Euthanasia is a very touchy subject, especially within the medical field. As a healthcare advocate, it is our job as professionals to better the lives of our patients. What happens when there is nothing more you can do?
I understand, being a Home Health Aide that works a lot with Hospice, that comfort care is important. But truly, when a suffering patient looks to you to ease the pain what do you do? Should you apologize and say their is nothing more I can do?
I can hardly say no more treats to my cat when he gives puppy dog eyes, much less a patient dying alone of cancer. In my opinion, for what it is worth, Euthanasia is most certainly not murder and should never be referred to as such.
If Euthanasia was legal, but very strict in regulations and rules, it would be very beneficial to many terminally ill patients. This may be the only healthcare decision a patient makes within their life, and they should be allowed to make such a decision when conditions permit. We all have choices in this world, what gives you or I the right to take such choices away from someone in such a situation.
What is your opinion? Do you agree or disagree? Do you have a story, personal or not that pertains to this topic?
But saying hospice facilities are knocking alert hospice patients uncouncious with morphine because they're a handful.... or saying they purposefully cultivate a culture of death is alarmist. Extraordinary claims require extraordinary proof. The links provided by a previous poster only link to some rather questionable blogs that have an obvious axe to grind. I am not at all convinced this is happening.
I am not convinced either. Especially because the bigger problem with hospice census (that I have experienced) is that doctors wait way too long before referring patients and they spend less than a week in hospice care. Hospice likes the longer term patients because the cost of bringing them on to service evens out once they've been on for a month. This has to do with the way Medicare pays for hospice care, which is a set fee per patient per day. The hospice company has to figure out how to spend that money among its patients whether they require minimal equipment and care or tons of visits, medications, equipment, etc. It all has to come out of the same daily rate of around $170.00 per day/patient.
So, no. This idea that thousands of patients are being killed off by hospice and no one is saying anything about it does not seem believable to me. Sure, there are probably a few family members who disagreed with the decision of utilizing terminal sedation and they probably were not the health care agent and so are pissed off. That sounds more like the real truth to me.
We are working hard to get the docs to refer earlier and this is a problem all over the country, which is why I mentioned in previous posts that we need to do a better job of educating about hospice.
I cannot imagine how you could ever kill someone off - there are so many hoops to jump through and people who have to be "in the know" about medicating a hospice patient with a narcotic or sedative.
To just imagine the scenario already presented is like a movie - it most likely never happens like that.
Specializes in NICU, PICU, Transport, L&D, Hospice.
The answer is there are always more patients that "qualify" for hospice.
Also, It's an easy way for hospice to keep their days of service down so it doesn't look like they're admitting people who don't really need it.
I know it's terminal sedation. It's used inappropriately at times. Period. Look online. Google it. There are hundreds, if not thousands of stories. Some by doctors or nurses who had it happen to their family member.
I'm all for death with dignity. I'm against stealth euthanasia.
In my view your comments reflect a deep misunderstanding of hospice care, philosophy, and end of life options for families. It smacks of the same type of misinformation which is common on the internet about all sort of topics from vaccinations to jet streams.
The fact that you are here spouting anecdotal recollections of something nefarious without the ability to provide any credible sources for the information supports the notion that you are speaking from a platform of ignorance.
Again I will say that if you personally know of instances of people being killed by their health professionals for ANY REASON and did not advocate for the victim or report the illegal behavior then YOU are also at fault and should be ashamed.
Everyone in nursing is as good hearted and well meaning as you and I.
The End.
Put up or shut up.
As in, post sources that support your claim or shut your yap. You've got at least three of us here now who currently work in hospice and we haven't seen this.
OK, I was alerted to this thread and wished to add to the good comments already made. Many wonderful people are dedicated to providing good EOL care, but there are problems in EOL care, just as there are in every other niche of health care. Are we willing to admit to any problems in EOL care? If not, then that is a problem.
Now, the Washington Post has a series of articles on some of the problems that have existed for quite a while, though media are loathe to publicize such since hospice is promoted by both State and Federal government figures since it saves billions over acute hospital care (and rightly so). The Wash Post is not going to print anything like this unless something is really going on!
I have spoken with hospice medical directors, administrators, hospice nurses, social workers, volunteers, therapists in addition to innumerable family members as well as patients who confirm these problems being discussed on this forum do exist. The euthanasia movement has formally taken over the hospice lobbying group, the National Hospice & Palliative Care Organization. They admit it on their website at the Caring Connections page where they show the history:
NPHCO's Caring Connections is the successor to Last Acts Partnership (hospice coalition), which was formed from Last Acts (hospice coalition) and Partnership for Caring (the successor organization to Choice in Dying, aka The Euthanasia Society of America/Society for the Right to Die). See:
NHPCO is the actual LEGAL and corporate successor to the Euthanasia Society of America and some of its leaders (NOT all!) are definite euthanasia supporters. Fact!
Take a look at the journal article, "The Rise of Stealth Euthanasia" by Ralph Capone, MD, Kenneth R Stevens, Jr., MD, Julie Grimstad, LPN, and myself, Ron Panzer, BA, LPN at:
You may not be doing any wrong and may be providing excellent care. I applaud and support care that affirms the mission that Dr. Cicely Saunders brought to the world. but there is something else going on by some and they're not all making this up.
I've had physicians crying hysterically on the phone telling me about their loved one who was subject to a hastened death. Even physicians and nurses are not always able to protect their own loved ones, because they trusted (which normally we should be able to do).
Nearly all those Washington Post articles are written by the same two people, which makes me wonder if they have an axe to grind.
In one article, a family claims their father was enrolled in hospice for "pain management" of chronic back pain, and was then administered fatal doses of morphine. The article is quite vague. It claims hospices are increasingly enrolling patients who "aren't close to death". Okay. When should a terminal patient be admitted to hospice? Isn't the whole point to provide care and pain management before it gets to the "just before" stage?
In another article a daughter described how her mother died at home shortly after a hospice nurse left, but before the oncoming nurse arrived. She seemed to imply that her mother died because the off going nurse left before her relief arrived. First, I have never heard of a visiting hospice agency that promised 24/7 nursing coverage. If one needs 24/7 nursing, one is admitted to an inpatient hospice facility. Second, the fact that the daughter thought that having such coverage would prevent her mother from dying reveals a fundamental misunderstanding of what hospice is and isn't.
The hospice providers in these articles clearly can do a better job educating families and addressing their concerns. But nothing to indicate to me they were engaged in some sort of profit-driven euthanasia scheme.
edmia, BSN, RN
827 Posts
I am not convinced either. Especially because the bigger problem with hospice census (that I have experienced) is that doctors wait way too long before referring patients and they spend less than a week in hospice care. Hospice likes the longer term patients because the cost of bringing them on to service evens out once they've been on for a month. This has to do with the way Medicare pays for hospice care, which is a set fee per patient per day. The hospice company has to figure out how to spend that money among its patients whether they require minimal equipment and care or tons of visits, medications, equipment, etc. It all has to come out of the same daily rate of around $170.00 per day/patient.
So, no. This idea that thousands of patients are being killed off by hospice and no one is saying anything about it does not seem believable to me. Sure, there are probably a few family members who disagreed with the decision of utilizing terminal sedation and they probably were not the health care agent and so are pissed off. That sounds more like the real truth to me.