Hospice programs have begun to flourish, but unfortunately, along with the great good they can do, a dark side has emerged as well, according to a recent article http://www.washingtonpost.com/news/storyline/wp/2014/08/21/as-more-hospices-enroll-patients-who-arent-dying-questions-about-lethal-doses-arise/ in the Washington Post:
An excerpt: Betty Mathews, 76, a retiree from a Las Vegas casino, was diagnosed last year with colon cancer, received chemotherapy treatments and then was enrolled in a hospice in August 2013. The hospice sent a nurse every Friday, Mathews said.
“I kept telling them to give me a blood test to see if I still had cancer,” Mathews said “They gave me pain-killers but I never took anything. My hair was growing, I was gaining weight. But they wouldn’t give me the test. The hospice people kept coming every Friday. I thought I was going to die.”
Last month, nearly a year after enrolling in hospice, the agency finally did a blood test. It indicated that she did not have cancer, she said.
Had she known she was healthy, “I would have got up out of this bed and started living.”
Mathews’ case may be the exception, but it illustrates an important point: We must be very careful about relegating those with terminal diagnoses to a twilight zone of hopelessness, in which they find themselves simply waiting to die, and are thus deprived of what could be many good days, weeks, months and even years, of living.
Moreover, individual hospice programs and the doctors associated with them should be evaluated carefully before they are engaged. While the goal of “dying well” is most certainly commendable, we must not forget that “living well” is still the priority of good palliative care.