One of Dr. Alyson Emmons’ hospice patients was requesting that her ventilator be removed, which most assuredly would lead to her death. But the patient was in deep depression, raising the question of whether hers was a right-to-die situation or a suicide.
“This was a very difficult case,”Emmons says, “deciding when someone is letting depression interfere with their decision making.”
Another family doesn’t want their elderly mother to know she is dying and wants their medical team to keep the secret. “What do we do?” Emmons asks. “Is that ethically allowable?”
Such dilemmas occur every day and are among the important and delicate issues that patients and families raise.
As a recent appointee to the Compassus Medical Director Advisory Council, Emmons, a doctor of osteopathic medicine, will help Compassus navigate those dilemmas which, in turn, will benefit patients and families.
The advisory council’s 12 members set an example for the company’s 230 medical directors. They serve as a resource and provide guidance on policies and best practices. Emmons will serve a three-year term on the board.
“Ethics in hospice care is one of things you’re not really taught in medical school,” Emmons says. “As time went on, I found I was being confronted with situations I was not trained to handle.”
Most doctors who began practicing more than a decade ago were not trained to handle ethics-related situations, including when it’s time to stop treatment, she says. Doctors are committed to saving patients, so they don’t stop curative treatment until the very end.
“Many of them see hospice as giving up on a patient,” she says. Consequently, many patients come to hospice too late, giving them and their family only a week or two to prepare for their death.
Emmons, an internist, is working to change that. “I love internal medicine, with how exact and precise things are,” she says, “but what I love about hospice is I feel I can really make a difference, helping people at a critical time and that maybe is more important than my other job.”
Emmons works for Gericare, the geriatric branch of Advocare, in subacute rehabilitation at Virtua Memorial Hospital in Mount Holly, N.J. Prior to that, she worked as a hospitalist for five years for Advocare in New Jersey for Virtua at the Marlton and Voorhees campuses, and in emergency room medicine.
She graduated from Philadelphia College of Osteopathic Medicine in 1996 and specializes in internal medicine. She added hospice care to her practice in 2010 and is board certified in Hospice and Palliative care since 2011.