The Hospice movement is active all over Utah, but there still are medical professionals who will not inform patients or care-givers about the availability of help for the terminally ill. Flo Wineriter told the May meeting of Humanists of Utah why and how that help can be given. Part of his speech is reproduced here.

First let me ask you to think about this question: If you had less than six months to live, would you want your doctor to tell you the truth? Secondly, if you were given such information, what would you do with the time you had left to live?

With those thoughts in mind, let me tell you something about the Hospice movement.

Philosophy

Hospice has a philosophy rather than a place. The goal of the Hospice program is to provide comfort, purpose, and understanding to patients with terminal illness and their families.

Our culture has difficulty dealing with the dying process. We seem to be able to accept death when it occurs, but we have a lot of trouble handling the process of getting there. The reluctance to recognize and accept the reality of a condition that is terminal seems to be as common to professionals in the medical field as it is with lay people. Doctors are trained to cure disease and to maintain life. Because of their training doctors generally regard the death of a patient as a failure on their part.

To some degree this is understandable. Life is precious, it is short and we all want to remain as conscious part of the life experience just as long as possible. We are willing to accept a certain amount of deprivation, pain and suffering to stay with the known. There is ample evidence of this when you consider the number of people living in various stages of restricted lives such as hospitals, nursing homes, prisons, detention camps and poverty. Few of us "give up" life without a struggle, as you can see from appealing death row inmates, and World War II death camp survivors. The "will to live" seems to be instinctual. All levels of life display survival instincts when confronted with life-threatening situations.

Hospice is designed to step in and begin working with patients and their families when the patient's life expectancy is six months or less. The sooner we can be called in the better an opportunity we have to help patients and their families come to terms with death and, even more important, to get the most quality of living into the remaining time they have left.

Our major challenge is to convince medical doctors to recognize and accept the reality that death is highly probable within six months. Doctors are trained to extend life and, like the rest of us, they are inclined to maintain an overly optimistic attitude. They want to try every tool available to cure a cancer or at least put it into remission.

Doctors tend to be more concerned about the "quantity of life" than they are about the "quality of life." They urge cancer patients to try chemotherapy, radiation, and other treatments to prolong life as long as possible. Frequently treatments are suggested and recommended even when death is likely within a few weeks. Doctors appear to be "hoping for a miracle" as much as possible. We in the Hospice movement feel such an attitude is unfair because it simply delays death rather than prolonging life.

Interventions

Active treatment of death-causing disease is in conflict with Hospice Care. When a patient is found to be terminal, and willingly accepts Hospice care, all active treatment of the disease stops. Hospice care, in contrast to medical care, is intended to improve the quality of life. We do this by removing pain as much as possible, helping patients to clarify what will make the rest of their lives meaningful, and helping them to find ways of implementing those goals and desires. Those goals can be as adventurous as riding a hot air balloon, or as tame as finishing a hobby project.

We encourage patients to resolve outstanding conflicts with family members, to clarify distribution of assets and responsibilities. Our goal is to help patients and families have a peaceful and conflict-free death. Family members are taught how to care for the patient; how to bathe them, how to give pain medication, how to help them out of bed and into bed, how to communicate openly, in general, how to make the patient comfortable.

--Flo Wineriter