Of course, we want our family member to have a dignified death. Of course, we want them to be comfortable. So, we say, Give us the papers, and let us sign on the dotted line.
Often -- well, make that pretty much always -- if it is not the hospice company, itself, then it is the insurance company, or medical provider, or someone responsible for seeing that the medical provider gets paid, that is coaxing us into palliative care, and selling it as the humane option.
But, we should be wary to know, what's in it for them, Not always, perhaps, but often it is in the best financial interest of the medical provider to get the patient on hospice or Do Not Resuscitate.
Our emergency rooms are expensive, yet law does not allow hospitals to turn patients away -- regardless whether they can pay. So, if hospitals can get the most expensive of those patients on palliative care, they can prevent some of them from returning to the emergency room time after time.
Likewise, cancer treatments, heart replacements, and such can be very expensive. And so, often, it is in the best interest of the medical provider to let the patient know the treatments can be painful, or even damaging, and despite all that, not do any good, anyway.
Insurance companies, likewise, can dodge expenses if they can get some of their clients on palliative care, steering them clear of expensive procedures for which they would have to foot the bill.
There is a saying: Follow the money. While I would guess those who pitch hospice and Do Not Resuscitate are honestly and earnestly offering what they think best for the patient, I think we would be wise to realize medical providers and insurance companies often benefit financially by having us sign on for hospice and/or Do Not Resuscitate. These programs can be good, but there are dangers in them.
Indeed, a person should have the right to say "No" to having his life dragged out. Quality of life can, indeed, be more important than life stretched beyond its worth. But, life still remains precious. We should not too quickly sign it away.
Consider the requirements for getting on hospice. First, the person's doctor, and a doctor from the hospice program, must certify the person will die in six months or less. Second, the patient and family must opt for comfort care instead of curative care. In exchange for signing up, what does the patient get? A company sends a hospice worker to visit, to provide comfort care. That worker or team of workers can visit with the family, as well, helping them through the impending loss of a loved one.
The word "hospice" might once have meant no more than offering comfort and peace to those going to their deaths. These days, however, hospice is an industry. Companies are created to get paid to come in and provide this comfort care. Often, it is government money, Medicaid, that pays the bill.
There are surely times when hospice is beneficial, when the love provided by the hospice workers makes a difference in whether the person goes to death in peace, and whether the family is comforted. Still, clearly, the program has its shortcomings.
Palliative care can have grave shortcomings, and I use the word "grave" knowing it can have a double meaning.