My father, my siblings, and I are facing a difficult time right now. My mother became ill the day after Christmas as her chronic leukemia transformed into an acute leukemia. Within days she was intubated in the ICU of MD Anderson. She has remained hospitalized though no longer requires intubation. Initially, it was felt that if we could just support her through the chemotherapy, she could recover. There were complications with one organ system after another, but each was dealt with and the ultimate goal remained recovery. However, in the last week all systems crashed. There is kidney failure, heart failure, respiratory distress, and probably a stroke. In addition, her response to chemotherapy has been less than ideal. We understand that recovery is no longer the goal. Comfort and preparation for death is. So it is time to seek out hospice in the Houston area.
Let me be clear that not all hospice organizations are the same. Some truly seek to care for the patient and provide a dignified and patient centered end to life. Others want to provide minimal care and collect their payments from Medicare. I am sorry to say that the hospice organization affiliated with the local Catholic health care institution falls in the latter category. The representative of this organization spoke to my father, my sister, and me before she had any knowledge of my mother's condition. Her focus was on providing morphine for "pain". My mother has no pain. When I asked her about nutrition and hydration she immediately told me to remember that we are talking about hospice care. They do not do hydration or any form of artificial nutrition. John Paul II, the US Conference of Catholic Bishops Ethical and Religious Directives for health care, and the Congregation for the Doctrine of the Faith all clearly state that nutrition and hydration are ordinary care even if administered by artificial means. If a patient can benefit from such care, we are morally obligated to provide it. I find it appalling that a hospice organization that purports to be Catholic would shun this basic principle. I do not know if my mother needs artificial nutrition and hydration. However, I cannot in good conscience entrust her to the care of an organization that views this basic level of care as extraordinary and unnecessary. Similarly, when I asked about the use of oxygen for her respiratory distress, I was told that while they do administer oxygen, their immediate response to a patient struggling to breathe is to administer morphine. They would not check an oxygen saturation (a non-invasive test done at the bedside by clipping a sensor to my mother's finger) to see if my mother was getting adequate oxygen. It is true that morphine can help some respiratory distress, but the hospice representative presented it as an agent of sedation to stop the discomfort of shortness of breath. She had so many different reasons to offer morphine, it seemed she just couldn't wait to euthanize my mother.
My father will be speaking with a representative from a different hospice agency this evening. I have already spoken to a representative from this agency and found it to be much more in line with Catholic bioethical principles. It is a sad commentary on the state of Catholic health care when a secular for-profit hospice agency sounds more Catholic than the local Catholic agency.