The ProPublica story contains, as famous earlier, a nod to the Christian roots of the hospice motion. Right here is that passage, which is lengthy, however important:
The philosophy of hospice was imported to america within the Nineteen Sixties by Dame Cicely Saunders, an English physician and social employee who’d grown appalled by the “wretched habits of huge, busy hospitals the place everybody tiptoes previous the mattress and the dying quickly be taught to fake to be asleep.” Her counterpractice, which she refined at a Catholic clinic for the poor in East London, was to deal with a dying affected person’s “complete ache” — his bodily struggling, religious wants and existential disquiet. In a pilot program, Saunders prescribed terminally in poor health sufferers cocktails of morphine, cocaine and alcohol — whiskey, gin or brandy, relying on which they most well-liked. Early outcomes have been hanging. Earlier than-and-after images of most cancers sufferers confirmed previously anguished figures knitting scarves and elevating toasts.
Saunders’ imaginative and prescient went mainstream in 1969, when the Swiss-born psychiatrist Elisabeth Kübler-Ross printed her groundbreaking examine, “On Loss of life and Dying.” The themes in her account have been dwelling their ultimate days in a Chicago hospital, and a few of them described how lonely and harsh it felt to be in an intensive-care unit, separated from household. Many People got here away from the ebook satisfied that end-of-life care in hospitals was inhumane. Kübler-Ross and Saunders, like their contemporaries within the ladies’s-health and deinstitutionalization actions, pushed for better affected person autonomy — on this case, for individuals to have extra management over how they might exit the world. The primary American hospice opened in Connecticut in 1974. By 1981, a whole bunch extra hospices had began, and, quickly after, President Ronald Reagan acknowledged the potential federal financial savings — many individuals endure pointless, costly hospitalizations simply earlier than they die — and licensed Medicare to cowl the fee.
Forty years on, half of all People die in hospice care. Most of those deaths happen at dwelling. When completed proper, this system permits individuals to expertise as little ache as potential and to spend significant time with their family members. Nurses cease by to handle signs. Aides help with bathing, medicines and housekeeping. Social employees assist households over bureaucratic hurdles. Clergy provide what consolation they will, and bereavement counselors present help within the aftermath.
Essential phrases: “When completed proper.” Does religion have something to do with that?
Truly, Saunders was a devout Anglican and, at first, she thought-about basing the primary hospice in an explicitly Anglican setting — which led some to imagine she needed to start out a proper “group” for worship and repair, resembling a convent of sisters.
It’s clear that non secular questions and points have been on the coronary heart of her work and she or he struggled to understand how formal that could possibly be, whereas working in medical contexts. This web site on the origins of her work may be very useful. Here’s a piece of a 1960 letter by Saunders that exhibits come context:
‘We’ve got determined that it shall be an interdenominational basis, though we may have one thing within the paperwork stating as firmly as potential that it should be carried out as a Christian work in addition to a medical one … I discovered that I simply couldn’t assume it was proper to be unique. To start with, I couldn’t be solely evangelical and thought that maybe it will due to this fact should be Anglican to maintain it secure from heresy or secularisation. However then it didn’t appear proper to be that both, and in our authorized Memorandum stands the assertion: “there shall be a chapel out there for Christian worship”, and I don’t assume that actually we could possibly be a lot broader than that!’
There’s way more historical past there and, frankly, I do know that the ProPublica piece couldn’t dig into that.
However right here is the underside line for me: There are a lot of, many explicitly Christian hospice facilities in america and what occurs in them is a vital a part of this story. That is prompt within the headline, with the phrase “visionary” suggesting one thing aside from a for-profit “hustle.”
To be blunt: The story must let readers know what good, even holy, hospice care appears like — contrasting that work with the horrible abuses depicted (with good trigger) by ProPublica.
Listed below are some related questions: What number of Christian hospices stay alive and properly? What number of households are touched by that work? What are their authorized and even theological requirements that forestall the sort of abuse seen in lots of fly-by-night secular, for-profit networks? Are there scandals within the faith-based facilities as properly?
It’s potential that masking these points would have required an excessive amount of extra ink. I get that. However, if hospice care has been corrupted, readers must know that there was one thing essential that BECAME corrupted and that Christian religion was a part of the imaginative and prescient that was misplaced. The underside line: Among the circumstances depicted by ProPublica verge on assisted suicide, with the patent unaware of what’s taking place.
This isn’t, by the best way, a brand new subject. See this Christianity At present report from 1998: “Hospice Care Hijacked? A bottom-line, cost-efficient mentality obscures the motion’s unique Christian imaginative and prescient.”
Right here is one other useful supply of context, care of the California Catholic Convention: “Frequently Asked Questions About End-of-Life Care.” Right here is one essential piece of that CCC function (see additionally this information from the U.S. Catholic bishops, “Ethical and Religious Directives for Catholic Health Care Services”).
What’s the distinction between a hospital and a hospice?
A hospital is for sufferers searching for medical remedy to remedy their sickness or harm. A hospice is for sufferers who’ve a terminal sickness, who’ve suspended healing efforts and who need to die in a homelike setting. Hospice care is “consolation care,” which might happen in both a hospice facility or in a affected person’s dwelling.
The hospice affected person is attended by a staff of caregivers together with medical personnel, counselors, clergy and members of the family. The objective of hospice care is to make sure that the bodily, religious and emotional wants of sufferers are all met in order that they might dwell properly whereas dying.
Yet one more time: The ProPublica function is should studying. Nevertheless it wanted to incorporate some important details concerning the unique imaginative and prescient of faith-based hospice work, which nonetheless exists from coast to coast, in addition to what occurs when the love of cash corrupts end-of-life care.
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FIRST IMAGE: Photograph posted with a function — “End-of-Life Signs: What to Expect as a Loved One Nears Death” — on the Samaritan health-care weblog on hospice care.