Final Exit: a wake-up call to hospice

The publication of Final Exit resulted in a public response that was exuberant, largely sympathetic and, to many within hospice, disquieting. The book and the public response it engendered can not be understood without exploring the Hemlock Society and the political agenda which both the Society and book advance. Hospice must begin a response to this book, and any discussion with Hemlock supporters, from a basis of consensus. Hospice must acknowledge that those within the euthanasia/assisted suicide movement believe as deeply as we in hospice in the need to address the suffering of people enduring the effects of terminal illness. We must further acknowledge that there remain unmet needs in the care of the dying which for primarily socio-political reasons hospice has been unable to resolve. There are several compelling reasons for hospice as an organized movement to oppose the political initiatives of the Hemlock Society--at least in their present form and within the current social context. These reasons involve core ethical issues and issues of direct social consequence, each of which seems sufficient to reject the current proposals. Hospice programs and personnel must enter this debate in earnest. Before serious consideration is accorded to legalization of euthanasia/assisted suicide, we must insist that genuine access to comprehensive hospice/palliative care becomes a reality for all dying patients and their families.