In the Business of Dying: Questioning the Commercialization of Hospice

25 Pages Posted: 20 Nov 2010 Last revised: 13 May 2014

See all articles by Joshua E. Perry

Joshua E. Perry

Indiana University - Kelley School of Business - Department of Business Law

Robert C. Stone

affiliation not provided to SSRN

Date Written: November 2, 2010

Abstract

This article critically questions the commercialization of hospice care and the ethical concerns associated with the industry’s movement toward “market-driven medicine” at the end of life. For example, the article examines issues raised by an influx of for-profit hospice providers whose business model appears at its core to have an ethical conflict of interest between shareholders doing well and terminal patients dying well. Yet, empirical data analyzing the experience of patients across the hospice industry are limited, and general claims that end-of-life patient care is inferior among for-profit providers or even that their business practices are somehow unseemly when compared to nonprofit providers cannot be substantiated. In fact, non-profit providers are not immune to potentially conflicting concerns regarding financial viability (i.e., “no margin, no mission”). Given the limitations of existing empirical data and contrasting ideological commitments of for-profit versus non-profit providers, the questions raised by this article highlight important areas for reflection and further study. Policy makers and regulators are cautioned to keep ethical concerns in the fore as an increasingly commercialized hospice industry continues to emerge as a dominant component of the U.S. health care system. Both practitioners and researchers are encouraged to expand their efforts to better understand how business practices and commercial interests may compromise the death process of the patient and patient’s family – a process premised upon a philosophy and ethical tradition that earlier generations of hospice providers and proponents established as a trusted, end-of-life alternative.

Keywords: Hospice, For-Profit Medicine, Nonprofit Medicine, Ethics

Suggested Citation

Perry, Joshua E. and Stone, Robert C., In the Business of Dying: Questioning the Commercialization of Hospice (November 2, 2010). Available at SSRN: https://ssrn.com/abstract=1711879 or http://dx.doi.org/10.2139/ssrn.1711879

Joshua E. Perry (Contact Author)

Indiana University - Kelley School of Business - Department of Business Law ( email )

Bloomington, IN 47405
United States

Robert C. Stone

affiliation not provided to SSRN ( email )

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