served on the board and/or as back up on call cover for the local hospice director. As a family doctor, I've cared for patients on hospice care. Our hospice enabled several of the patients (with brain damage or dementia, end stage lung disease or with unstable heart disease, unfortunately not any of the cancer patients) for whom I "shared" care with alive, active and in their homes much longer than I'd have thought possible.
The reason was the incredible attention from and the medication adjustment made possible by the dedicated nurses of hospice. Without that attention and the attention of their families that was educated by the nurses, the patients would have been in pain, short of breath, and hungry - or in the hospital where every bodily function could be poorly substituted by our technology.
In fact, two patients who out-lived their (at the time) 3 year eligibility time period for hospice died in the hospital, where we couldn't keep them nearly as comfortable in spite of our technologies and the dedicated attention of the ICU nurses.
God bless hospice doctors, nurses and volunteers!
You do great work. The problem here is that not everyone wants to go into a hospice or a nursing home. Many people simply want to get the dying process out of the way once they've sorted out their affairs. They have rights too, and they don't appreciate being denied access to Nembutal, especially when all doctors can get a lethal dose quite easily.
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