Hospice eNews

What the Media Said about End-of-Life Care This Week

Week of September12, 2005

…a service of Florida Hospices and Palliative Care

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HOSPICES & NURSING HOMES RESPOND TO HURRICANE KATRINA

Hospices far from the hurricane disaster site are helping patients in the aftermath of Katrina. Hospice of Northwest Ohio opened its doors to a woman with lung cancer who had ridden over 20 hours from Mississippi in a pickup truck and was nearly out of oxygen. AseraCare Hospice, of Clarks Summit, Pennsylvania, is sending donations to a sister agency in Mississippi. Staff from the Southeast Texas Hospice, in Orange, are paying daily visits to shelters. Hospice evacuees who wound up in the Pensacola area may contact Covenant Hospice or Hospice of the Emerald Coast for assistance.

Beverly Enterprises, Inc., went on 24/7 stand-by to accept nursing home patients from Louisiana and Mississippi who were evacuated from Katrina’s path. The company has admitted evacuees to homes in Arkansas, Mississippi, Alabama and Georgia. Beverly also chartered a plane to take payroll cash to employees in Hattiesburg and Tylertown, Mississippi, as well as delivering 1,000 pounds of supplies, medication and food to employees and patients in Hattiesburg. In Arkansas, Beverly employees are providing relief help and have set up a family search operation near Fort Smith, where many evacuees from New Orleans are living.

The Hospice Foundation of America put a bulletin board on its website to help hospice patients reconnect with their families. Messages can be posted at www.hospicefoundation.org, and hospice employees and others will be able to contact persons who have posted. Family members may also call 800-854-3402. (Hospice Letter, 9/2, Arkansas Democrat-Gazette, 9/9, E-mail from Kate Viggiano, Hospice Foundation of America, 9/6)

CATO INSTITUTE EXAMINES DEA AND PAIN TREATMENT

The Cato Institute held a seminar on September 9 called “Drug Cops and Doctors: Is the DEA Hampering the Treatment of Chronic Pain?” The presenters examined the DEA’s policies and actions on diversion of painkillers and the effects on the healthcare community, patients and the treatment of chronic pain. Speakers included Oklahoma Attorney General Drew Edmondson, President of the Center for Practical Bioethics Myra Christopher, President of the Pain Relief Network, Siobhan Reynolds, Director of the Duke Institute on Care at the End of Life, Richard Payne and others.

Speaking in the session on Pain, Diversion and Public Policy, Edmondson expressed the concern of attorneys general across the country that patients suffer needlessly because federal policies and actions “have a chilling effect on the treatment of pain.” “As a former district attorney, I fully appreciate the need to find and prosecute doctors who are illegally prescribing pain medications as a method of diverting those pills to another source,” Edmondson said. “On the other hand, I also appreciate the need for a physician to prescribe appropriate medications in adequate amounts to manage a patient’s pain.”

Edmondson asserted that fear of DEA prosecution keeps some physicians from prescribing adequate doses of pain relievers for patients, and thus are “prevented from doing what is best for their patients.” “There is no easy answer to this problem,” he said. “The solution will only come with frank discussions and genuine effort from everyone involved in the process.”

Videos of the presentations are available at the Cato Institute website, www.cato.org. Click on “Events,” then on “Watch or Listen to Archived Events Online.” (Cato Institute Website, Oklahoma Attorney General Website)

END-OF-LIFE NOTES

* A research study from the Netherlands has “found that doctors are helping hasten the deaths of sick children in a variety of ways, sometimes at the edges of what the law allows.” The study, which was published in the current issue of the Archives of Pediatrics and Adolescent Medicine, examined the deaths of 64 children and found that 42 “involved medical decisions that could hasten death.” Only one case involved euthanasia and the others ranged from withholding life support to administering opiates “with the intention of ending suffering and hurrying death.” (AP, 9/5)

* Dr. Carlos Gomez, national expert in end-of-life care, recently spoke at a Roanoke public forum called “Everything You Wanted to Know About Artificial Hydration and Nutrition But Were Afraid to Ask.” The forum was sponsored by the Roanoke Valley End of Life Care Partnership. Gomez, who was featured on Bill Moyers’ PBS series, “How We Die,” has worked extensively with minority communities on end-of-life issues. (The Roanoke Times, 9/8)

* Current Connecticut end-of-life statutes “create a confusing patchwork of authority,” and efforts are being made to update and reform them. A Connecticut Law Tribune article says that patients and physicians are confused and that “medical professionals tell us that they often disregard the legal documents and ask the family members they see as most involved for their opinions about care.” (Connecticut Law Tribune, 9/5)

* “Addressing money issues is critical” when a family member is terminally ill, says an article in The Wichita Eagle. Experts recommend learning which benefits are available, planning ahead so there is no gap in insurance coverage, reviewing life insurance for possible cash benefits, identifying future expenses and creating or updating estate planning documents and wills. (The Wichita Eagle, 9/4)

* “End-of-life” and “palliative care” may be relatively recent buzzwords, but the concepts go back to ancient Egypt. One Middle Kingdom papyrus from a doctor contains a careful observation and diagnosis of a patient and a long list of injuries divided into three parts: “an ailment I will handle,” “an ailment I will fight with,” and “an ailment for which nothing is done.” Dr. David Mininberg, a physician with a master’s degree in Eastern Studies, says, “In light of today’s practices, in my opinion, it’s an incredibly enlightened view. …. The third category is what I think most impressive: not to treat. In other words, rather than undertake end-of-life, heroic measures with no chance of success, he simply gives supportive care.” The article is available online at www.forbes.com/lifestyle/health/feeds/hscout/2005/09/08/hscout527740.html. (Forbes Website, 9/8)

OTHER NOTES

* A HHS commission has recommended specific proposals to reduce Medicaid’s use for long-term care. Among the recommendations is the elimination of loopholes that let some older people shelter their assets in order to qualify for aid. The article says, “There’s no assurance that Congress will agree in the current session on the details of Medicaid cuts, or to expand the long-term care insurance program. Even so, the intensifying focus on Medicaid’s costs should be a red flag to anyone counting on government aid for long-term care.” (The Wall Street Journal, 9/7)

* Maryland Attorney General J. Joseph Curran, Jr. (D) released a report, “Prescription for Disaster: The Growing Problem of Prescription Drug Abuse in Maryland,” which “warns of a burgeoning crisis of prescription drug abuse and diversion” in the state. The report recommends the establishment of an electronic prescription monitoring program, increased penalties for distributing pharmaceuticals illegally and a public outreach and education campaign. (US Fed News, 9/7)

* New guidelines issued by the American College of Cardiology (ACC) and the American Heart Association (AHA) emphasize early diagnosis and new treatments for combating heart failure. The guidelines are available on the ACC website at www.acc.org and at the AHA website at www.americanheart.org. They will also be published this month in the Journal of the American College of Cardiology and Circulation. (Drug Law Weekly, 9/6)

* A Texas juvenile court judge “ordered treatment and state oversight for a 13-year-old cancer patient to continue after her parents were unable to produce specialists’ opinions in time for the hearing.” The parents of Katie Wernecke believe that the high-dose chemotherapy ordered by Katie’s physicians will do more harm than good. Judge Carl Lewis says that “the state might in the end have to throw up its hands,” because Katie herself is failing to cooperate – pulling out IVs, drinking soda after a ‘nothing by mouth’ order, and refusing to allow her pulse to be taken.” (The Houston Chronicle, 911)

Correction: An error in the original source of last week’s article, “NHPCO Addresses Responses to Hurricane Katrina,” incorrectly identified the website of the National Hospice Foundation as www.hospicefoundation.org. The correct URL is www.nationalhospicefoundation.org. HNN regrets the error.