Reinforcing a commitment that palliative care is a priority, U.S. Senators Tammy Baldwin (D-WI) and Shelley Moore Capito (R-WV) reintroduced the Palliative Care and Hospice Education and Training Act (PCHETA), an ONS health policy priority that benefits both patients and healthcare providers, in July 2023. The bipartisan legislation would bolster the palliative care and hospice workforce and meet the increasing need for care by investing in training, education, and research.

Few things carry more stigma in the United States than death and hospice. Death is familiar in oncology, yet providers may not discuss it with patients until their cancer has progressed to the point that medical intervention is no longer an option. With the American Cancer Society estimating more than 600,000 American deaths from cancer in 2022, it’s time to change our practice.

The Palliative Care and Hospice Education and Training Act (PCHETA), an ONS health policy priority that supports both patients and the profession, returned to the U.S. Senate floor in May 2022. Senators Tammy Baldwin (D-WI) and Shelley Moore Capito (R-WV) reintroduced the bill to improve and sustain the workforce and the well-being of patients and their families with life-threatening illnesses.  

Ron, your 73-year-old patient, decides to transition to hospice care after receiving lung cancer treatment for three years. His partner finds Ron’s decision to move to hospice difficult to accept and encourages him to look for a clinical trial or try alternative treatments. You suggest that the couple speaks with a hospital chaplain, and Ron agrees. His surprised partner says, “Why do you want to talk with a chaplain? We’ve never been religious!”

Legislators across the United States are recognizing what ONS has advocated for more than a decade: the need for improved access to and better understanding of palliative and hospice care. In September 2021, Senator Tammy Baldwin (D-WI) and Representative Yvette D. Clarke (D-NY) voiced their support for palliative care through a letter to the U.S. Congress.

When Senator John McCain (R-AZ) passed away in August 2018 from aggressive glioblastoma just one day after his family announced he stopped treatment, it put a poignant highlight in Washington on a need of which oncology nurses are far too aware: palliative care and hospice. Ideally, palliative care begins at the time of a cancer diagnosis and is aimed at managing symptoms throughout the cancer journey. Hospice begins when a patient’s prognosis is six months or less, yet in most cases, as McCain’s illustrates, patients begin hospice far too close to death. Many point to a lack of awareness and education—for patients and the public as well as oncology nurses and other palliative care providers.

Phil is a 63-year-old man who is admitted to the inpatient oncology unit for severe pain resulting from metastatic small cell lung cancer. His wife and two daughters are at his bedside. Earlier in the day, the medical oncologist discussed additional treatment options or hospice care. Phil decided on comfort care with the hope of getting his pain managed and going home on hospice.