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