By Kevin Kelly
Catholic Key Associate Editor
KANSAS CITY — Hospice care isn’t about “giving up” and dying, one of the city’s leading physicians for the care of the elderly told some 50 people Jan. 19.
Instead, said Dr. Austin Welsh, it is a practice dating back to the Middle Ages and the Order of Malta that helps people reach the natural end of life in dignity and love.
“I can’t tell you how difficult it is to tell someone to sign up for hospice,” Welsh, founder of the Catholic Medical Association in Kansas City, said at the annual pro-life lecture at St. Thomas More Parish.
“There is a fear that care will be less and life will be shortened,” he said. “But there are numerous studies and articles that show that people actually live longer in hospice.”
The modern hospice movement was begun in Great Britain by Dame Cicely Saunders, who established the world’s first hospice, St. Christopher’s, in 1967.
“It was the first building in the world dedicated to hospice,” Welsh said. “It was a place you went to die.”
Dame Saunder’s vision was to create not just a place, but a movement within the medical community that cared for not just the physical needs of terminally ill patients, but spiritual and psychological needs as well as they approached the end of life.
The hospice movement quickly spread to the United States, and the first hospice opened in Connecticut in 1974, he said. Today, in Kansas City alone, some 47 hospice agencies care for the dying — and their families, who are also important, Welsh said.
“In hospice, when you treat the patient, you treat the family,” he said.
Much of hospice also involved palliative care, making the patient as comfortable and pain-free as possible.
Welsh said there is nothing in Catholic teaching that forbids pain medications, including morphine, that might even shorten life.
Nor are there any hard and fast rules that the church imposes on what kind of care, including artificial feeding, is required. For example, the church teaches that food and water taken in through feeding tubes is required in the course of ordinary care. But they are not required if a patient’s body is rejecting the food and water and artificial feeding increases pain.
At the same time, the church teaches strongly that suicide, even for terminally ill patients, is morally wrong.
“I have had patients more times than I care to remember ask me for suicide pills,” Welsh said. “There is a great fear and emptiness among some people as they face the end of life. But no one in the hospice movement wants to hasten death.”
Instead, that time in hospice care can be a time when families reconcile and peace is made, he said.
“It can be a beautiful thing,” Welsh said. “I have seen patients hang on until that last ‘black sheep’ family member shows up, then they die with their families around them.”
Welsh urged his audience to entrust their end of life decisions, in the event they become unable to make them, to a person that they trust and love.
Living wills with instructions for end-of-life care, though valuable, cannot cover every possibility, he said.
Welsh also said it is important to communicate with a physician who knows you and your health history very well.
He also urged his audience to ask questions of hospice agencies before they choose one for themselves or a loved one.
“Dying is a release,” he said. “It should be a peaceful thing.”