Palliative Medicine and Death with Dignity

Palliative Medicine and Death with Dignity Co-Mingle

I have a lot of sadness around writing this. I've decided to officially resign from the volunteer rolls of the hospice organization I've served with in my community.  This does not come as an easy decision. Truthfully, I've not been in a position to volunteer for some time now anyway.  More importantly, I'm often reminded and all too aware of how my name and my points of view are considered by some in palliative and hospice medicine to be too controversial.

I know that some in the hospice community believe I am "anti-hospice." Thankfully, those who actually know me and my work also know that I am a strong proponent of palliative care, of which hospice is an integral part.

I find the highest value in palliative and hospice care.

In fact, some of the richest experiences I've ever had in my life have come from interacting with the dying and those who care for them. I don't want to sound cliché, but some of my best friends are hospice nurses.

What troubles me is this: some hospice folks are unwilling to discuss certain dying matters.  And others want to but can't, for fear of losing their jobs.  It seems to me that folks who work in hospice should feel fully informed on Death with Dignity laws, so they will know how to respond to patients who have questions.  Believe me, even in states where there is no law permitting end-of-life prescriptions, patients still ask about that.

The fact that over 90% of the patients who choose to pursue an end-of-life prescription are also enrolled in and receiving palliative care and hospice services up to the time of their deaths is clear evidence to me that all end of life options are important.

Not "either-or, but "both-and."

I know these tools and the people who provide them can live and serve in harmony.  The average length of stay in Oregon hospice is over 40 days. Here in Maine, it's about 18.  The Oregon statistic speaks to me of a vital, viable service being offered that does support quality of life and give needed time to people to feel as complete as possible in their lives before they die.  In my mind and my heart, the end objective is to meet the needs of the one who is dying in a purposeful, compassionate, and open-minded way that honors who they are and what has meant the most to them.

I believe in dialogue when there is controversy.

I've dearly enjoyed my time as a hospice volunteer and I will continue to promote hospice and palliative medicine as a means to achieve quality of life as long as possible.

I will also continue to devote my time and energy to bringing visibility and awareness to how Death with Dignity laws work and how they are in complete harmony with the compassionate efforts of all end-of-life workers and caregivers to support peace, comfort, and respect to patient choice.  I believe in discussing studied research on this issue.  And I believe this education is important.

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