Hospice and assisted death are two terms used to refer to options available to people who are near the end of their life or who are chronically or terminally ill and with no known treatment for the illness. There has been debate regarding the merits of each, with the moral and ethical considerations revolving in the background. Regardless, both options operate on the philosophy of “death with dignity”, that a patient has a right to choose when and how to die.

Aside from personal choice, hospice care and assisted dying differ in how to achieve that “dignity in death”. Where a hospice is geared towards alleviating the suffering of a patient and giving comfort for the remainder of life, assisted dying is pointed towards ending the suffering altogether, on the person’s own terms. More about each concept and their differences are discussed further below.

What is Hospice?

In essence, hospice is a service for the humane treatment and care for the dying. Typically, the persons who avail of hospice care are terminally, chronically or very seriously ill and often beyond any cure or form of treatment. The purpose of hospice care is to have “dignity in death”, not to prolong life but to ease the conditions of the patient or even improving the quality of life until the end. Hospice care is also available for patients of any age. The term pediatric hospice emerged as a specialized care for children with terminal illnesses.

Hospice care may be given inside an institution or within the person’s home. The services often focus on symptomatic care, easing pain, and overall alleviating suffering. Other services include attending to the emotional and spiritual needs of the patient. Related to hospice care is palliative care, although palliative care services are done while treatment is ongoing; on the other hand, hospice care is done when treatment has already been discontinued. Also related is palliative sedation, which puts the patient in a state of sedation moments before death.

Hospice care can trace its history back to Greek and Roman times and is pretty well defined in the various modern forms it takes throughout the world. Hospice care was first introduced into legislation in the United States in the year 1974, although this legislation was not passed. However, throughout the years, hospice care has gained widespread acceptance.

What is Assisted Death?

Assisted death is the term used for ending one’s own life, mainly through the use of lethal drugs. This option is available for terminally ill adults who are mentally competent to make the choice. The purpose of assisted death is also to have “dignity in death”, but letting the patient have a choice in the moment and method of dying, not just to ease the suffering but to end it. Assisted death is not available as an option to children, or mentally incapacitated adults.

Assisted death is all about dying on one’s own terms but is very limited in scope and definition. Proponents of assisted death reserve this option only for those who are going to die, meaning there is a high probability for death within some specified timeframe. Also, the act is done by the person themselves. Assisted death is differentiated from the related term assisted suicide which is available to those who are suffering in some way, but not necessarily on the verge of death. Another related term is euthanasia, colloquially termed mercy-killing, where the patient is suffering and close to death, gives voluntary permission for someone else to end the life.

Assisted death is quite a new term emerging from the concepts of euthanasia. Euthanasia and assisted suicide were first legalized in the Netherlands in 2002. Other countries and parts of certain countries have varying laws as to who can end their life on their own terms, resulting in the coining and differentiation of these three terms.

Difference between Hospice and Assisted Death

Definition

Hospice is a service for the humane treatment and care for the dying for the remainder of their natural life while assisted death is a service for the dying to end their life at the moment and method of their own choosing.

Purpose and “Dignity in Death”

Through hospice care, “dignity in death” is achieved by not suffering too much and still having a good quality of life for its remainder. With assisted death, “dignity in death” means not having to suffer needlessly and also to spare relatives and friends from some sort of suffering as well.

Choice and Control

By choosing hospice care, a patient basically chooses life, controlling as best one could, the quality of life, and letting the illness dictate the moment of dying. With assisted dying, the choice is death, controlling the moment and method of death.

Related Terms

Hospice care is related to palliative care and palliative sedation. Assisted dying is related to euthanasia and assisted suicide.

Restrictions

Hospice care is available to patients of all ages, children, and adults alike. Assisted dying is only available to terminally ill adults with the mental capacity to decide.

In History and Legislation

Hospice care has a long history and widespread acceptance. It was first introduced into legislation in the United States in 1974 although the legislation did not pass. Euthanasia and its other forms were first legalized in the Netherlands in 2002. The concepts of euthanasia, assisted suicide, and assisted dying still face some opposing views in less liberal countries.

Availability throughout the world

Hospice care is available in one form or another throughout the world. Assisted dying and its related terms are only available in the more liberal parts of the world like Canada, the Netherlands, Switzerland, parts of the United States of America, and Australia.

Hospice vs Assisted Death

Summary

• Hospice and assisted death are two options available for the terminally ill to have “dignity in death.”
• Hospice care is a fairly well-accepted option for those who are terminally ill to live out the remainder of life, to ease suffering while enjoying some form of good quality of life.
• Assisted death is a fairly controversial option for the terminally ill to end one’s own life at moment and manner of one’s own choosing, to end the suffering and the suffering of loved ones.

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