Hospice & Palliative Care Code of Ethics

Preamble

Hospice is a health care system of interdisciplinary services provided to patients and their families during the final stage of life. These services are delivered with sensitivity to the fact that, as hospice and palliative professionals, we have entered into people’s lives and affairs during a period of heightened need and potential vulnerability.

The National Hospice and Palliative Care Organization is an advocate for patients facing the end of life and their families and the voice of hospice and palliative care services. Through its standards, policies and procedures, NHPCO seeks to promote an ethical corporate culture among its members involving both internal and external relationships. NHPCO encourages all its members to provide services, which are grounded in fundamental ethical principles of health care. These principles include Autonomy, Beneficence, Conscientious Objection, Nonmaleficence, and Justice.

The National Hospice and Palliative Care Organization offers this Hospice and Palliative Care Code of Ethics as a guideline to hospice and palliative care programs and professionals to assist them in assuring that hospice and palliative care throughout the country is provided in accordance with the highest standards of ethical behavior.

Members of the National Hospice and Palliative Care Organization should subscribe to the following precepts:

I. To meet the hospice and palliative care needs of patients and their families.

• To remain sensitive to and be appreciative of the ethnic, cultural, religious, spiritual and lifestyle diversity of patients and their families.
• To ascertain and honor the wishes, concerns, priorities and values of the patients and their families consistent with the law and the organization’s values as stated in its policies.
• To support, affirm and empower the families as caregivers.
• To acknowledge and respond with sensitivity to the interruption of privacy that is necessitated by care at home; to enter no further into family life and affairs than is required to meet goals of the plan of care.
• To respect and protect the confidentiality of information concerning patients and families.
• To provide quality hospice and palliative care services in a timely manner to all who qualify, regardless of race, religion, sexual orientation, ethnic background, or ability to pay.
• To recognize the vulnerability of those who receive care, and thus refrain from accepting personal gifts of significant value.
• To recognize the vulnerability and privacy needs of the patient and family, thus displaying extraordinary sensitivity in offering opportunities to promote hospice and palliative care.

II. To act honestly, truthfully and fairly to all concerned.

• To fully disclose to patients and families information regarding cost, services and complaint policies, as well as any policies regarding discontinuation of service.
• To honestly and conscientiously cooperate as an agency in providing information about referrals and to work with other agencies to ensure comprehensive services to patients and families.
• To be truthful and accurate in public advertising and information dissemination.
• To make and accept referrals solely in the best interest of the patients
• To refrain from giving or accepting gifts of value or monetary compensation for the purpose of obtaining or making referrals.
• To make every effort to honor the intent of benefactors and donors supporting the hospice and/or palliative care program.
• To ensure that hospice services are not diluted for financial reasons.

III. To instruct both local and national communities in the tenets of hospice and palliative care philosophy.

• To encourage dialogue about hospice and palliative care in all appropriate public forums.
• To encourage inclusion of hospice and palliative care in all federal, state and commercial health care plans.
• To provide the consumer with sufficient information about hospice and palliative care, to enable true informed consent.
• To act as a liaison in consumer discussions concerning decisions regarding end of life care.
• To assume a leadership role in ensuring access to hospice and palliative care for all people facing the end of life.
• To serve on committees or in groups concerned with policy-making decisions, which will affect health care in this country.

IV. To continuously strive for the highest level of skill and expertise of the staff and volunteers in the delivery of care.

• To recruit, select, orient, educate and evaluate each staff person and volunteer to ensure competency based on identified job requirements.
• To remain sensitive to and be appreciate of the ethnic, cultural, religious, spiritual and lifestyle diversity of staff and volunteers.
• To support, affirm and empower the staff and volunteers in the delivery of care.
• To recognize the unique stressors inherent in hospice and palliative care work and provide access to ongoing support for all staff and volunteers.
• To ensure that contracted providers are properly trained and qualified, and that they provide care consistent with the values and philosophy of hospice and palliative care.

Recognizing that situations do and will arise when ethical principles conflict, the National Hospice and Palliative Care Organization recommends that every hospice and/or palliative care program have a process and format in place to deal with situations arising from conflicts based on ethical principles.

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Developed by: National Hospice and Palliative Care Ethics Committee
Copyright 2002 National Hospice and Palliative Care Organization
1700 Diagonal Road • Suite 625 • Alexandria, VA 22314 703/837-1500 • 703/837-1233 (fax) • www.nhpco.org