How Some Hospices are Killing Patients: One Family’s Story

Bioethics   |   Steven Ertelt   |   Jan 2, 2004   |   9:00AM   |   WASHINGTON, DC

How Some Hospices are Killing Patients: One Family’s Story

by Karla Dial Staff Writer
January 2, 2004

[Editor’s Note: This article is a follow-up to our well-received exclusive profile of the hospice industry, "Are Euthanasia Advocates Taking Over America’s Hospice Industry?"  * Names have been changed in this article to protect the identity of people mentioned in it.]

Washington, DC ( — The idea of hospices killing patients can evoke a lot of responses — ranging from wide-eyed incredulity to blatant derision. Hospices don’t kill people, some might say; it simply does not happen.

Marilyn Martin* would beg to differ.

Martin’s father was diagnosed with Parkinson’s disease in 1995. Five years later, his wife put him in a hospice. Within two weeks, he was dead.

"The night he died [the hospice] called me," Martin recalled, "I rushed over in the middle of the night and asked what happened. A nurse said that after we had all left, she gave him some morphine to help his breathing.

"He wasn’t having any trouble breathing. So I knew right away they had just overdosed him."

Martin believes her father was killed for money — specifically, so her mother could inherit some of the millions in his bank account and continue her jet-set lifestyle, unfettered by a debilitated but nonterminal spouse. And she found a hospice that was willing to help her do just that.

Family history

Martin’s father got his money the old-fashioned way — he earned it doing contracting work with the federal government. Shortly after his diagnosis, he retired, but continued working as a consultant, making trips to Asia and South America. For the first few years, he was relatively asymptomatic, untroubled by tremors.

What he did have a problem with was swallowing, and sometimes-garbled speech. And according to Martin, his wife didn’t help.

"My mother didn’t always stick to the diet," she said. "She’d give him things like peanut butter, which was a definite no-no on the list. So he’d choke on occasions. But there was one very bad incident when he was hospitalized."

That’s when the trouble began.

Martin’s father had an advance directive stating that he didn’t want to be kept on artificial life-support systems if he was ever incapacitated, but that he wanted to be fed; the directive named Martin and her mother as executors. After the choking episode that hospitalized him in 1998, his doctor ordered a round of tests that determined the Parkinson’s was progressing, and he’d eventually need a feeding tube.

"My mother was embarrassed," Martin said. "She was constantly traveling [to Europe], out doing her own thing. But it was his choice. They tested my father and said he was perfectly capable of making this decision himself, so there was nothing she could do about it."

Marcia Gideon*, a certified nursing assistant in the Eastern metropolis where the family lived, had been looking after Martin’s father two years at that point, while his wife made frequent trips overseas. She accompanied the pair to doctor’s appointments, and remembers the feeding tube visit vividly.

"His wife got all crazy about that," she told "He couldn’t really talk, but you could see by his face that he really wanted the feeding tube. She said he never wanted it and it was in his living will — but all that was in there was him saying he didn’t want artificial life support.

"So she took him to another doctor and said that, and he said, ‘Well, let me ask him.’ And he saw that [Mr. Martin] really wanted the feeding tube, so he got it. She was really upset. After that, she would always say she was going in [to see the doctor] with him, and I could wait outside. It was like she didn’t want me to know what was going on."

From bad to worse

After that, Gideon said, she and the other two nursing assistants who took turns caring for Martin’s father started noticing that his wife was holding a lot of meetings at the house with people she didn’t recognize. And within six months, Martin said, her mother said she was going to put her father in a nursing home.

"I got very upset," she said. "There was no reason for him to be put in a nursing home. We had an argument. My mother said it was just something she was thinking about."

Martin was more than willing to have her father move in with her so she could look after him full-time — and so were his hired caregivers. But the next afternoon, Martin checked her answering machine and heard a frantic message from Gideon.

"She said there was an ambulance coming to pick my father up to take him to a hospice, and if I wanted to do anything about it, I needed to get over there right away," she said.

Gideon was just as upset — and she finally knew what all the secret meetings had been about.

"One day she came in and said, ‘I’m putting [Mr. Martin] in a hospice home," she recalled. "I said, ‘Hospice? That’s where people die! [Mr. Martin’s] not dying.’ So we called [Marilyn], and she came down. [Mr. Martin] was holding onto her and crying because he knew what they were doing and he didn’t want to die. His primary doctor wouldn’t do it, but she found some doctor that would put him in a hospice."

Actually, Martin said, it wasn’t a doctor at all — it was a nurse, recognized by one of her father’s caretakers, who made the diagnosis that he was fit for hospice care.

"She said a nurse she knew … walked in the house, met my mother, and then they walked out and had their meeting in the car," Martin said. "They knew from the get-go that I was willing to have him live in my house and I’d put a stop to it. That was July 14, 2000."

Things happened very quickly after that.

When her father arrived at the hospice, Martin said, the administrators asked her for a copy of his advance directive, because they didn’t have one.

"How do you take a man into your establishment based on the word of some woman who doesn’t even have documents?" she asked. "I had them. But he was already there."

So Martin consulted her father’s doctors—all three of them.

"My Mom kept switching them," she explained. "When she didn’t get the answers she wanted, she moved on. I spoke to all of them, and they said there was nothing in the medical record that indicated he was terminal. The last one said I needed to talk to my mother, because she was ‘manipulating everyone.’

"I told my mother, and she said he couldn’t talk to me like that. I said he was my father’s doctor, not hers — so she became one of his patients so he couldn’t talk to me anymore."

Meanwhile, Martin and her husband visited her father daily in the hospice. They found him alert, quick to laugh and clown around. But a quick check of the cans of Ensure he relied on for nutrition told her that they weren’t feeding him very much — and by the end of his first week they’d stopped feeding him altogether.

Martin’s two brothers arrived from another state at the end of the first week. Just two hours after Martin had left the hospice, they found him "drooling on himself, not the same person at all," she said.

"I caught a nurse shooting something down his throat with a large syringe, and she said it was Roxonol [liquid morphine]," Martin said. Her husband went into the hall and jotted down the names of the medicines on her father’s cart; one was Haldol, an antipsychotic that, according to drug monographs, isn’t recommended for Parkinson’s patients.

"[The Haldol] would explain why my brother saw a drooling man," Martin said. "And if this man isn’t terminal or in pain, there’s no reason for the morphine."

A few days later, Martin was told her father was dead. It was Aug. 2, 2000 — less than two weeks since his admission to the hospice.

A tragic end

Convinced it was a hospice murder, Martin started calling anyone who would listen, asking them to investigate: Her local district attorney. The state Department of Aging. The state Office of Quality Healthcare. After getting a police investigator to agree to meet with her, she got a call back from him a few hours later, canceling the appointment. The Office of Quality Healthcare actually did an investigation and told her they’d found "discrepancies" and would be sending her a report. She never got it. Five times, she requested the report under the Freedom of Information Act, and three years later, still hasn’t received it. She did, however, receive a phone call from someone in the office telling her she was "stepping on people’s toes and had to back off."

"I know my mother wanted this to happen," Martin told "She won’t discuss it with me. I told her what she did was a felony. She said no one ever told her that giving morphine to someone for no reason was wrong."

Gideon has continued her work as a nursing assistant — but her view of the hospice industry has been forever changed.

"I don’t feel the same way I used to about hospice," she said. "I know they don’t all operate in this manner, but there are some that are taking lives and allowing people to die before their time. It’s unlawful.

"This man wanted to live. He had grandchildren he enjoyed seeing, and she just took all of that from him. For someone to just wake up and decide one day that he shouldn’t live anymore—that’s wrong. I want it to stop. I don’t want this to keep happening to a lot of other families.

"I don’t believe this is the only family this has happened to."

Related web sites:
Hospice Patients Alliance –