Hospice vs Suicide Article
October 26, 2007
Hospice Care: A Viable Alternative to Assisted Suicide?
A terminally ill patient’s right to
die promises to be a topic of controversy for some time to
come. This includes physician-assisted
suicide, a practice that has been implemented in a number of
European countries and to a limited degree in one state in the
The reasons most often given for those considering
this option revolve around “dying with dignity,” and “becoming
a burden to the family” or address concerns about suffering,
or being kept alive by machines. Patients often state that if
any of these events occur then they would like their lives to
be terminated in a peaceful, painless and humane manor.
There is also another factor that may be influencing these thoughts:
Depression. When a person receives a discouraging diagnosis or
a terminal prognosis, the natural response is feeling out of
control. And that almost invariably leads to depressions. Depression,
in these instances, often subsequently leads to thoughts of suicide.
In my experience with Hospice patients, depression usually resolves
in a short period of time, with or without medication. However,
like pain, depression is a symptom that can be treated and controlled
successfully. Depression is not a good foundation from which
to make end of life decisions.
It’s important to state that I have
no strong beliefs, religious or otherwise, that suicide is
wrong or bad. And I respect
the considerations of people in a position to have to look at
what life may be like after receiving a dire diagnosis. However,
based on years of working as a Hospice nurse, I have come to
believe that suicide is not the best choice for people with families
who care about them.
This article addresses the concerns most often stated for choosing
humane suicide, and suggests that Hospice Care is an alternative
to this choice.
Dying with Dignity
Over my years as a Hospice nurse, I have observed that dignity
comes from within and cannot be taken away by an unfortunate
condition of life. One only need read stories of concentration
camp survivors or prisoners of war to understand that the ability
to maintain one’s dignity is inherent; it can only be
given away and only when the sense of self is lost.
With Hospice Care, every attempt is made to
maintain and support a patient’s sense of self and therefore
their dignity. Patients are constantly reminded that they are
who they always
were, that it is only their bodies that are failing. Patients
who have lived with dignity continue to do so through their illness,
no matter what their symptoms do to their bodies. I have been
inspired time after time by patients who have met the challenges
of their illness with dignity.
Living in constant pain is a natural concern many patients
experience. However, with the pain management techniques
available today, almost all pain can be controlled, if not
eliminated. A person with a terminal illness can still have
a life that has quality and enjoyment, and can spend quality
time with their families and friends. Moving from a curative
treatment to the palliative care of hospice often produces
a dramatic improvement in quality of life that can be maintained
right up to the last days.
Being a Burden
When patients express to me their concern about being a burden
to their loved ones I remind them that whether they are a burden
or not is not their decision. It is determined by their loved
ones and that this is a choice that only their loved ones can
make. Invariably, when I speak with the family members who
are caring for the patient, they tell me that they would rather
have their loved one present, even though they have to care
for them. This is especially true when they know their loved
one will not be suffering due to pain.
Life By Machine
Finally, there is concern about being kept alive by machines.
In Hospice Care, we share this concern. As a group, we do not
believe in keeping people alive by artificial means; we do
not hook people up to machines. The philosophy of Hospice Care
is to create an environment in the patient’s home—a
familiar place— were they can die peacefully and naturally,
surrounded by people who love them.
The Reality of Hospice
I understand that Hospice Care is not for everyone. I have seen
patients who want to continue to “fight their illness,” to
have treatments such as chemotherapy, radiation, and surgery
long after they have been advised they can no longer benefit
from them. I respect their decision and, at the same time,
I regret the suffering I have seen as a result.
For those who accept that, short of a miracle (and I have seen
those), their life is coming to an end, most likely within a
few months, Hospice can be a positive choice. I have seen time
and again that the end of life can be a unique opportunity for
personal growth, a time for sharing and for coming to completion,
for passing on family traditions and family lore. I suggest that
this experience should not be denied, especially if the reasons
for denying it are controllable.
Dennis Kane has been a hospice nurse since the late 1908’s.
In addition to his private duty hospice practice, he consults
with hospice patients and their families and is a frequent speaker
on hospice to health care professionals. This article was adapted
from his report, How to Work through the Stages of Grief, which
is available at www.hospiceathome.com.
All content on this website and
in our reports is intended for information purposes only.
Always consult your medical practitioners for medical advice.