Hospice and assisted suicide: the structure and process of an inherent dilemma

The hospice philosophy involves making terminal patients as comfortable as possible, empowering them with control of the time they have left, but neither hastening nor postponing death. The passage of Oregon's Death with Dignity Act in November of 1994, and the failure of the 1997 ballot measure to repeal it, made physician-assisted suicide another option for terminally ill people in that state, and focused increased attention on a conflict seemingly inherent in the hospice philosophy. We conducted interviews with 60 hospice providers, 43 in Oregon and, for comparison, 17 in the northeast, for their responses to this situation. The data reported here reflect some of the social and individual influences that come to bear as hospice providers attempt to resolve their dilemma.