paul mchugh: the development of the hospice centers, the sense of being with patients through the several steps in the treatment of their illness-- all of that has come in part because we are interested in helping to make the dying person as comfortable as possible, as supported as possible, and as coherent as possible during this condition. hospice care is a gift from god in the viewpoint of most families and dying individuals who can have that. it's palliative care by people who are skilled in giving it. it often includes a spiritual and emotional component, but the tragedy is that hospice care is underfunded and is really an option only for people who are in very steep decline because hospice-care providers can get reimbursed only when their caseload averages less than six months' survival. research studies comparing hospice care to the usual support a dying patient receives in a hospital setting have provided some interesting insights. leslie bernstein: i was involved in a randomized, controlled clinical trial of hospice care that was conducted in a v.a. hospital in los angeles county