Right to Die - Right to Live

Historically, hospice care has been sacredly reserved as a blessing to relieve pain and suffering of a dying patient in the final stages of life. Hospice development was based upon a heart-felt motive of caring for individuals during a fragile time of life. Many early hospice institutions were faith-based and did their work without profit, even without payment to gracefully usher in a peaceful, painless and comforting death for the dying critically ill patient. But today, hospice care has evolved into something much different after so many accounts of patients being ushered quickly into death, carrying hospice into a different realm in many people’s eyes. A sacred institution meant for suffering and dying patients is no longer just for the dying, but for the terminal; possibly even at the first stages of disease. Without well-defined transitions between palliative and hospice care, and with the use of strong narcotic pain medications, hospice can result in a patient being transitioned to end of life care while not in final stages of life, even while still responding to physician ordered treatments; resulting in a deliberate manipulation to hasten a patient's death.  The practice is philosophized by the dying field to be for the good of the terminal patient. Sadly, all is being done without patient knowledge and/or choice, all for the purpose to hasten their death.

Pharmaceutical treatments that historically have been used by hospices to relieve the pain and suffering of the dying individual are now narcotic pain medications being used as chemical restraints to control behaviors and anxiety of the terminal (not yet dying) patient; used in an unlimited amount to keep the patient calm, even unconscious, until passing. All done without MD management and acceptable under insurance guidelines. The process is more specifically defined as terminal or palliative sedation and the calming meds are used to mimic a state of permanent unconsciousness, as would be if the patient was dying; but, they are not dying, they are only drugged. The drug-induced permanent unconscious state then justifies the withholding and withdrawing of life-sustaining meds and treatments as a next step, then ushering in a patient’s right to die under a manipulated death process. It is a physician-ordered tranquilizer opiate cascade that results in the individual’s physician assisted death without patient choice or knowledge that a manipulated death is being performed on them.  

When terminal or palliative sedation is used on one that has lost their ability to voice their choice, or they lack strength in health care surrogate, they can become prey to the sedation and suddenly change to final stages of life, withholding/withdrawing of life sustaining options are then justified under right to die laws with no accountability for a life. The institution of hospice for the dying then becomes an institutionalization of the terminal at the stage of their disease when they lack voice, either physically from a catastrophic event or through decisional capacity; where the choice to hasten a life to death then becomes the choice of one other than the patient.  A blatant and deliberate violation of ones human rights.

It is not voluntary euthanasia in that the individual is given a lethal substance by choice, but rather the patient is involuntarily given strong narcotic sedatives such as morphine to mimic final stages of life with no other qualifier except that they are elderly, demented, disabled or chronically ill and have lost their voice to make their own choices; others decide if life supporting options are chosen or a hastened death using excessive off-label narcotics and even psychotropic drugs of terminal sedation.  The patient does not have to be in pain to receive the narcotic pain meds, but meds are used off-label as an indirect manipulation to hasten the patient to final stages of life, a hastened death process. Terminal sedation then causes the individual to remain in a state of lethargy and ultimately pass from a common side effect of the strong sedatives, respiratory failure, possibly exasperated by dehydration, malnutrition and/or infection. No one would want to die like this, it is not a peaceful death.

This process is administered not by patient choice, in fact, the patient is never told what is happening and death comes in a short period of time, weeks or days, as the drugs are increased by diagnosis of terminal disease progression. It has been labeled as involuntary stealth euthanasia and it happens under the radar of the public; even the caregivers and employees of the hospices do not realize, terminal sedation is not a natural dying process. Due to HIPAA laws and probate laws, this process is well concealed. Hospices know a dead patients can not file criminal complaints on the violation in patient rights or hastened death, they are not going to protest, and only heirs to the estate (not family)  have voice after the hastened death.

It is our goal to increase public awareness of the use of terminal and palliative sedation without patient choice/knowledge, also called involuntary stealth euthanasia, being used by hospices nationwide and outside of the public eye. The use of chemical restraints, justified under terminal and palliative sedation, is to control behaviors in a terminal patient without least restrictive environment first considered.  Pain killers are no longer just being used for relieving pain and suffering in the dying patient. Policies of hospices that focus on "right to die" need to be reexamined for change to provide life supporting options for all patients and focus on a patient’s "right to live" instead of forced terminal sedation that focuses on passing under a manipulated death. This includes advocating for the use of behavior and safety supports and promoting life-sustaining options in the hospice environment; minimizing the use of strong narcotics to control agitations and behaviors outside of MD management in the elderly, demented, terminal and chronically ill. More specifically defined criteria are needed establish the transition of a patient
from palliative to hospice care and prevent ending the life of a terminal patient not in final stages without patient choice.

Please show your support by donating to Choices Right to Live at Go Fund Me, all donations at this time will go to support the work of Hospice Patient Alliance to end terminal and palliative sedation, involuntary stealth euthanasia, when it is without patient choice. Send your story to [email protected]