Palliative Care: Pain Relief or Imposed Death?
By Judie Brown
Merriam-Webster defines the word palliate as a transitive verb that means “to reduce the violence of (a disease); also: to ease (symptoms) without curing the underlying disease.” In other words, to palliate means to make a patient comfortable while treating his disease.
This definition should translate into actions being taken to relieve a patient’s pain and suffering while doctors and others involved in his treatment work to make him better, or at least comfortable.
Never should pain-relieving treatment—palliative care—be designed to ease the patient into death. This should not happen even in hospice.
However, in practice that is exactly how many policy professionals view palliative care. Elizabeth Wickham, PhD explains: “Today’s palliative care is an approach or a process guided by a trained and certified palliative care team to help the family determine at what point there should be a shift in the goals of care, putting the patient on a different track, away from cure and on toward death.”
Thus, when the United States Congress got involved last year with the introduction of the Palliative Care and Hospice Education and Training Act (PCHETA—H.R. 1676/S. 693) we should have been on alert immediately. But this legislative proposal slipped by until this past week when we learned, to our dismay, that the House of Representatives passed H.R. 1676 by a voice vote with very little debate and the ball was now in the Senate. The Senate version, S. 693, was introduced in March of this year and has not seen any action as of yet, so the time to stop it is at hand.
But why stop it now?
Well, consider what Dr. Wickham said when you review this history.
In 2010 the Miller Center, which describes itself as “a nonpartisan affiliate of the University of Virginia that specializes in presidential scholarship, public policy, and political history,” held a debate on the subject of end-of-life care, including palliative care and rationing. Pro-life attorney Ken Connor participated and stated: “There is nothing that equips government bureaucrats to make quality of life decisions about people who are dying.” He went on to talk about how eager many in Congress would be to save money on end-of-life care so that they could spend more money on pet projects. He made it a point to say that “end-of-life decision making ought to be made by the physician at the bedside, by the family of the patient and by the patient themselves.”
In other words, Congress has no place in this discussion.
What will this bill actually do?
Well, you might argue, the current bill being considered by the Senate and passed by the House only deals with education on palliative and hospice care, so it is not the same thing, is it?
Oh, yes it is!
One of the outspoken advocates for these types of programs is Ira Byock, MD, who has been at the forefront of the palliative and hospice care movement for years. And as he and his coauthors write in Financial Implications of Promoting Excellence in End-of Life-Care, “too many Americans die badly.”
While that is true, a quote in that report deeply concerns me:
“To me, hospice is an elegant, high-quality, cost-effective delivery model that should be provided throughout all of health care,” says Hospice of Michigan’s CEO, Dottie Deremo. “Our challenge is that hospice, too often, is perceived as ‘selling death.’ Nobody wants to admit they are dying. These services are needed much earlier in the course of a chronic illness, without getting caught in artificial barriers of curative treatment versus supportive care,” she says.
“Could we provide what patients want and need, have it look and taste like hospice, and call it palliative care, transition services, or comfort care?”
In other words, if we put Deremo’s question a different way: Can we take this pig, put a skirt and lipstick on it, and call it a dog?
Inserting a government education program into the practice of medicine and turning over patient care to a committee instead of the family is bound to have very sad consequences. Experience tells us this is so. This is why we must oppose Senate Bill 693—the Palliative Care and Hospice Education and Training Act. That bill is better off dead.
In part two of this article we will investigate where palliative care and hospice have gone wrong, but for now here is what you can do:
- Learn more about palliative care pitfalls by reading about healthcare’s Third Path to death—a path that involves palliative care and hospice.
- Contact your senators and ask them to oppose PCHETA. Refer them to this article.
- Make sure your senator’s staff knows that, if they have questions about why you are making this request, they can study the history of palliative care abuses by reading “Hospice and Palliative Care: Ethical Concerns” by Germaine Wensley, RN and “Five Things You Should Know about Palliative Care” by Ione Whitlock.
Speak up and give a voice to those who are weak and who may be in danger of prematurely losing their lives to a system that thinks they are better off dead.