MY BROTHER WAS EUTHANIZED
December 2020
By Kathleen Friedman
Note from the editor: The below report is sadly similar to many HALO receives. These stories serve as a reminder to be vigilant whenever a medically vulnerable loved one is receiving hospice care, and not to delay seeking help if you suspect that a life is in danger in any healthcare setting.
I believe my brother, Joseph Baxter, was euthanized at a hospice and palliative care center in New Hampshire.
From the evening my brother was taken to the hospital by ambulance on June 24, 2020, the doctors were pushing hospice on us. My husband, a board-certified Gastroenterologist and Internist from New York, responded to the doctor on call that Joe at least deserved a chance to get to his first chemotherapy treatment. Joe had stage 4 esophageal cancer. The previous week, he had undergone surgery to place two stents in his esophagus so he could eat food or drink Boost shakes until his first chemotherapy treatment. Joe was three weeks shy of his 65th birthday. From diagnosis to death, it was two months.
The hospital’s doctors kept insisting on hospice. I finally caved on Monday, June 27, after being told that he possibly had another perforation in his esophagus. (A few days prior to this, a third stent had been surgically placed to try to “plug” a perforation that no doctor was able to determine was even there.) The day he was to leave the hospital for the hospice center, my husband asked for a CT scan to determine if there was a perforation; and, if so, where it was located and if it could be sealed. In response, we were told that Joe would be unable to lay flat and be still for the scan. My husband saw Joe when he was being prepared for the move to hospice. Guess what? He was lying flat and still!
Once he got to the hospice center, they would not give my brother intravenous fluids. I knew he was thirsty and dehydrated (as acknowledged by my husband, a physician) and asked for an IV. The hospice doctor replied, “To what end?”
My husband asked for oxygen to be administered by nasal cannula. After some discussion with my husband, this was provided reluctantly.
The day my brother died, the hospice doctor asked me a peculiar question: “Will there be anyone else coming to visit your brother?” I replied, “No.” Six hours later, I received the call that Joe had passed away. Below is a day-by-day summary of what unfolded:
Day 1 (Monday) in hospice: The doctor asked Joe if he had any short-term goals. Joe responded that he wanted to get out of bed and use the bathroom; get to his first chemo treatment (which had been scheduled for July 13, 2020); attend his 65th birthday party at a local lake in VT; visit his nephew for his 4th birthday in August; and then fly to Las Vegas. The doctor told Joe that she would bring in a physical therapist to evaluate his ability to sit up and walk. He was given Ativan and morphine throughout the evening “to help him sleep and for pain” I was told.
Day 2 (Tuesday) in hospice: My family and I arrived at about 10:30 am. Joe was awake and alert. I asked if the physical therapist had been in to see him to evaluate his ability to walk to the bathroom. He replied, “No, nobody has come in so far.” He then called his bank to pay some bills and face-timed with my son and his family in Florida. He also asked me to get him a thick shake. Later, he asked for a Dr. Pepper. He drank both. He was looking and acting fine. I asked again about giving him some IV fluids as the urine in the collection bag was becoming a darker color. The hospice staff told me Joe could not have an IV. He could have as much fluid as he wanted, but it would have to be given orally, which my brother had difficulty with due to his cancer. He was sipping some liquids, but his intake was barely enough to prevent dehydration. As evening approached, he was given more Ativan and morphine.
Day 3 (Wednesday) in hospice: My son drove up from New York to visit with Joe. He was less coherent than he had been the prior two days. I was told he was very anxious and in pain during the night and was given more Ativan and morphine. However, he was able to converse with his nephew for a few hours. In addition, when my son and husband were in his room, they were discussing something, thinking Joe was asleep. To their surprise, he heard every word they were saying. (I believe they were looking for the cell phone extension cord. Joe came out of his sleep-like state and told them exactly where it was.) Joe’s urine output had decreased, and the color was a dark orange. He received more Ativan and morphine as the day wore on, but no IV.
Day 4 (Thursday) in hospice: Joe seemed overmedicated and could not communicate. I was told he had been given more Ativan and morphine. My son left at 1:00 pm. The hospice doctor asked me if any more family/visitors were coming. I responded, “No.” At 5:30 pm, my sister and husband asked Joe (who was pretty much “out of it”) if we should go to dinner. He waved his hand “go.” At 8:30 pm, we received the call that Joe had passed away. We immediately went to see him. His body was cold. They said he had just passed at about 8 pm, but my husband, a physician for over 40 years, said it was longer than that.
I know my brother wanted a shot at fighting his cancer. This photograph was taken of Joe in the hospital emergency room where my husband and I took him for some rehydration and a GI consult on June 16, a week before he was brought back to the ER and two weeks and two days before he died. He doesn’t look like a person with two weeks left to live.
In a nutshell: No physical therapist was brought in; no IV fluids were administered; it was a struggle to get a nasal cannula; and there was no regard for what Joe wanted, nor for his “short-term goals.” All he got was lots and lots of Ativan and morphine – a planned and programmed death by euthanasia.
If I had known I could take Joe home, I would have. He had excellent insurance. I was told he wouldn’t make the trip. Well, he didn’t “make the trip” he was promised at hospice, either.