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My sister is refusing it because all it does is make her sleep. Seems like they knew she would be unresponsive. I feel like they want her to die sooner.

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My mother is under hospice care. Mom can't take morphine- after a couple doses she has sevear hallucinations. Instead we agreed that mom could take oxycodone and is allowed one every thirty minutes if she chooses - she needs to ask for it. If mom eventually gets to where she isn't able to verbalized her pain needs we will work with hospice to figure something else out. Just because one is under hospice care, it does not mean you loose control in how you or your loved one is treated. Speak up.
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They want her to be as pain-free as possible. If Sister is not in terrible pain and prefers not to take it, that is her decision.
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I don't believe hospice wants patients to die sooner. My husband, who was under hospice care, was prescribed morphine by hospice after he fell in a nursing home. I had been given a choice of surgery or confinement in bed, with morphine. He had a bad heart, and I believe surgery would have resulted in his death during surgery. I chose confinement to bed and morphine. When he died four months later, the medical examiner phoned me and said that despite my husband's multiple medical conditions, the cause of death was the fall. (Not the morphine.) I am 85, and if in constant pain, would chose morphine.
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Aside from relieving pain morphine is known to control the very distressing feeling of air hunger when the lungs are not functioning properly. I'm so sorry your sister has reached this point, ALS is a terrible disease. She may choose to fight it until her last breath and that is her right, but it will be a balancing act to both honour that and keep her comfortable.
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