Date: 09/01/2009

Spiritual and Ethical Concerns


Votes: View--> Action Taken:

02:11 PM -- Spiritual and Ethical Concerns

Dr. James Karel, Chaplain at the Hospice of St. John introduced himself and began his presentation. Dr. Karel described his practice as a physician and his interest in the spiritual aspects of health care. He described how he became involved with hospice care. Dr. Karel described his role as chaplain. He described interacting with family members and conducting a spiritual assessment of new patients. He described sharing results of his assessment with families, and how sometimes families are surprised by the results. He also investigates the family relationships with the patient, and other issues such as politics and religion, and described how the goal is to be open and supportive.

02:23 PM

Dr. Karel discussed the national health care reform legislation and spoke to certain misleading information in the media. He spoke to the increasing costs of health care, the unnecessary tests doctors order, and the cost of expensive medical equipment. Representative Soper asked how long he spends with patients. Dr. Karel stated that he tries to see everyone once a week. Dr. Karel spoke to the length of stay for most patients. He stated a majority of people last three weeks in hospice, but that some last years. He stated that some patients are confused about hospice and even expect to continue curative treatment such as chemotherapy, and that there needs to be more education to prepare patients. Representative Roberts asked how to move the debate forward without touching a nerve about end of life care. Dr. Karel said many people are concerned about costs. Dr. Karel said that it is an issue of priorities and that some people are afraid of change. Senator Newell asked what changes Dr. Karel would make to the system. Dr. Karel said he would like more education in the media and a promotion of everyday conversations to promote hospice and palliative care. Dr. Karel described the history of the Medicare hospice benefit. He stated that physicians could improve how they communicate about hospice or palliative care.

02:39 PM

Dr. Karel raised questions concerning the relationship between doctors and pharmaceutical companies. He described how some patients and their families want to "do everything they can do" and then feel guilty if they cannot beat the disease. He then described how hospice patients from different religions and beliefs may view death. He then commented on the importance of planning and how hospice can help people deal with the end of life.