The Hospice e-News
What the Media Said about End-of-Life Care This Week
Week of August 8, 2006
…a service of
An article in the Omaha World-Herald says that the more than 137,000 Nebraskans who
signed a petition to have a “humane care” measure on the ballot in this fall’s
elections may not be getting exactly what they expected. They may have expected that it would protect
persons in the same condition as Terri Schiavo, but
families in other situations may be deprived of their rights to make medical
decisions for their loved ones.
The proposed measure would require caregivers to
give everyone in their care food and water, by any means, unless they already
have advance directives stating their preference otherwise. There are no explicit exceptions for parents of
minor children, those who do not have the mental capacity to decide for
themselves or those who may be suffering from dementia or sudden severe
incapacity from events such as strokes or traffic accidents. The bill also contains no exceptions for
cases in which providing food or water might be uncomfortable or harmful. And while families would not be able to
participate in decisions to withdraw care, outsiders could file suit to force
nutrition and hydration regardless of a patient’s condition.
The
Rebecca Anderson is a genetic counselor and medical
ethicist at the
While Nebraskans United for Life, a right-to-life
group, supports the measure and plans to push it in a fall mailing, other
right-to-life groups have concerns about the amendment. Greg Schleppenbach,
director of Nebraska Catholic Conference’s Pro-Life Office, says that his group
is not “part of it at this point.” Schleppenbach says that the Conference is sympathetic to
the potential for unethically withdrawing nutrition and hydration but realizes
that it is a complex medical, legal, ethical and moral issue for people.
Several persons interviewed expressed concern that
the amendment was drafted by out-of-state authors and that Nebraskans for
Humane Care Committee, Mann’s organization, is funded entirely by out-of-state
interests. Eric Evans, overseer of
public policy for Nebraska Advocacy Services, says, “One of the downsides of
the petition process is it really doesn’t give as much opportunity for full
debate as a process that goes through the Legislature.” An amendment sponsored in this fashion “can
quickly become part of the constitution without an opportunity to have vigorous
public debate on it,” he says. (
PRAYER
POLICIES CAN BE PROBLEMATIC
Requiring employees to attend prayer sessions, says
an article in Home Health Line, is a
violation of Title VII of the Civil Rights Act of 1964. The article profiles a homecare and hospice
agency that is being sued by an employee who claims to have been fired after
she objected to a requirement to attend a “prayer circle.” The Equal Employment
The agency’s attorney says that the RN was
discharged for “legitimate cause” and not because she objected to the prayer
circle. “All religious activities
–including prayer – are voluntary for our patients and employees,” added the
attorney.
According to the article, “Home health agencies
come down on both sides of the fence on the issue of holding prayer sessions in
the workplace.” Theresa Draper, a human
resources specialist at Intrepid USA, says, “Anything that sets aside one
employee from another in a way others may notice, is in essence asking for
difficulty in your office. With the EEOC
in the headlines, it’s a good time to be cautious.” Draper’s organization does not hold prayer
sessions, because it has employees of many faiths.
Jerry Cleveland, president and CEO of Ministry Home
Care, disagrees with Draper. “I don’t
believe that starting a meeting with a prayer or reflection in a religious
organization creates a hostile work environment,” he said. Marla Cotham, of
Baptist Home Health in Paducah, Kentucky, says that her organization
occasionally has prayer circles, but they are announced for “anyone who cares
to participate.” Cotham
adds, “Our agency is like an airport with visiting staff ‘landing and taking
off’ constantly so no one is acutely aware of who participates and who doesn’t,
which probably reduces the likelihood that anyone feels isolated or left out.” She hasn’t been aware of her agency having
any turnover problem due to religious activities.
Home care attorney John Gilliland, of
* Have a written policy stating that your
agency does not discriminate based on race or religion. If your employee handbook doesn’t have one,
add a statement that says, “We don’t discriminate based on religion, race,
creed, or national origin.”
* Create a policy that outlines the
procedures employees should follow if they feel discriminated against. Be sure to include what a person should do if
their supervisor is the one who is doing the discriminating.
* Make it clear that
participation is voluntary.
Lou Bernard, of Covington, Kentucky’s Pearson &
Bernard, says that agencies should state that religious activity is voluntary,
that no one will be compelled to participate, and that no one would be
retaliated against if they choose not to participate. He recommends that agencies wanting to make
it clear that they are religious in nature and “incorporate their religion into
their work environment” should include stories or Bible verses on their
websites. (Home Health Line, 7/31)
PUBLIC
POLICY NOTES
* Senator Chuck Grassley (R-Iowa), commenting
on the GAO’s survey on executive compensation in nonprofit hospital systems, expresses
disappointment that 35% of the hospitals failed to respond to the survey and
that some of those who responded failed to answer all the questions. Grassley said, “It’s clear that much more
needs to be done to ensure that nonprofit hospital executives are not being
paid extravagant amounts and are being held accountable for what they’re
paid.” (
* The
* After pressure from the healthcare
industry and legislators, the Bush administration has “backed away from many of
the proposed changes” to Medicare payment rules. The final rule issued last week “reaffirmed
the overall goal of more accurate payments,” but did not include a planned
“sweeping revision in the classification of patients intended to account for
the severity of their illnesses.” As
originally written, the proposal would have included 20-30% cuts for payments
for some new complex treatments and technologies. Now, hospitals will see small or no cuts and
possibly some small increases. Some of
the changes will be phased in over a period of years. (The
New York Times, 8/3)
* With Southern Specialty Rehab and
Nursing’s decision to admit Kalilah Roberson-Reese, a
29-year-old with severe lung disease and brain damage, the latest case to
involve
RESEARCH
AND RESOURCE NOTES
* Marymount Hospice
and The Atlantic Philanthropies have issued the International Expert Advisory Group Report on Palliative Care. The report is available online on the St.
Patrick’s Hospital Marymount Hospice website at www.stpatricksmarymount.ie/. Click on “Hospice & Palliative Care,”
then on the report title. (St. Patrick’s Hospital Marymount
Hospice Website)
* A study recently published in the
British journal Lancet Neurology says
that researchers have developed a “risk score” which may aid in determining the
likelihood of a person developing dementia. The main risk factors – obesity, high blood
pressure, high cholesterol – are identical to those for cardiovascular
disease. Researchers say that a person’s
risk of dementia is doubled by having any one of those factors and having all
three factors
increases the risk six-fold.
The test itself covers those risk factors, age and years of
education. (WebMD, 8/2; Yahoo! News,
8/3)
OTHER
NOTES
* Dr. Anna Pou’s
patients and colleagues have established a defense fund to cover legal fees
incurred in defending her from second-degree murder charges. Pou, and nurses
Cheri Landry and Lori Budo, were accused of
administering lethal doses of medication to four long-term-care patients at
Memorial Medical Center in New Orleans in the wake of Hurricane Katrina. Tenet Healthcare, which owns
*
If you preplan your funeral, says a USA
Today article, not only will your survivors know exactly what you want, but
you may save them some money. However,
the prepaid plans vary – some are cash-value life insurance policies, but
others are invested by the funeral homes.
State regulation of such practices is “uneven,” and the plans are not
covered at all by federal law. Some
plans are transferable to other areas of the country and other funeral homes
and some are not. In any case, leave
your survivors instructions about what you’ve done and where to find pertinent
papers. (
* Increasingly, funeral
homes are offering “life videos,” made from the family’s pictures, slides and
videos of the deceased, to be played at wakes and funeral services. Funeral videographers
take pictures of the wake, funeral service and burial itself. Ronald Lyons, a funeral videographer
in South Florida, says, “It’s emotional.
But it’s a hell of a memory for the families.” Alan Naumann, who’s
been filming funerals in Minneapolis since 1988, says he prefers funerals to
weddings. “It’s much more rewarding,” he
said. “You’re impacting lives and making
a difference.” Naumann
will teach a funeral videography class at an upcoming
* In the last year, the
* The
* Sunrise Senior Living, Inc. recently
announced that it will acquire Trinity Hospice, Inc. for $68 million. This will be
Glatfelter Insurance Group is the national sponsor of Hospice News
Network for 2006. Glatfelter Insurance
Group provides property and liability insurance for hospices and home
healthcare agencies through their Hospice and Community Care Insurance Services
division. Ask your insurance agent to
visit their website at www.hccis.com.
* There will be no publication of The Hospice e-News on the week of September 12, 2006. *