Bad News

Are you distressed by the many negative news stories we’ve seen about hospice in recent days? I certainly am.

From the headlines last week in the Dallas Morning News – Frisco hospice exec admits overdosing patients ‘to hasten their deaths’ and make more money– to the report out this week from the Office of the Inspector General, Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio, which focused on the very things that are, or are supposed to be the hallmarks of hospice care: pain management, patient AND family support, 27/7 care availability and provision of the 4 levels of hospice care. What did they find? That “hospices do not always provide needed services to beneficiaries and sometimes provide poor quality care. In some cases, hospices were not able to effectively manage symptoms or medications, leaving beneficiaries in unnecessary pain for many days.”

Dying patients who are in pain and are left untreated is part of the reason Dr. Cicely Saunders started modern day hospice 40+ years ago. It is part of the reason I went into hospice 30+ years ago; to relieve pain and suffering and support patients and their families to live fully and comfortably until death. It is unthinkable to me that a person in pain would not be aggressively treated, as the report suggests “…for many days”.

Then, the idea that someone would knowingly give patients overdoses to hasten their deaths to make more money is beyond my wildest imaginings. And yet, it is happening. Certainly, this type of behavior is rare, but I have to wonder: if your boss told you to give a patient an overdose to speed up their death in order to make more money, would you do it?

That is the issue that troubles me most. Unfortunately, there will always be people in the world – and sometimes in positions of leadership – who have no morals or ethics. But what about the good people who work for them? What is the best course of action when you’re asked to do something that goes against your values/ethics/morals?

As an evolved and morally aware species we’re capable of noble heights – and abysmal depths. The darkest of those depths have been sounded in times when people turned away from what they knew was right to “follow orders”. As the signs in the airport say, “If you see something, say something.” Ultimately, we’re each answerable for our choice to speak up or to stay silent when we see something that cuts against our founding principles and our mission.

If you are a hospice worker and you are told to do something that goes against your better judgment, don’t just follow orders. It is your legal responsibility as a licensed nurse or doctor or social worker to question any illicit activity. It is your ethical responsibility as a healthcare worker to do what’s in the patient’s best interests. And it’s your moral responsibility as a human being to treat your fellow beings with compassion and dignity.

Our modern day Hospice founder Dame Cicely Saunders