by Kathy Dial
LifeNews.com Staff Writer
December 19, 2003
Washington,
DC (LifeNews.com) -- Imagine for a moment that a close relative—your
father, a sister, a grandparent—is suffering from a terminal illness.
It's past the point where your loved one can care for himself—and beyond
your capabilities to help him. Time is running out, but you want to
make his last days as comfortable as possible before death comes to
claim him.
If you're like 10 percent of Americans, you find a hospice to take him
in. Since hospice care is covered by Medicare, you know the financial
burdens of his final weeks will be eased—and you can rest comfortably
in knowing that the hospice staff will do all it can to ease your loved
one's pain while allowing nature to take its course.
It's a peaceful thing to think about. Or is it?
Ron Panzer, president of the pro-life Hospice Patients Alliance (HPA),
says there's a hidden threat inside the hospice industry that's been
growing like a cancer for decades—and most people don't realize it until
it's too late:
Hospice workers all over the country are routinely killing patients.
"Families who report in to HPA tell us they've overheard nurses
say things like, ‘I'm just like Jack Kevorkian, only I do it with morphine,'
" Panzer, whose organization receives thousands of calls like that
a year, told LifeNews.com. "And they get away with it week after
week after week, because ‘it's hospice!' "
Panzer has heard it all through the years: Family members describing
their relative as terminally ill, but functional and not in unmanageable
pain—until a visit from a hospice nurse left the patient dead within
an hour. Family members who have been told by hospice workers how to
administer pain medication—only to realize afterward that it was a lethal
dose. And honest hospice workers who have been threatened or fired after
finding out about cases of euthanasia and Medicare fraud. It's all taking
place, he says, in a competitive industry that's favored by the federal
government and making millions with little accountability.
"No government agency listens to these families," he said.
"Absolutely no agency responds appropriately. From the local and
state to the federal levels, these families are ignored—tens of thousands
of them every year. Local district attorneys will refuse to prosecute
reports of hospice killings because they're so-called ‘expected deaths.'"
As the seed is planted …
Not every hospice in America is out kill patients
before their time in order to make a buck, Panzer said. The industry,
which began in England in the late 1960s before the first American hospice
was founded in 1974, has done much to deserve its golden reputation
as the best end-of-life care option available.
In the beginning, Panzer said, "they were mostly nonprofit hospices,
and before that, they were volunteer hospices set up by doctors, social
workers and nurses. They might take donations, but they weren't getting
paid in the early 1960s. "It wasn't a business—it was a labor of
love."
But by the time Florence Wald, MSN, established Connecticut Hospice
in 1974, a dark seed was already taking root in the fledgling industry.
"I'll tell you the way I see it, and I know that I differ from
[British hospice founder Dame] Cicely Saunders, who is very much against
assisted suicide," Wald told the Journal of the American Medical
Association (JAMA) in 1999. "I disagree with her view on the basis
that there are cases in which either the pain or the debilitation the
patient is experiencing is more than can be borne, whether it be economically,
physically, emotionally or socially. For this reason, I feel a range
of options should be available to the patient, and this should include
assisted suicide."
That mindset attracted the attention of euthanasia advocates. Since
1938, the right-to-die movement has existed in the United States—first
calling itself the Euthanasia Society of America, most recently changing
its name to Choice in Dying.
"They did it as a public-relations move to make their agenda more
palatable to the gullible public," Panzer said, "representing
a hastened death as a ‘choice,' just as abortion has been represented
as a ‘choice' and a ‘right.' "
Choice in Dying has led the charge to promote advance directives and
living wills—viewing them, Panzer said, as a stepping stone to assisted
suicide and then euthanasia in a country that needed time to get acclimated
to that kind of thinking. And the United States needed a lot of time:
The concept of euthanasia has its roots in the eugenics movement that
spawned the Nazi death camps of Hitler's Germany. That wasn't palatable
to Americans who fought in World War II.
… so grows the tree.
But Panzer believes that the idea, which lay
nearly dormant for half a century, found the crack it needed to break
through to the surface in the 1980s.
"Medicare was looking at how to cut costs when providing very complex
and intensive care to patients who were terminal. Statistics show the
greatest expenditures for a patient are in the last months of life,"
he explained. "The hospice benefit was started in the early 1980s
and was found to successfully reduce the costs of Medicare. So it was
officially approved by Congress as a Medicare benefit."
Dr. Linda Peeno spent years in the managed-care industry, witnessing
firsthand the kind of mindset it introduced to patient care. She left
the field to become a patient advocate 10 years ago, unable to deal
with the cost-containment attitude that shortchanged patients out of
good—sometimes life-saving—care.
"This troubled me even when I was directing a nonprofit HMO,"
she told LifeNews.com. "We entered an agreement with a hospice,
and immediately I saw our nurses trying to shift patients to hospice
as quickly as possible. Once you get a family member to acknowledge
that the condition is terminal and hospice is a resource, there was
this belief they'd stop seeking other resources [and treatments]. So
our costs were limited dramatically."
In the meantime, the euthanasia movement was finding inroads into the
hospice industry: In the late 1990s, Choice in Dying was absorbed by
a new organization called Partnership for Caring—founded by Dr. Ira
Byock, a hospice physician.
Why did they merge?" Panzer asked. "Any organization that
was pro-life would never in any way be associated with Choice in Dying,
which is a front for the euthanasia movement."
When the cost-containment practices of managed care spilled over into
all forms of health care—turning physicians more into gatekeepers than
caregivers, Panzer said—the euthanasia movement saw a ripe opportunity:
Right-to-die advocates began to infiltrate the top levels of the policy-making
organizations in the hospice industry.
In other words," Panzer said, "hospice as we knew it is not
hospice as it is today."
Medical literature has documented those inroads: JAMA reported in 1999
that physician-assisted suicide and the hastening of death is not "unheard
of" or "rare" in medicine. A survey of 355 oncologists
revealed that 15.8 percent reported having participated in euthanasia
or assisted suicide—and of those, six patients did not "participate
in the decision for euthanasia or assisted suicide." That means
they were killed because the doctors wanted them dead, not because they
chose it.
The industry's top policy-making bodies are the National Hospice and
Palliative Care Organization, Last Acts Partnership, and the Hospice
Foundation of America. Though none of those organizations maintains
publicly accessible position papers on assisted suicide on their respective
Web sites, Partnership for Caring does: It says it "takes no position."
"The Partnership for Caring Board of Directors has taken legalization
of physician-assisted suicide off the table as an issue for policy development
and political action," says the document, titled "Leaving
Our Differences at the Door," found on a page last updated in April
2002. "Partnership for Caring will not join the debate about physician-assisted
suicide, and will take no position for or against its legalization because
to do so would divert energy from Partnership for Caring's mission to
eliminate the suffering of dying Americans."
That's just the sort of nebulous language Panzer has come to expect
from the industry.
"They are not up-front about the euthanasia agenda, but you will
not find one word mentioning the sanctity of life or the pro-life movement
[on their sites]," he told LifeNews.com. "On their Web sites,
they post articles from doctors who are right-to-die people."
For example, Panzer points to Byock co-writing an article with Dr. Timothy
Quill—who promotes terminal sedation for patients, even if they are
not suffering from the uncontrollable agitation that's often found in
the final stages of life.
"If you expand the utilization of terminal sedation to other patients,
it becomes the preferred method of euthanasia and is currently being
implemented in hospices across the U.S. in that way—even though it's
illegal," he said.
The road to abuse
That's a system that's ripe for abuse by family
members with ulterior motives. It's what many believe has happened in
the case of Terri Schiavo—the disabled Florida woman whose husband has
kept her in a hospice for years while seeking the court's permission
to remove the feeding tube on which she depends so she can starve to
death. Michael Schiavo lives with and has fathered two children with
another woman and stands to inherit Terri's estate if she dies—the reason
her parents believe he's never divorced her.
"The Terri Schiavo case cannot be understood without … the background
of hospice and the right-to-die movement," Panzer said. "She
was placed [in hospice care] as a test case for the right-to-die movement
to establish a legal precedent to end the lives of the disabled using
hearsay evidence [about her end-of-life wishes], which is very common
in hospice settings and in cases where one family member wishes to end
the life of the patient.
"The Schiavo case represents the railroading of the disabled into
death, using hospice as the vehicle to implement their dark agenda.
Hospice is the preferred killing field, because no prosecutor will go
after a hospice killing. It's a sacred cow."
Because of the savings hospice care can net the federal government through
Medicare, Panzer believes the government doesn't want to hear any bad
news about the industry—even news of murder. It would tarnish the image,
turn people away who would otherwise use the industry for their relatives—maybe
even make some stock prices tumble. It's also easy to falsify patient
records—to make it look as though every effort was made to manage their
pain for as long as they needed to die naturally, as the government
requires hospices to do under the per-diem payment basis (for every
day a patient is enrolled, not for each service rendered)—even if those
efforts weren't made.
"I can see how that would be the line of thinking," Peeno
said. "It's much like what happens in psychiatry sometimes with
patients who are negligently treated—[the legal system] says they were
mentally ill to begin with. So you shut down any attempt to understand
how the system hastened the process.
"We're all going to die—but there's a legitimacy to the process.
It shouldn't be accelerated for an economic goal."
That's a story that's caught journalists' attention before, but has
never really made it past them to the public. Panzer and some of the
families that have lost members to abusive hospice systems have all
been interviewed over the last few years by some of the top news magazines
in the nation—include PrimeTime Live and 20/20. But after the producers
and reporters have done all the legwork, they return to New York—where,
so far, their editors have always killed the story.
So the industry remains unchecked—even by the mainstream media.
"If all the dead bodies from this hospice homicides were piled
in one place, it would resemble a Nazi death camp—because the Holocaust
is already here in America," Panzer said. "You don't see it
because they've figured out if they kill one at a time, they can get
away with it."
"And they are."
Related web sites:
Hospice Patients Alliance - http://www.hospicepatients.org
