I need help writing about social policy in hospice care. What are some recent issues or pieces of legislation that might make good areas for an essay? 

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thanatassa eNotes educator| Certified Educator

With the aging of the baby boomer cohort and the increasing cost of healthcare, hospice care has moved to the forefront of debates on end-of-life care. What distinguishes hospice care from other forms of end-of-life care is that it focuses on palliative measures and quality of life rather than prolonging life for the terminally ill. Because hospice care does not involve the aggressive treatments that might prolong life, it is controversial, with some people equating it with a form of euthanasia. For many patients who do not want extensive medical interventions to preserve life when such life would involve constant pain, keeping their bodies alive when they lose the mental capacities that serve to define them as people, or experience other quality of life issues, hospice care provides a framework along with advanced directives and medical power of attorney that allows them to choose their own manner of death with dignity.

Hospice care becomes an issue of public policy due to the shared nature of medical costs. In other words, even in the United States, which does not have a fully socialized system of medicine, people don't cover their medical costs purely as individuals. In other words, many medical programs such as Medicaid, Medicare, veterans' medical benefits, and health insurance for public employees are publicly funded. Moreover, many hospitals and hospices are tax exempt and medical expenses are tax deductible. This makes medical choices not just private matters, but ones in which everyone has a stake.

For your essay, there are two possible approaches you might take. The first is arguing from an economic perspective. As hospice care is considerably less expensive than hospital care, one could argue that it should be the common standard of care for terminally ill patients. In such an essay, however, you would need to address the counterargument that if it became the default standard of care, people might be forced into hospice care against their wishes or religious convictions.

The second possible stance you could take would be against hospice care, arguing that since many religions and individuals object to hospice care on the grounds that their belief systems demand that life should be prolonged as far as possible, regardless not only of cost but even of the wishes of patients, the public should not fund hospice care. 

The third reference listed below gives a timeline of major pieces of legislation passed in the United States concerning hospice care.

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