Saturday, August 30, 2014

Washington Post Puts the Spotlight on Hospice/Palliative Care Abuse

By Margaret Dore, Esq., MBA
Choice is an Illusion, President

Below and finally, a comprehensive article in a major paper describing what a lot of us know already, that non-consenting, non-dying people are being killed with morphine and other drugs under the guise of hospice/palliative care.  The article, excerpted below from the Washington Post, describes cases in the US. There are similar cases in Canada and the UK (e.g, the former "Liverpool Pathway").

There are a myriad of reasons why these cases occur, including mistakes and negligence, which is described in the Post article.  The wishes of heirs interested in a speedy inheritance and/or to get dad out of the way before he changes his will, can also be at play.  For a particularly egregious example, see William Dotinga, "Grim Complaint Against Kaiser Hospital," at http://www.courthousenews.com/2012/02/06/43641.htm


With hospice, eligibility is determined by a prediction of less than six months to live.  This is the same eligibility cutoff used for legal assisted suicide in Oregon and Washington State.  This is, however, just a prediction and there are many people deemed eligible who live longer than that and/or who are not dying.  See, e.g., the Washington Post article excerpted below and this article from the Seattle Weekly: "Terminal Uncertainty."  See also this affidavit from Oregon doctor Kenneth Stevens, MD and this affidavit from John Norton.

This hospice/palliative care abuse issue is important for itself, as well, as for its implications in the larger debate over assisted suicide/euthanasia legalization.  Consider, for example, the letter below from Washington State.  The author, the owner of a care facility, describes how since passage of Washington's assisted suicide law, doctors more readily resort to morphine, sometimes without consent.  He states:
Since [Washington's assisted suicide law] passed, we have . . .  noticed that some members of the medical profession are quick to bring out the morphine to begin comfort care without considering treatment. Sometimes they do this on their own without telling the client and/or the family member in charge of the client's care. http://www.choiceillusion.org/2013/12/it-wasnt-father-saying-that-he-wanted.html
He also describes a general devaluation of older people, as follows:
Since our [assisted suicide] law was passed, I have also observed that some medical professionals are quick to write off older people as having no quality of life whereas in years past, most of the professionals we dealt with found joy in caring for them. Our clients reciprocated that joy and respect.  (Id.).
He concludes by asking readers to not make Washington's mistake of legalizing assisted suicide. He states:
Someday, we too will be old. I, personally, want to be cared for and have my choices respected. I, for one, am quite uncomfortable with these developments. Don't make our mistake.  (Id.).
* * *
Below, the excerpt from the Washington Post article.

As More Hospices Enroll Patients who Aren't Dying, Questions About Lethal Doses Arise

http://www.washingtonpost.com/news/storyline/wp/2014/08/21/as-more-hospices-enroll-patients-who-arent-dying-questions-about-lethal-doses-arise/?

By Peter Whoriskey at peter.whoriskey@washpost.com


MAIDEN, N.C. — Clinard “Bud” Coffey, 77, a retired corrections officer, did the crossword in The Charlotte Observer after breakfast every morning, pursued his hobby of drawing cartoons, talked seven or eight times a day to his son Jeff and, just two weeks before his death, told a pal that he still felt “like a teenager.”

He did, however, have some chronic back pain, and in late March he was enrolled in hospice care “essentially for pain management,” his doctor said. Over a two week period, he received rising doses of morphine and other powerful drugs, grew sleepy and disoriented, and stopped breathing, dying peacefully at home, according to his family and medical records they provided.

His death certificate, which was signed by the hospice doctor, listed the cause as “renal cell carcinoma” or kidney cancer. But that doctor had never examined Coffey, his family said, and medical records from just a few weeks earlier do not mention it.

“My dad wasn’t dying of cancer,” said his son, Jeff Coffey. “Once he was on hospice, their answer for everything was more drugs. Everything we know about his death is consistent with an overdose.”

An attorney for the hospice company, Curo Health, said it could not comment on the case without authorization from Coffey’s family. When Jeff Coffey authorized the company to comment, however, the attorney said that the company would not comment because the Coffey family had hired an attorney in preparation for a lawsuit.

The hospice industry in the United States is booming and for good reason, many experts say. Hospice care can offer terminally ill patients a far better way to live out their dying days, and many vouch for its value.

But the boom has been accompanied by what appears to be a surge in hospices enrolling patients who aren’t close to death, and at least in some cases, this practice can expose the patients to the more powerful pain-killers that are routinely used by hospice providers. Hospices see higher revenues by recruiting new patients and profit more when they are not near death.

There are no statistics on how often such abuses may be occurring. But complaints from around the country illustrate the potential dangers of enrolling patients in hospice even though they are not near death, the families involved say.

– In South Carolina, famed college football coach Jim Carlen, who was suffering from Alzheimers but could walk with a walker and speak, died days after entering a hospice as an in-patient because, according to family attorney Eric Bland, Carlen’s diabetes and blood pressure medicine were withdrawn and replaced with lethal doses of morphine and klonopin, an anxiety medicine. An attorney for the hospice said they would dispute the allegations.

“We are proud of the care we provide to our patients, including Coach Carlen,” said Sam Outten, Greenville-based attorney representing Tidewater Hospice.

– In Tennessee, Shalynn Womack has testified to the state legislature about her mother, who had been receiving hospice care under a diagnosis of “failure to thrive.” She entered an inpatient hospice for what was supposed to be a brief stay — a “respite” — but died after being given what her daughter called a “toxic cocktail” of morphine and other drugs.

– In Maryland, Beverly Gargiulo, 62, of Pylesville, was admitted to the hospital for ulcers, was mistakenly advised to get hospice care, and then was given excessive doses of pain-killers and died, according to a family lawsuit. A jury last year awarded the Gargiulo family more than $900,000.

To read the rest of the article, please click here.

Email the author:  peter.whoriskey@washpost.com