Warning — Hospice Abuse Can Kill You.

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.

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.

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[1] Peter Whoriskey, As More Hospices EnrollPatients Who aren’t Dying, Questions about Lethal Doses Arise: The HospiceIndustry is Booming, but Concerns are Rising about Treatments for Patients Whoaren’t Near Death, Washington Post, August 21, 2014 (Link).

[2] Anemona Hartocollis, Hard Choice for aComfortable Death: Sedation, New York Times, December 27, 2009 (Link)

[3] Shai J. Lavi, The Modern Art of Dying: A History of Euthanasia in the United States (Princeton University Press 2005) at 126.

Links to more articles on this topic:

• Euthanasia and assisted suicide: A physician's and ethicists perspectives.
• Mother was dehydrated to death. Assisted suicide will lead to more abuse.
• Doctors forced to refer for starvation deaths.
• Dying of Thirst is excruciating agony.
• The ethics of food and drink. Starvation is not Mercy.