At this point, the social worker phoned her manager stating her discomfort with the patient's request for hospice services. At the hospice intake interview, the patient and her husband tell the hospice social worker that the patient intends to hasten her death by refusing all food and fluids. Their coach instructed them on the protocol for “voluntarily stopping eating and drinking” in order to hasten death (VSED) and encouraged them to contact hospice for the palliation of symptoms which sometimes accompany VSED if they chose to do that. They both decided long ago that they did not wish to die by a lingering, debilitating death, and if that became a reality, they would choose to die “by their own hand.” Feeling more debilitated and fatigued by her chronic diseases and recent hospitalizations, the patient and her husband sought a “coach” from Compassion and Choices (an aid in dying organization). The patient is married and she and her husband have no children. Her primary care physician believes that depression is a major contributor to her fatigue and prescribed an antidepressant for her. V's breathing requires home oxygen therapy for most of the day and her other medical issues include some mild hypertension and chronic pain from osteoarthritis of her hip. V has decided that she does not want to be intubated in the future and she asked her doctor to sign a do not resuscitate order for her. After three hospitalizations in the last eight months, each requiring several days on a ventilator, Ms. V is a 76-year-old retired bank teller who has end-stage chronic obstructive pulmonary disease. The social worker tells you that there is a concern about a new client on the program whose case history is as follows: Imagine yourself as the director of a Catholic hospice program receiving a telephone call from your intake social worker.
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