Blauner, Michael L, August 1980 - HOSPICE: BUSINESS OR CHARITY? Abstract: In my thesis, I explore some of the problems facing palliative care organizations, both nationally and in the state of Florida. After tracing the history of this movement, as well as the social undercurrents that spawned it, the thesis focuses on the development of one hospice in the Tampa Bay area. The financial situation of this hospice is discussed; its monetary problems had led to a neglect of the emotional and physical needs of its patient volunteers. Consequently, the numbers of active volunteers connected with the organization had dwindled. The above problems, in turn, are demonstrated to have been engendered by recent state legislation that strictly regulates all phases of hospice care, the requirements connected with being the recipient of a grant from the Health Care Financing Administration, and having an organization that has historically allowed one person to run all facets of the operation rather being structured along the more egalitarian lines of similar institutions. The conflicting beliefs that have motivated various leaders of this organization are explored through the use of ethnoscientific analyses of interviews conducted with various members of this hospice. I demonstrate how these conflicts led to a lack of full cooperation from the organization's Board of Directors. I claim that the dearth of mutual assistance within the hospice structure forced the organization's leaders to expand their expense structure in order to hire people to do tasks that could have been accomplished by qualified volunteers. This hospice's immediate future will be saved by the H.C.F.A. grant, but the organization must integrate itself into its surrounding community and reduce the physical and emotional burdens with which the volunteers must cope. The cost effectiveness of hospice service to society is also examined. Observations are made of the development of palliative care programs in traditional health care institutions. These services are contrasted with the duplicative costs of hospice programs; additionally, questions are raised about the wisdom of training specialists in dying who may succeed in further isolating society from this phenomenon. A series of recommendations are made whereby the Tampa Bay hospice, by altering many procedures currently utilized by its Board of Directors and staff, will achieve the ideals set forth by its founders. The thesis concludes that this particular organization has undergone many tribulations which have forced it to exist primarily for its own bureaucracy; hopefully, the future will re-establish that patient care is the raison d'etre of this hospice. .