Abstract
Hospice care today faces economic, cultural, and social challenges that will force it to rethink its basic ethical mission and its basic values if it is to grow and prosper. Three different values can be said to inspire the hospice movement: palliation and the relief of suffering, enhancing individual control and autonomy at the end of life, and the value of healing or maintaining meaning and personal integrity in the dying process. An emphasis on palliation alone will not be sufficient to sustain a comprehensive hospice benefit in the future. An emphasis on patient autonomy alone is not in keeping with the history or spirit of the hospice movement, which in fact has had a vision of "good" dying. The notion of healing or making whole provides the richest and most adequate concept upon which to ground the social and ethical case for hospice care in the future.
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