A British physician who treats only dying patients told health care specialists and other community leaders here this weekend that a properly run hospice program such as those pioneered in Great Britain "can make euthanasia obsolete."
"A hospital is no place to die if you're going to take your time about it," said Dr. Richard Lamerton of St. Joseph's Hospice in London's East End.
He and other specialists at the two-day conference on services for the dying patient agreed the ideal situation is for the patient to die at home.
He was careful to explain that a home care program, with help available to patients and their families 24 hours a day, was an integral part of ST. Joseph's and other British hospices for terminally ill.
Lamerton was the main speaker at the gathering of more than 100 healh care professionals, clergy and others brought together by the Washington Hospice Committee, an interdisciplinary group committed to developing a facility in the Washington area to care for needs of dying patients and their families.
A hospice, the British physician explained, "has four parts: the inpatient facility, the home care service to enable patients to die at home, berevaement care for the patient's family after he has died, and the teaching program."
Lamerton insisted -- and showed color slides to prove his point -- that an institution for dying patients need not be a gloomy place.
"There is a real freedom in knowing you are about to die," he said,". . . in knowing you don't need to plan any more, that you don't need to worry."
A patient who has accepted impending death "quite often attains a greater maturity . . . selfish people often consider others more: superficial people take a new look at religion," he said.
This "greater maturity" that develops, he continued, "means dying people are good company, usually.That's why care of the dying is never depressing."
He added that the "healthy death" of a patient at the hospice, tended to encourage, rather than depress, fellow patients. "People say: 'If I can die like that, I don't mind going.'
"In the world today our whole experience of death comes from what we see on television . . . No amount of telling people that death isn't like that will do the same thing as seeing someone die a good death."
For cancer patients particularly, pain control is crucial. The British hospice uses a mixture of morphine. Compazine "and a bit of whiskey for flavoring," the doctor said. It is given by mouth -- "We only give injections to someone who is comatose" -- every four hours both to patients at home and in the hospice.
The Washington hospice Committee was launched earlier this year when the Washington Episcopal Diocese, which had originally been concerned with the venture, asked that a more ecumenical and broader based support group be established.
Yesterday morning's session of the conference at the National Presbyterian Church was devoted to exploring some obstacles the project faces.
A major one is financing Hospicetype care is not generally covered by either private or government health insurance, even though it is usually less expensive than hospitalization.
One member of the audience, however, insisted there are ways around bureaucratic red tape. Pointing out that regulations require "180 points" to be eligible for aid in New York state where she is a medical social worker, she said, "I can usually get these patients in . . . After all, they get 48 points if they wet the bed, so you just tell them to wet the bed."