One med student's reflections on hospice

Those who have been reading this blog for a while know that I'm a fan of having hospice care taught at Medical School. Here is a reflection from a med student after a hospice rotation that I found on this blog.

Here are some highlights (with spelling edits by me):

• The whole [hospice] philosophy of how to treat these patients is counter-intuitive to medicine as most of us know it, but it really makes sense. If someone is on Hospice, they are not hospitalized for any illness related to their terminal diagnosis unless they choose to come off Hospice.
• I can tell you that in comparing death in the hospital from multiple system failure, versus death in Hospice due to MSF, there is no comparison. Physicians in the hospital who are not trained in Hospice care generally overtreat until the very end, and keep patients hooked up to every device possible. This includes IV fluids, which at some point end up just causing the patient to drown in their own fluids (termed the "death rattle".
• [a hospice] death more closely resembles the natural death that has probably occurred for thousands of years prior to our ICU death interventions. The main problem with Hospice is that it is underutilized by family members who are convinced either through their own misunderstandings or by their physician that their loved one still needs medical interventions.