Hospice abuse can be euthanasia without consent. The Euthanasia Prevention Coalition (EPC) supports good hospice care, but we are also extremely
concerned about hospice abuse. Good hospice care leads to less support for euthanasia and assisted suicide while hospice abuse leads to a greater demand for the legalization of euthanasia and assisted suicide.
By Sara Buscher, an attorney from Appleton Wisconsin. She was elected to leadership positions in Elder Law and in Civil Rights Law, working as
an advocate on behalf of people with disabilities and the elderly.
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Bud Coffey with his sister. |
What do Bud Coffey, Jim Carlen, Roseann Gillespie and Beverly
Garguilo have in common? Their deaths from apparently lethal doses of morphine
and sedatives while in hospice. These cases are described in a Washington Post exposé by
award-winning investigative journalist Peter Whoriskey.[1] They were not dying nor in extreme pain when
they enrolled in hospice, but were given excessive doses of painkillers, dying
a few days or weeks later.
So how does it work? A 2009 front page New York Times article
explained that a strong sedative, typically lorazepam, and a strong pain
killer, typically morphine, are supplied drip by drip through an IV until heart
rate and breathing are slowed to the point of making it impossible to eat or
drink.[2]
“In so doing, it can intentionally hasten death.” This practice goes by various names,
including “terminal sedation”, “palliative sedation” and “slow euthanasia.” An earlier national survey found 83% of doctors
said it is ethically permissible.[3]
The Washington Post article reports on complaints from around
the country illustrating the potential dangers of hospice for patients who are
not near death, but who are prescribed lethal doses. Yet no data is
collected about such abuses.
The article explains that as the hospice industry has grown, more are enrolling
patients who aren’t close to death. Lawsuits have sought to recover more than
$1 billion in federal money from hospices who have “fraudulently” billed
Medicare for these patients. To qualify for Medicare hospice payments, patients
must be certified as having terminal conditions likely to lead to death in six
months.
Medicare tracks the number of patients who leave hospice
alive as a check on honest enrollment practices. The proportion of “hospice
survivors” has increased to the point where some experts believe hospices are
deliberately enrolling patients who aren’t dying. They can collect $155 a day
($4,650 a month), without visiting them at home. At hundreds of U.S. hospices, more than one in three patients were released
alive, according to a new
study funded by Medicare. A “hospice survivor profiled
in the article refused to take the drugs while she got better. She was finally
given a blood test that proved she did not have cancer, but only after spending
a year of her life in hospice.
Sadly, Bud Coffey’s family realized too late that the drugs
they were giving him per hospice directions had likely ended his life.
Whether patients are nearing death with a terminal
condition or not, EPC opposes the intentional ending of peoples lives with lethal doses. Families and patients should avoid inappropriate hospice
enrollment. If a hospice is willing to falsify records to get paid by Medicare, in the US, that hospice is more likely to engage in other unethical practices.