I have tried to remain silent on the blog about the health care debate in our country. I have very strong political opinions and do not feel that this blog is the place to have political debate. This is a blog about hospice, and the last thing I want to do is turn people away from hospice because they disagree with me politically. I don't think what I'm about to say is really a political statement, but I felt I needed to put that disclaimer up front just in case. Now.
I really wish President Obama would stop using the term "end of life care" when talking about medical care for the elderly! I'm thrilled that our president is a fan of hospice care, but I want to make sure that everyone knows that what is being discussed in the news today is not hospice care. They are talking about how we would provide medical care to the elderly, how it would be distributed, and most importantly how it will be rationed. Those subjects have nothing to do with hospice, but I fear that hospice is about to be drug into this debate in a way that will not be good for the hospice movement.
I'd guess that most of you have seen the video of President Obama talking about whether a 100 year old woman will be allowed to get a pacemaker in his new health care system. If not, here it is.
There's that term - "end of life care". Not long after he uses the term, he says that the government may have to let doctors and patients know that the treatment they are considering isn't going to help and instead of the treatment they should just take a pain pill. This is where I get really scared. To me, end of life care, is hospice care. Those two terms are synonymous. I also think that when people think about pain pills and the end of life, they think hospice. Everything about what he said makes me cringe in fear that the next words out of his mouth will be, "we'll put her on a great hospice program". While that would be great for business, there is a major difference between what the president is talking about and what I want to do for a living. A huge part of being a hospice patient is the ability to choose to be a hospice patient. It's not a death sentence handed down! Hospice is a choice to pursue treatment that will ensure your comfort and quality of life.
I talk to people all the time who are making what I believe to be a stupid medical decision. I vividly remember a patient we had recently. I went to the hospital to do a hospice consult with he and his family. We talked. He cried quite a bit. He was scared of dying in pain, and we talked about that. He asked me to pray that God would take him that night while he was sleeping. I did. He told me that the doctor had told him that he could do a procedure to remove a "bunch of sludge" between his heart and lungs and that, if he survived the procedure, he would be able to breath much better. (He would still be very much hospice appropriate, but breathing better.) The doctor had also advised him against the procedure and told him that he thought there were good chances he would die on the table. He was thinking about his options, and would let me know. He had the surgery, survived it, and when home on hospice after a couple of weeks recovery in the hospital. When I went to the house he told me that he figured the only two possible outcomes from the surgery were less pain and misery or going to heaven after dying painlessly on the operating table, so he chose the surgery. Making that choice boggles my mind, but I love the fact that he got to make the choice. He got to decide what was best for him, and that is, to me, the core of what hospice is all about.
Mr. President, I'm begging you, we can debate health care until we are all blue in the face, but let's not act like "take a pill" end of life care that you qualify for because of your age or your lack of usefulness to society is the same thing as what hospices across our country are doing today. To make that implication is nothing short of insulting to me and the thousands of hospice workers across our nation who believe to our core that each and every person has the right to choose how and where they want to live out their final months.
4 comments:
Heck yeah! Thank you for your post. As a former proofreader, I am all for using the correct terminology. It's so great that issues like these are getting discussed in a high-profile way—although I really wish the discussion wasn't so vitriolic—but you're absolutely correct: Let's use the terminology correctly.
Thank you.
Speak the truth.
This debate is causing a lot of fear in the people in our community (rural).
My wife works in hospice and I absolutely agree that it's horrible how the current political debate is making hospice sound like a death sentence.
I would urge you to replace your current video with the original 3:56 clip in which Obama's actual response to the 105-year old mother is included, it is more clear that he's not talking about that example when he brings up the choice between an ineffective treatment and a painkiller, and he repeats several more times that he wants patients and doctors making these decisions. His use of "end of life care" is needlessly scary, but it's good to know that his first response was personal - "I want to meet her."
Actually, I think he's quite accurate in how he uses the term. It's entirely appropriate to think of care for the very old, and care for those in declining health, as part of a continuum of end of life care, with hospice at the very end of that arc. Too often old people with significant QOL impairment receive full-on aggressive intervention, the only alternative to which is hospice care. Using end-of-life in a context broader than hospice suggests that the diminishing returns of aggressive intervention are recognized even when death is not imminent.
Post a Comment