Thursday, September 15, 2005
The Hospice Blog has an interesting commentary discussing the new "Will to Live" documents. These documents have been promoted as an alternative to the Living Will document. These new Will to Live documents and a discussion of them are available at the National Right to Life website (click on the Terri Schindler-Schiavo link to access the information). Here is some of the backgound concerning the documents as well as some commentary:
Background Discussion: As an end-of-life planning document, it's actually pretty comprehensive, and addresses many specific situations that patients could find themselves in. However, one clause, is troubling, and from my perspective would make it impossible to admit a patient to hospice.
I direct that the following be provided:
* the administration of medication;
* cardiopulmonary resuscitation (CPR); and
* the performance of all other medical procedures, techniques and technologies necessary to correct, reverse, alleviate life-threatening or health-impairing conditions, or complication arising from those conditions.
In my mind, patients signing this document, would be opting for curative treatment, not hospice care. I'm wondering whether any of your readers have had prospective patients present this document, and how they handled the situation.
I have a relative who is very active in the RTL movement, and who is an ardent follower of everything that the Hospice Patients Alliance puts out. He is very opposed to hospice. He worked on an article that appeared in a Catholic publication that recommended that Catholics sign the Will to Live. In fact in many Catholic publications, readers are being advised that they would be out of communion with the Church, and in a state of sin, if they signed a Living Will. When I pointed out patients signing this document would likely be ineligible for hospice care, he replied, "That's the point." No where are readers being advised that this document would make them ineligible for hospice care.
I suspect we're going to be seeing this document more and more, and I think a discussion would be productive.
Response: My gut says that the clauses the e-mail noted do not make it impossible for people to go on hospice, but they do make it harder. The majority of hospice patients go on hospice because there is no aggressive treatment available. This document seems to be saying that if there is something that can be done to cure me, then I want that done. To be honest, it's rare to find a person who doesn't feel that way. The question is what you do when you don't have any more options. This document keeps someone who has options from receiving hospice, but doesn't address (in the e-mail version at least) what to do when there are not other "aggressive" options.
My last note is that I think the claim that there is a lot of euthanasia in hospice is a crock of crap. That's all I have to say about that, because I can't prove my stance just like others can't prove that there is a lot of it going on. It's something that people with an agenda say to scare people, and does nothing but keep people who do need help from getting it.
Obviously the Hospice Blog has a definite viewpoint on these documents. That said, I found the information quite helpful and plan to raise some of these same issues for my class. [bm]