Monthly Archives: May 2013

Physician-Assisted Suicide? NO!

The question of physician-assisted suicide has come up again. The Patient Choice and Control at End of Life Act was signed into law last week in Vermont, making it legal for doctors in that state to prescribe lethal injections. Vermont joins Oregon, Washington and Montana as states that allow this practice.

Of course, prescribing a shot that will lead to death is in direct opposition to the Hippocratic oath. Physician-assisted suicide also runs counter to the philosophy of hospice care. Those who promote physician-assisted suicide refer to the act as “death with dignity.” We feel that hospice care provides “end of life with dignity.”

We at Hope Hospice work to ease the discomfort brought on by a terminal illness. We have seen patient pain relieved through medication.

Famed hospice physician Dr. Ira Byock points out, “The hospice focus is on life and the alleviation of suffering,” whereas “the goal of assisted suicide and euthanasia is death.”

In the Wall Street Journal (May 25-26, 2013), Dr. Paul McHugh a former psychiatrist at Johns Hopkins Hospital wrote an op-ed column about the new Vermont law.

He pointed out: The advance of the hospice movement has made a shambles of the terminators’ insistence that medicine prolongs suffering and denies dignity. The doctors, nurses and social workers committed to hospice care demonstrate how an alliance with nature at life’s end plays out in just the way the medical profession intends. As hospice ways become more familiar, the public can overcome the fears that the terminators used to win over the Vermont legislature.

So-called right to die legislation has been considered recently in four other states: Massachusetts, Connecticut, New Jersey and our neighboring state of Kansas.

The National Hospice and Palliative Care Organization has stated: When symptoms or circumstances become intolerable to a patient, effective therapies are now available to assure relief from almost all forms of distress during the terminal phase of an illness without purposefully hastening death as the means to that end. These modalities and the means to safely administer them must bewithin the expertise of and available from all hospice/palliative care providers as an alternative to [physician-assisted suicide].

We agree.





Hospice Notes

Michelle Munz wrote an article that appeared in the May 16, 2013, St. Louis Post-Dispatch about the increasing acceptance of hospice care in the African American community of St. Louis. At Hope Hospice, we have had a significant number of African Americans among our patient population from the day we opened. You can read this interesting story by clicking HERE.

One of our Hope Hospice nurses, Jason Winfrey, recently conducted a huge garage sale in St. Louis to benefit his HOPE scholarship fund. HOPE (which is not connected to Hope Hospice) pays college tuition for students in Liberia. Jason Winfrey was a medical missionary in Liberia about a decade ago. Read our item on Jason from last year by clicking HERE.

With Memorial Day on the way, we remind you to take a moment Monday to remember those who died while serving in the United States Armed Forces. As you take a moment to honor your own friends and family members who died in military service, consider the vast number of men and women from throughout our nation who have given their lives for our freedom. Remember, too, that lives given in less popular wars are just as significant as those laid down in the so-called “good” wars.

The Illinois General Assembly has passed legislation legalizing medical marijuana. The bill awaits the signature of the governor, who has indicated he will sign the bill. Governor Pat Quinn mentioned to reporters that veterans groups support medical marijuana because they believe it to be useful in dealing with PTSD. In a Chicago Tribune report on the matter, Eric Zorn wrote this week: In 2010, the U.S. Department of Veterans Affairs formally allowed its patients to use marijuana for medicinal purposes in hospitals and clinics located in states where such use is legal. Will this passage in Illinois influence lawmakers in Missouri? Stay tuned.

Consider the Conversation: A Documentary on a Taboo Subject made its debut in early 2011. It is a film about end-or-life decisions. It has aired on numerous PBS stations around the US over the past two years, but has yet to air in St. Louis. We encourage KETC and the Nine Network to consider offering this film via one of its several channels. Click HERE to watch a short preview of Consider the Conversation.


Saying NO to Hospice Care—Why?

Why do patients (and their families) sometimes choose NOT to enroll in hospice care, even after being referred to hospice by a physician? A study conducted by a team of gerontology doctors in Seattle in 2010 provides a few answers. Many of those answers reveal inaccurate perceptions about hospice. Others indicate that hospice personnel may not have presented information as well as they could have.

Some of the respondents (including survivors of patients who had died) said that the patient was “not ready.” This was because of the widely held (but incorrect) belief that hospice care is only for the final days or hours of life. Some family members were reluctant to admit that their loved one was dying. In other cases, there were disagreements between patient and primary caregiver (his or her spouse) regarding the suitability of hospice for that patient’s circumstances.

In a handful of cases, there was concern by wives that they would have to give up some of the caregiving roles for their dying husbands. They expressed thoughts that they might be falling short as wives by allowing others to provide care.

One respondent, who did eventually sign on with a hospice, initially balked because one hospice representative painted a picture of hospice care as being very restrictive but another rep described hospice as being much less restrictive. Some patients who were using oxygen were reluctant to sign on with hospice because it would have meant a change in oxygen providers. And, in a couple of cases, there was patient/caregiver confusion between hospice care and home care.

At Hope Hospice, our community liaisons are experienced professionals who take as long as necessary to explain exactly what hospice care is. We work hard to correct misconceptions. We know that hospice is unfamiliar to many of the patients and family members we meet. We recognize that choosing hospice care may not be an easy decision to make. We know that this choice comes during a stressful period for patient and caregivers.

We strive to state clearly our role in a patient’s end-of-life process. We answer any and all questions. We value the input of family members and their role in the loved one’s hospice experience. We take pride in our ability to address a patient’s specific needs. We believe strongly in the service we provide.

To speak with a Hope Hospice community liaison or other staff member about hospice care, please call us at 314-984-9800.

The St. Louis Hospice Picture

We are fortunate in metro St. Louis to have numerous hospice organizations, staffed by many dedicated professionals. A quick look at the local hospice scene can provide useful information for patients, family members and other caregivers who are considering choices.

Each of our area’s large hospital groups has a hospice. Doctors who work for these groups may refer patients to their own group’s hospice. Patients, however, are free to choose whichever hospice they feel best fits their needs.

These larger hospital groups are generally classified as non-profit, often because of their affiliation with religious organizations. And, even though they are based in St. Louis, they may have facilities in several states.

Some smaller groups, also structured as non-profits, have hospice care as part of their multifaceted medical operations.

Several multi-state for-profit hospice organizations have personnel working in St. Louis, but are controlled by leadership in places like Ohio, Georgia and Minnesota.

Hope Hospice is an independent, for-profit, locally based hospice agency. Unlike some of the non-profits, we do not solicit charity contributions from United Way or other donors.

Unlike some of the multi-state for-profit hospices, we do not have to answer to ownership that’s based in another part of the US. This is, we think, one of our best qualities. If a Hope Hospice staff member needs an answer to a question, the boss/co-owner is right here in the office in St. Louis, not in Atlanta.

Because we are not affiliated with a large hospital group, we depend on patients being referred to us because of our performance record, not because a physician was obliged to pass along our name. Because we are a for-profit organization, our revenue does not come from charity, but from the work we do.

When considering a hospice in St. Louis for yourself or a loved one, please keep Hope Hospice in mind. If you have questions, call us at 314-984-9800.