Ethics & Hospice - An Interview with Christy Whitney

Christy Whitney is the CEO of the highly successful Hospice and Palliative Care of Western Colorado in Grand Junction, a community singled out by the Dartmouth Atlas of Health Care for its high-quality, highly efficient end-of-life medical care. Christy gave a presentation in April, 2011, at the National Hospice and Palliative Care Organization Management and Leadership Conference in National Harbor, Md., on “Ethical Choices in a Competitive [Hospice] World.” 

In the context of increased government scrutiny of hospices’ decisions regarding who they enroll on the Medicare Hospice Benefit, as well as of increased finger-pointing going on between hospices of different corporate models, Christy explored some of the nuances of hospices’ business, marketing and enrollment practices, some of which are not truly unethical but probably deserving of careful self-reflection. She explored the balancing of ethical values of patient autonomy, beneficence and distributive justice. I caught up with Christy for an interview after her presentation at the Gaylord Convention Center, overlooking the Potomac River, to expand on these topics—as well as other challenges facing hospice leaders today. 

What are advance directives?

Advance directives are legal documents that enable people to speak about the kinds of medical treatments they might want at some future date when they are no longer able to speak directly for their treatment preferences, most often because of physical incapacity. Read here about how I completed my own advance directive—and lived to tell the tale—at the website of National Health Care Decisions Day an organization that seeks to inspire, educate and empower people about the importance of advance care planning.

NHDD Speak Up Video from NHDD on Vimeo.

The Hospice Compliance Letter

The Hospice Compliance Letter is a bi-monthly newsletter that I write for subscribers to the Hospice Compliance Network. It focuses on both compliance with government regulations and quality improvement programs by Medicare-certified hospices. The January, 2011, issue included a special, in-depth report on the heightened regulatory scrutiny of hospices by various agents of Medicare, which currently pays about 85 percent of the costs of hospice care in America. Interviews with hospice leaders, consultants and lawyers found considerable impact on hospice providers and on patients’ access to hospice care because of that heightened government scrutiny—most of which targets the problematic question of whether and when seriously ill patients are considered sufficiently terminally ill to qualify for hospice care. However, it is also widely assumed—by government regulators, the national Medicare Payment Advisory Commission, the Office of Inspector General and many hospice leaders—that abuses of the hospice benefit by providers are all too common in the $12 billion hospice industry. That makes it harder for hospice advocates trying to do the right thing to effectively challenge government regulators. Click here to read more from this in-depth report on hospice eligibility in the Hospice Compliance Letter, which has been made available publicly because of the importance of the subject.