Thomas A. Sharon, R.N., M.P.H.

The fifth proposed new national priority is for the amended PPACA to “guarantee appropriate and compassionate care for patients with life-limiting illnesses.” To be cautious, one should be aware that there is a lot of political correctness packed into the quoted statement. This quote from the IOM is referring to hospice care, which as it is presented currently, is a means of stopping all manner of expensive treatment in exchange for receiving large doses of Morphine and waiting for death. In such situations it is impossible to rule out assisted suicide or euthanasia since lethal amounts of pain killers are conveniently available in the privacy of the patient’s home. Medical examiners do not get involved when a person with terminal illness dies a few months before the doctors’ expectations unless there is obvious evidence of a homicide, like a smoking gun with a confession.

Therefore, although end of life care is an important part of the system, it should always be a matter of choice and the decision should never be irreversible or require that the patient lose all hope of survival. In fact I have been working with a hospice organization that does not stand in the way of continuing treatment or bringing in complimentary alternative medicine (CAM). We have established this program in my community and we call it “hospice with hope.” The idea hit me when I was sitting with my friend and client, Sam (of blessed memory) at his oncologist’s office. He had advanced cancer in his pancreas, liver and lungs. The doctor said, “The chemo therapy didn’t work. There is nothing more that can be done, so I am recommending that you go into hospice care.”

Sam stared at the doctor with a stone like expression on his face in response to this shocking news and replied, “That’s a death sentence.”

I interjected with, “Doctor, are you saying nothing can be done, or that there is nothing that you know of that will help.”

The doctor replied, “There is nothing that I personally know of to treat this condition.”

At that point, Sam decided to enter into the world of alternative medicine, but it was too late because the chemotherapy had wrecked his appetite and nutritional status and caused him to suffer from dehydration and starvation syndrome; which, of course, destroyed his natural ability to fight the cancer with the help of herbs, and other recognized methodologies. Nonetheless, there should have at least been a concerted effort to protect Sam’s nutritional status during the chemotherapy with herbal and nutritional supplements. Without these considerations the entire concept of “palliative” care becomes nothing more than a design for a death panel.

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