The hospice movement: Idealized concept vs. reality

Abstract

The study sought to explain how a constituency of people seeking to improve a human condition were deflected from their original ideals.;The research focused on two main sources of information. First, it examined the facts about hospice programs and their historical development. This history showed that hospices were places to care for the sick and weary traveler, and were traditionally linked with medical care until the nineteenth century. After the nineteenth century, hospices became separate from physicians and hospitals because of the development of the profession of medicine. This professional development excluded the chronic and terminally ill in order to focus on the science of cure.;In the twentieth century this separation became less distinct as medical treatment became more sophisticated and could prolong life. The point at which active medical treatment should cease became less clear. As their ability to prolong life increased, there developed a concern among non-physician professionals for the quality of that life. The second major component of the research was to analyze the dynamic process of a social movement for change--the hospice movement.;The study found that despite its ideal goals, the leaders of the hospice movement were never clear on how their values differed from those of traditional medical care. Therefore, the sharpening of conflict between interest groups which occurs in a social movement never took place. This facilitated an early co-optation of the hospice movement by medicine and medical entrepreneurs.;The implications of the study are the complexity and profundity of certain issues which make it difficult to take a strong position against the larger culture. It also has implications for the way in which social workers participate in social movements, and the need for a greater understanding and acceptance of the interest group politics which are part of any movement for change.