HOW
RIGHT-TO-DIE HOSPICE
DIFFERS FROM TRADITIONAL HOSPICE
SERVICE
SYNOPSIS:
Each hospice service should define
for its prospective clients
just where it stands with respect to all end-of-life questions.
This will empower families to choose the most appropriate service
to support the dying process of a particular patient.
New right-to-die laws might stimulate all
hospice programs
to examine (or re-examine) their actual and public policies
with respect to cooperating or not cooperating
with any new methods of dying authorized by law.
OUTLINE:
1.
UNANIMOUS AGREEMENT WITH THE RIGHT-TO-DIE
2.
A RIGHT-TO-DIE HOSPICE WILL ALLOW PASSIVE DYING
3.
CHOOSING THE BEST DATE OF DEATH
4.
RESPONDING TO NEW RIGHT-TO-DIE LAWS WHEN PASSED
5.
QUESTIONS TO ASK:
DO YOU APPROVE SHORTENING THE PROCESS OF DYING?
DO YOU ALLOW PATIENTS TO USE THE RIGHT-TO-DIE LAW?
HOW
RIGHT-TO-DIE HOSPICE
DIFFERS
FROM TRADITIONAL HOSPICE SERVICE
by
James Leonard Park
1.
UNANIMOUS AGREEMENT WITH THE RIGHT-TO-DIE
From the very beginning of any right-to-die hospice
service,
everyone involved already affirms the right of each patient-and-family
to choose their own pathway towards death.
The approved and available methods of dying are laid
out in advance
---with the pros and cons of each pathway.
All board members, staff members, & volunteers
are known in advance to endorse the freedom to choose death.
No conflicts of philosophy should arise in a right-to-die hospice
service.
If and when there are enough resources,
a right-to-die hospice could even provide
exactly the same supports offered by a traditional hospice service.
No patient will be forced
into any particular end-of-life choices.
And the patient-and-family can change their plans at any time.
No client or potential client will ever have to guess
about the responses of the right-to-die hospice.
The philosophy and operating principles of the hospice service
are spelled out in complete detail in its literature and website.
The hospice patient (and the family) need not worry
about offending the moral
standards
of any of the other people involved.
Everyone associated with this hospice
already agrees to go with the plans-for-death
as chosen by the patient and/or the proxies.
When trying to get cooperation from a
traditional hospice service,
there might have to be negotiations and discussions
concerning the rights and responsibilities of everyone involved.
This might add unnecessary stress to the end-of-life situation.
2. A RIGHT-TO-DIE HOSPICE WILL
ALLOW PASSIVE DYING
Because the patient and his or her family has
completely freedom,
the right-to-die hospice service will permit the option
of allowing nature to take
its course,
rather than using any more active methods of dying.
There should be no pressure to speed up the process
of dying
for the convenience of the staff.
If the patient-and-family choose to allow
nature to take its course,
they can later change their minds:
They can always choose a shorter pathway towards
death.
Traditional hospices expect everyone to wait for natural death.
The family itself might be divided about the best
timing for death.
And they will be permitted to resolve any differences of opinion
about the best timing and the best methods of dying for their
patient.
The official deciders
will be established upon admission.
Thus, even if some family members do not agree,
those who have legal power
to decide this death can still go ahead.
The others should be kept informed of the decisions.
3. CHOOSING THE BEST DATE
OF DEATH
Because this is a right-to-die hospice,
each new patient will be asked for the ideal date of death.
At first this might be only an approximate date.
And after the patient has received a few days of hospice care,
then a more firm date might be established.
And continuing to have the freedom to die at the best time
will allow the date of death to be adjusted either way
—either
an earlier date of death
if the patient continues to
suffer
or a later date of death
if palliative care can make life
tolerable.
The best combination of methods
of managing dying
will be chosen once the ideal date of death has been selected.
Obviously, some methods of dying take longer than others.
And frequently the methods of managing dying
will be used in combination with one another.
4. RESPONDING TO NEW
RIGHT-TO-DIE LAWS WHEN PASSED
A right-to-die hospice service can be established
anywhere on Earth,
because the legal methods of dying are already known in that location.
The doctors practicing in that jurisdiction
are already familiar with the available ways of managing dying.
If and when a new right-to-die law comes into effect
in that location,
the right-to-die hospice will already be prepared to respond.
Its charter already says that it will allow
all legal, doctor-approved systems of managing dying.
So, when a new pathway towards death is opened,
the literature and website of this hospice
can be revised immediately to announce to everyone interested
that this newly-authorized pathway towards death
will also be available thru this existing hospice service.
When new right-to-die laws are passed,
traditional hospice services might be divided:
Some long-time employees and volunteers
might have difficulty adjusting to more liberal
end-of-life laws.
Thus, a new law allowing gentle poison as a method of dying
might cause a split in a traditional hospice service.
And a practical separation might be needed:
Half of the old board, staff, & volunteers
will remain on the side of only
allowing passive means of dying.
The other half might create a new hospice service
that will cooperate with the new right-to-die law.
The more liberal side might welcome
the new freedom to choose the best time and best methods of
dying.
Also, any hospice service that allows gentle poison
will probably also endorse the established
methods of managing dying:
(1) providing comfort-care,
(2) inducing terminal coma,
(3) ending curative medical treatments and disconnecting life-supports,
&
(4) giving up water and other
fluids.
5. QUESTIONS TO ASK:
DO YOU APPROVE SHORTENING THE PROCESS OF DYING?
DO YOU ALLOW PATIENTS TO USE THE RIGHT-TO-DIE LAW?
"Do you allow patients to shorten the process of
dying?"
This is an open-ended question, which might uncover
useful facts.
Many hospice services that are based in religious beliefs
really do not approve the most liberal end-of-life choices.
And a complicated answer to this question
might disclose the fact that this hospice program
endorses only
passive methods of allowing death to come.
For example, in response to a question about
the duration of dying,
they might say something like this:
"We provide such good
palliative care that patients never ask for
death."
"We make hospice patients so comfortable they want to keep on
living."
"Because of legal concerns, we offer only supportive care."
"We do nothing to either hasten or prolong the dying process."
On the other hand, a hospice program that
endorses the right-to-die
will offer responses like these:
"Yes, you can choose any
duration for the process of dying."
"We encourage the patient-and-family to decide the best day to die."
"We approve all legal, doctor-approved methods of managing dying."
The duration of dying will be shorter with any
combination
of the following four medical methods of managing dying:
(1) increasing
pain-medication to whatever level the patient desires,
even if the drugs will dramatically shorten the duration of dying;
(2) inducing terminal coma
when chosen by the patient-and-family,
which will keep the patient unconscious until the end;
(3) ending all curative
treatments, medications, & life-supports
with an estimate of how soon death will come;
(4) giving up water in all
forms, again with the certain knowledge
that dehydration will bring death sooner.
In any jurisdiction on the planet Earth
that has an explicit law authorizing gentle poison as a method of
dying,
another question can be asked:
"Do you allow patients to use the right-to-die law?"
A traditional hospice service will reply that they
do not believe
in 'euthanasia' or 'physician-assisted suicide'.
Or they might say that everyone associated with the hospice program
must be gone from the room
whenever a patient uses gentle poison as a method of dying.
But a right-to-die hospice will openly approve this
method
of dying:
"We endorse and facilitate choosing a quick and painless death
by means of taking and receiving the approved chemicals for dying."
And in all locations where the right-to-die has not
yet become law,
the right-to-die hospice will answer along these lines:
"If and when a right-to-die law authorizes additional methods of dying,
we will follow all of the defined procedures and safeguards
for enabling patients to choose immediate death."
Created
January 1, 2016; Revised 1-8-2016; 1-2-2018; 10-6-2018; 11-22-2019;
9-30-2020;