1) Do you think our society could be doing a better job of addressing issues related to end-of-life?

Death and the end-of-life seems to be yet another topic of discussion that people avoid. People are often very uncomfortable discussing death and many fail to make their wishes known in regards to what they want to happen should they ever be on life support. Even if wishes are known, unless there is a legal document (like a DNR) available, family members are often reluctant to carry out wishes, especially if the wish is to not have life supporting measures. We should encourage open and compassionate conversations between family members not only as soon as an issue is identified and before death is imminent, but also for any families with older adults.

2) What ethical issues might be faced by a counselor working in a hospice setting? 

How to counsel a patient one way or the other would be difficult and could pose ethical dilemmas. Informing a patient that they have a choice about life support measures without encouraging or discouraging specific measures can be a challenge. Wanting to give a patient hope, but not be unrealistic would be another difficult issue. They also have to deal with the family and loved ones of their patients. Often, as seen in the documentary, there is disagreement, misunderstanding, and conflicting opinions between loved ones regarding the end-of-life. Making sure that a patient is well informed in spite of what some family members may want threatens ethical care. Even at the end of life, a patient should be informed and involved if at all possible. If disagreement is between the patient and the loved ones, that makes it even more difficult than disagreement between loved ones. Another issue faced might be the use of medicine and practices to manage pain and symptoms and the reality of how much it will actually help the patient. While this falls more on the medical staff, a counselor is often involved in these discussions with the patient and families.

3) Did this documentary change any of your pre-existing beliefs about hospice care and/or assisted suicide?

I thought this documentary did a fairly good job of showing the three sides of suffering that can come with the end-of-life for some; 1) the suffering of the patient themselves, physically and emotionally, when facing the reality of death, 2) the suffering of the loved ones who are witnessing the decline of health, facing loss, and making decisions, and 3) the suffering that the medical professionals go through when running out of treatments they can offer, and having those tough conversations with patients and their families. Speaking from personal experience, I appreciate hospice care and feel that they do a good job of making someone comfortable who is at the end of their life and has, in reality, run out of other options. Regardless of if it is a day, or two weeks spent in hospice care, I believe in most circumstances, there is a small portion of peace that comes to the family that they do not necessarily get in a hospital setting. While more grief and hopefully acceptance are yet to come, sometimes hospice care means that the hard decisions are coming to an end and I believe that is where the peace starts its journey.