The 6th Commandment and Hospice


Doesn’t hospice break the 6th commandment?

Or, to be King James Version about it: Thou Shalt Not _____.

By background, I’m a pastor. Early in my career, I attended a gathering where several irked clergy colleagues argued over the language of the Commandments. In the original Hebrew, did #6 in God’s “top ten” mean murder or kill or both? Ministers may endlessly debate meanings and theological viewpoints, but for some families confronted with end-of-life choices for loved ones, they see little difference between the words.

I often tell sweet stories about all the wonderful stuff that hospice can do for patients while they are dying, for families as they care for a loved one, and for the survivors as they grieve a beloved.

But others will tell different stories. If it’s not hospice will kill you, it could be they will over-medicate you, and you’ll be: too doped up or too hyper or become addicted to drugs or . . .

I first worked for a hospice in 1998 and heard people back then say, “Hospice will kill you.” This warning could come from a friend of someone considering hospice care that knew a family member who knew of another family member that had had a terrible experience. This statement might also have supposedly come from a doctor or other “reliable” source. Over twenty years later and working for a different hospice, I still occasionally witness versions of that horrible, and very not true statement. And, of course, my old 1998 adventures in hospice care coincidentally occurred in the same year that Google was “officially born.” Since then, all the bad stories aren’t only overheard, since we can quickly do an online search for an ever-expanding hornet’s nest of grim hospice tales.

There are unsettling and unfortunate stories. Everyone in hospice, from the home health aides to the physicians, is human, and therefore makes mistakes. The very human patients intentionally and unintentionally make foolish choices and more mistakes are possible. The family caring for a loved one—a family of nervous, weary, and frequently second-guessing humans—might also make mistakes. But all of those mistakes are rare, and rarely fatal.

Headlines, years ago and today, have included terrible accounts of mercy-killing nurses “putting patients out of their misery.” A novel or film might depict a handsome doctor harvesting organs to sell to the highest bidder. Or a conniving wife with hair that’s always perfect will knock off the dying husband for the insurance. Lurid fact or best-selling fiction, it’s easy for anyone to point a finger (literally or online) at the facts or the fake news and declare, “See, bad things always happen in hospice.”

Hospice is a relatively new part of health care. The modern hospice movement emerged in England in the 1960s, and the United States by the early ‘70s. The hospice where I currently work in the Central Valley of California began in 1981. It’s one of the oldest hospices in this region. Not surprisingly, the first years of its existence included a variation of the mercy-killing nurse. Unfamiliar with hospice’s priority of helping terminally ill patients die with dignity, legal actions were brought against the hospice’s founder to stop the “murders.” After all, sick people were being drugged and then they . . . died.

The accusations fizzled, with more and more people soon learning that compassion and kindness were the goals.

Other hospices from that era likely have similar histories. Diseases like pancreatic cancer and congestive heart disease may cause death, but it’s the perceptions—misperceptions—that fuel rumors, accusations, and fears.

What is your view of hospice?

Since every hospice patient needs his or her doctor’s referral before entering hospice care, that’s an essential question for physicians. Do you know what your doctor thinks about end-of-life care?

It’s an equally important question for families. Loved ones will die. Hospice may be able to provide a quality of life that will include precious moments for sharing memories and the gift of time to say goodbye. But if we only listen to our fears, or only pay attention to the high-profile horror stories, or never take an opportunity to thoughtfully learn what a hospice does, the worst lie will persist: hospice kills.

It’s not a commandment, but at the top of hospice’s list is an affirmation of life.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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  1. Having been a hospice chaplain I can only speak of my experience and my study of scripture. The commandment is speaking of murder. In all of my time with hospice, I saw people dying of diseases who were given comfort and dignity by health care professionals who recognized that life has a beginning and an end. Both of those are equally a part of life on this Earth. Deliberately killing with malice and forethought was not a part of that care.

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