Before England's Dame Cicely Saunders started St. Christopher's Hospice in 1967, there were people who cared for the dying. They ministered to their physical, psychological and spiritual needs. The basic principles of the modern hospice movement are not different from what came before, however Dame Cicely Saunders worked to incorporate advances in modern medicine for the benefit of those with terminal illnesses. Through her work, vastly superior methods of symptom management were incorporated into the care of the dying.
In the late 1800s, leprosy patients were quarantined on the island of Molokai and left to suffer in disgraceful neglect till they died. When lepers were discovered, they were taken by ship and thrown overboard to swim ashore, often with the result that many drowned before reaching the beach. Any that attempted to climb back on board were shot.
In 1873, Father Damien arrived at the island of Molokai to tend to the lepers on the island. He dressed their wounds, provided medicines, worked to create a piped in supply of fresh water, build beds, schools, residences, churches and clinics. He looked at each "leper" and saw a "person." In 1882, he contracted the disease and lived with leprosy till he died in 1889.
In every way, we can call the work of Father Damien "palliative care" and the place it was provided, "hospice." He did not choose to hasten the death of the dying through an overdose. He did not choose to sedate the patients into a coma and dehydrate them to death (misuse of "terminal sedation"). He did not execute them with a lethal medication as Dr. Kevorkian would, nor did he shoot the seriously ill as the Nazis did. He cared for them, loved them and recognized them as his brothers and sisters.
His was a spirit of unflinching service and sacrifice. His work was true hospice, way before the modern hospice movement was begun. And he was not alone. The type of work he did has been undertaken by people of heart throughout the ages. His life stands as a reminder to us all that we have a choice. Will we choose to serve and care for those in need or, choose to push aside those who are weak and assure their death?
As economic pressures on society surge, the calls to routinely hasten the death of the ailing and disabled will also mount. In the name of "efficiency" and "the public good," utilitarian protocols will be and are being suggested. Dr. Ezekiel Emmanuel, the President' health advisor proposes limiting care available to the elderly. "Dr. Emanuel is part of a school of thought that redefines a physician's duty, insisting that it includes working for the greater good of society instead of focusing only on a patient's needs."
In 1939, Adolf Hitler expanded the scope of physicians to include "mercy killing," the exact language used by modern proponents of euthanasia, assisted suicide and terminal sedation to hasten death. He wrote that "persons who, according to human judgment, are incurable can, upon a most careful diagnosis of their condition of sickness, be accorded a mercy death." Despised for the evil he perpetrated upon the world, his heartless and evil designs toward the vulnerable is now embraced by many in our society as "forward thinking" and "progressive." Those who question Hitler's logic (clothed in modern euphemisms) are ridiculed. How far we have come!
Just yesterday I received a call from a woman whose elderly father was being overdosed with sedatives and morphine in a hospice somewhere in the South. He was not imminently dying. In fact, prior to entering hospice he was able to eat, drink, talk and walk. He had no pain issues! Suddenly, he was comatose and "dying." This was a call just like the hundreds of other calls I've received. However, this woman and her husband listened. They had him transferred from "hospice" to a hospice that was willing to care. The un-needed morphine and sedatives were stopped. And today, the woman called grateful to say that her father was alive. He is alive. His untimely death averted....
So, will we be like those who shot the ailing in Nazi Germany or shot the lepers off Molokai Island "for the good of society?" Hospice workers especially should ask themselves this question and the following: Will we follow in the saintly footsteps of Father Damien and care for the ailing till a natural death takes them?
Each of us, in our own lives, in our own way, faces this choice every day.