Generous Orthodoxy  

Thursday, August 19, 2010

Death and dying: does hospice care hasten death?

One of my most recent posts, "Death, Dying, and Hospice Care" (in Tips, August 9, 2010), was written partly to challenge the widespread misapprehension that hospice care (a more intensive form of palliative care) shortens life. Many people think that choosing hospice signifies a form of weakness, even cowardice, in the "battle" against cancer and other diseases. First of all, it's important to know that a significant number of cancer patients dislike--sometimes intensely--the "battle" imagery that has become commonplace in describing a patient's ordeal. Second, far from being a form of "giving up," choosing hospice care can be very pro-active because it often permits the patient to initiate life-affirming experiences in the final months.

As if on cue, just today a new study appears. A headline in today's New York Times reads, "Palliative Care Found to Extend Life of Cancer Patients" (article by Donald G. McNeil, Jr.). The respected New England Journal of Medicine reports the findings. The report notes, among other things, that there is often conflict between surgeons and oncologists, who want to continue the "battle," and hospice/palliative care representatives who are regarded as "giving up." But those patients who choose hospice/palliative care soon after receiving a dire diagnosis have been shown in the study as living months longer. For one thing, it gets them out of the hospital ("dangerous places for very sick people") and into their homes. They report less depression and anxiety, less pain and nausea, more mobility and more interaction with family and friends.

Dr. Atul Gawande, a Harvard Medical School surgeon, calls the study "amazing." Dr. R. Sean Morrison, e head of the American Academy of Hospice and Palliative Medicine said it was "the first concrete evidence of what a lot of us have seen in our practices--when you control pain and other symptoms, people not only feel better, they live longer."

From the standpoint of Christian faith, hospice care often makes the patient comfortable enough to pray, listen to tapes and music, receive communion in a more participatory way, discuss dying and the hope of the resurrection, and in general to be more alive and responsive to the beneficence and care of nurses, clergy, friends, and family.