BOSTON, MA — The hospice philosophy of end-of-life care emphasizes the right to die with dignity and without pain. The role of hospice is to provide care to the dying and support for their families and caregivers. Hospice care is underused, however, often because doctors don’t suggest hospice to patients or delay referring them until shortly before death, reports the September issue of the Harvard Women’s Health Watch. Learning about hospice before it's too late can be particularly important for women, who often shoulder most of the burden of caregiving.

Physicians may delay bringing up hospice for a number of reasons. For one, doctors are committed to conquering disease, so referring a patient to hospice can seem like a sign of medical failure on their part. Many say they don’t want to take away a patient’s hope. Physicians may also fear losing contact with their patients, not realizing that they can and should be a part of the hospice team.

Doctors and hospice experts agree that most terminally ill patients benefit from being in hospice for at least three months before death. Still, considering hospice is not always easy for patients or doctors. No one should feel compelled to choose between care that extends life and care that provides comfort, says the Harvard Women’s Health Watch.

“Our duty as physicians is to help our patients discover what’s good for them, and one way we can do that is by providing information about hospice care. If your doctor doesn’t start the discussion, consider starting it yourself,” advises Dr. Celeste Robb-Nicholson, editor in chief of the Harvard Women’s Health Watch.

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