"Who are the patients in local facilities who have no one to visit and are thus more likely to be abused?" she asked. "Are we stepping up? Are we encouraging each other to do so?"
"Part of our call as Christians is to be present in the lives of the suffering long before it comes down to that choice, and both share in that suffering, and accompany the suffering patient so that the fear of worthlessness – as well as the risk of bad care – can be alleviated."
The Christian faith in Jesus Christ can also be an explicit part of end-of-life care, Deacon Alan Rastrelli, M.D., told CNA. The Archdiocese of Denver deacon is a member of both the American Academy of Hospice and Palliative Medicine and the Catholic Medical Association.
"It is never too late, and that is where I concentrate my efforts to help those in doubt and despair know that Jesus, the Divine Physician, is always there with His hand reaching out," Rastrelli said. "With this kind of care, that is the antidote to defuse the cry for assisted suicide and euthanasia – so patients and families can be assured of dignified care during the rest of their natural life, and avoiding aborting life at the end."
Rastrelli told CNA he moved from anesthesiology into hospice and palliative medicine in order to address deficiencies in normal medical care at the end of life.
"End-of-life care requires addressing not just the somatic or physical symptoms, such as pain, but also the emotional, psychological, financial, and importantly spiritual component to a patient's suffering," he said.
Golder emphasized the Christian view that human beings are created in the image and likeness of God and this means "every patient is to be treated well and with dignity."
"It's particularly important to treat the vulnerable and dependent with love and care, as they cannot fend for themselves and are so often abandoned," she said, citing Mother Teresa's words that such people can be "Jesus in His most distressing disguise."
"Sick patients are the face of Jesus, and if we take the great judgment scene in [the Gospel of Matthew] at all seriously, how we treat the least among us is how we treat Jesus – and it has eternal consequences," she said.
In the inspector general report, Centers for Medicare and Medicaid Services administrator Seema Verma wrote that the cases of negligent care and abuse in hospices are "very serious" but not representative.
"We want to reassure beneficiaries considering hospice care that these cases are not indicative of the type of care the majority of hospice beneficiaries receive," she said.
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A CMS spokesperson told CNN the agency has "zero tolerance for abuse and mistreatment of any patient." It requires every Medicare-certified hospice to "meet basic federal health and safety standards to keep patients safe."
CMS said it has issued new guidance for hospice surveyors and inspectors "to help them more quickly identify and address the most grave patient safety situations." Surveyors must now follow a standardized process when they identify "immediate jeopardy situations."
The inspector general also found that the facilities with serious problems did not face "serious consequences" and recommended that the Centers for Medicare and Medicaid Services secure stronger legal authority to penalize hospices, comparable to its present authority to penalize nursing facilities. At present authorities cannot impose penalties, short of terminating hospices.
The reports also indicated missing areas of regulation. Hospices are not currently obliged by Medicare reporting requirements to report alleged abuse or exploitation.
Congressional action is needed to add remedies for poorly performing hospices and to add enforcement tools to protect patients are needed, the inspector general said.
According to Golder, though, punitive responses are not necessarily fixes on their own, as these can incentivize ignoring or hiding problems.