March 2 1998

ARTICLE TOOLS

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In January 1995, a physician diagnosed 50-year-old Cliff Dailey of Atlanta with a rare form of cancer. His doctor offered massive doses of chemotherapy as his only hope. Dailey's severe heart problems, though, lowered his already meager chances of survival to less than 10 percent.

"We knew going into this that there wasn't a great deal that medicine could do," says his widow, Rita. "But it was the only thing we had."

Finally, Dailey's doctor determined that continued chemotherapy would lead to a quicker death, and he recommended two different hospice programs.

Rita Dailey recalls that a representative of one of the hospices met her at the door. "She said, 'We'll help you all we can, and when he's dead, you call us. We'll pick him up.' "

In America's death-denying culture, hospice is struggling to overcome the perception that it is a choice to quit. On the contrary, its advocates assert, hospice is an interdisciplinary program that enables the terminally ill to live to their fullest with the time they have left.

Though the number of hospice programs has grown steadily—17 percent annually during the past five years—Yale University Medical School professor Diane Komp believes that a bottom-line mentality, fostered largely by managed care and Medicare, has "hijacked" the original hospice vision of the movement's Christian founder, Cicely Saunders. Saunders, a London physician, placed the spiritual dimension at the core of an integrated community team of lay volunteers and health-care professionals at Saint Christopher's hospice (CT, Dec. 17, 1990, p. 22).

"The idea that you can fund something by the government and duplicate what happened in London totally underestimates what Saint Christopher's hospice was all about," ...