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Hard Choice for a Comfortable Death: Sedation
NYT ^ | Dec. 26 2009 | ANEMONA HARTOCOLLIS

Posted on 12/29/2009 9:35:32 PM PST by malkee

In some of the rooms in the hospice unit at Franklin Hospital, in Valley Stream on Long Island, the patients were sleeping because their organs were shutting down, the natural process of death by disease. But at least one patient had been rendered unconscious by strong drugs.

The patient, Leo Oltzik, an 88-year-old man with dementia, congestive heart failure and kidney problems, was brought from home by his wife and son, who were distressed to see him agitated, jumping out of bed and ripping off his clothes. Now he was sleeping soundly with his mouth wide open.

“Obviously, he’s much different than he was when he came in,” Dr. Edward Halbridge, the hospice medical director, told Mr. Oltzik’s wife. “He’s calm, he’s quiet.”

Mr. Oltzik’s life would end not with a bang, but with the drip, drip, drip of an IV drug that put him into a slumber from which he would never awaken. That drug, lorazepam, is a strong sedative. Mr. Oltzik was also receiving morphine, to kill pain. This combination can slow breathing and heart rate, and may make it impossible for the patient to eat or drink. In so doing, it can hasten death.

(Excerpt) Read more at nytimes.com ...


TOPICS: Culture/Society; Miscellaneous
KEYWORDS: death; dnr; donotresuscitate; euthanasia; healthcare; livingwill; morphine; prolife
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To: catnipman
Thank you for that explanation.We just went thru this exact same experience with my 86 year old Mom earlier this month.Watching a loved one die is one of the most difficult things one can ever do. More than anything, my Mom knowing we were all there for her at the end was as comforting as any pain reliever but the morphine made her last hours much more bearable.The hospice nurses were exceptional in their care and gave my Mom just enough to relieve the increasingly agonizing pain and make her comfortable until she became comatose. She was lucid until the last 2 days.
61 posted on 12/29/2009 11:26:12 PM PST by Apercu ("A man's character is his fate" - Heraclitus)
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To: ntnychik

Wow! Incredible story. You make the point beautifully. They have no right to kill people because its convenient. Its hard enough losing a loved one without hardened “care” providers pushing things along. Thou shall not kill has not been repealed. And, this is why lawyers are necessary. Thanks.


62 posted on 12/29/2009 11:32:05 PM PST by April Lexington (Study the constitution so you know what they are taking away!)
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To: fatima
The word Hospice comes from Latin and used to mean an Inn or place to stay and rest up for your journey. They were popular in the time of the great pilgrimages to Holy shrines.
63 posted on 12/29/2009 11:34:31 PM PST by April Lexington (Study the constitution so you know what they are taking away!)
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To: HiTech RedNeck

You shut up, Red Neck. Anyone at a hospice is there voluntarily under a doctor’s care. If it was otherwise, they would be dying at home.


64 posted on 12/29/2009 11:41:10 PM PST by SatinDoll (NO Foreign Nationals as our President!!)
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To: malkee
I did not like my mom's hospice at all....worthless actually....

but hospice is "end of life"......morphine is used to quiet respirations and keep the patient relaxed and pain free...death might occur but that afterall is the idea of a hospice...to make your death more peaceful...( not in my mom's case at all)

really, what did you expect?....

if I had more say in it, I would have encouraged my mother to go at least a round of chemo or radiation....to lie there for 3 months knowing you're dying slowly and being helpless without hope is a horrible situation....."hope is a good thing, maybe the best thing"

65 posted on 12/29/2009 11:42:56 PM PST by cherry
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To: LukeL
did your dad request it?..did the family insist on pain control no matter what?....

its the absolute duty of the medical profession to relieve pain....there are consequences for sure....death for instance...

doctors can't win...they can be sued for not managing pain and they can be sued for prescribing too many pain meds....

if your father had a morphine drip he had to have signed a paper that he knew what it was...at least in my neck of the woods....

66 posted on 12/29/2009 11:47:48 PM PST by cherry
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To: April Lexington
those "pull the plug" forms are meaningless at any time the patient deems otherswise...you can revoke it at any time....

however, if you become comatose, you better make sure your POA knows what you want....

67 posted on 12/29/2009 11:49:35 PM PST by cherry
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To: the long march

Well Morphine suppresses breathing in high doses. He had cirrhosis and was a smoker, but I think the meds did something as he deteriorated extremely quickly (about 12 hours) I was also shocked he was not on a 3 lead ekg with telemetry or a pulse ox monitor. The nursing staff said he didn’t need them anymore.


68 posted on 12/29/2009 11:56:02 PM PST by LukeL (Yasser Arafat: "I'd kill for a Nobel Peace Prize")
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To: PilotDave

My cat preferred John McCain to Obama, actually.


69 posted on 12/30/2009 12:07:05 AM PST by HiTech RedNeck (I am in America but not of America.)
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To: malkee

They did this to my Mother in law! THEY KILLED HER!
My inlaws were well off but had the Medicare.
Medicare sent Hospice. Hospice right away
ordered the bag of morphine, “for later”.
MIL was awake, lively, eating and a week later dead.

Once you sign the paper for “No measures to revive”
you’re done. Once given the morphine, you cannot ask for
food or water and you’ll not be given any.
She was dehydrated to death.


70 posted on 12/30/2009 2:27:07 AM PST by bolta_lightnin (*Warning* This thread has just been haunted.)
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To: malkee
Soylent Green.
71 posted on 12/30/2009 2:36:03 AM PST by DTogo (High time to bring back the Sons of Liberty !!)
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To: ReneeLynn
“We were actually given the morphine in drops to give my stepfather. He refused them even though he couldn’t talk. He waved the bottle away. I wonder how many people who aren’t being cared for by family would do the same thing if they had the choice?

Although I don’t see anything wrong with the ‘cocktail’ if that’s what you want.”

Nor do I. My mother in law had Pancreatic cancer. Suffered for 3 months, blank stares, etc. Doped up for pain. No food, etc. Finally my wife (Quaker) asked for a hospice adviser to help. Three days later she died in her sleep. Was wearing family approved patches. Some grief but family relief. We all have living wills ordering the same if we can not communicate by voice, actions, etc.” I am happy with the choice. I am 67 and hurt a lot. I have no fear for the future!

72 posted on 12/30/2009 3:31:35 AM PST by primatreat (Betcha "O"wee wees his pants so much he uses "depends")
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To: ReignOfError

My 92 year old mother has breast cancer and congestive heart failure. She has been under Hospice care for several months. Her nurse has saved her life at least twice. Her nurse came as soon as I called. I thank God for that woman. I guess the nurse isn’t doing the job she was hired to perform.


73 posted on 12/30/2009 4:20:43 AM PST by seemoAR (If you can't dazzle them with brilliance, dazzle them with bull.)
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To: goodnesswins

The quicker the better. I mean...the quicker the death, the less it will cost us. I mean....The patient is going to die anyway, so..... I mean....if the patient is comfortable, it is better, so if we make the patient REALLY comfy they seem to die faster.

All in the name of ‘dignity’. Comfort should be given, but I do believe there are definitely economic reasons that Hospice would ‘hasten’ or ‘facilitate’ the passing. IMHO


74 posted on 12/30/2009 6:18:03 AM PST by RoadGumby (For God so loved the world)
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To: Hildy

Clearminded? Well, there ya go, just drug them into a coma until they die, who needs non-clearminded dying people?


75 posted on 12/30/2009 6:21:38 AM PST by RoadGumby (For God so loved the world)
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To: Marie
I want to go like my uncle did - restfully asleep. I DON'T want to go in terrified panic like the passengers in his car...

Seriously, you have my condolences and my agreement. What they did to your grandfather was horrible and unnecessary.

I, unfortunately, have too much experience with this issue. I have been through this issue with my and my wife's father, and with our daughter. I can understand and completely appreciate the competeing positions: that God alone should decide when someone's life should end, and that drugs should be used to end the life and or suffering of a person.

I urge those who have never really confronted this to restrain themselves. You are certainly entitled to believe you know what you would do. You may even actually do that. And you may not. But it is not really possible to know until you get there.

I pray you never need to get there.

76 posted on 12/30/2009 6:49:04 AM PST by 70times7 (Serving Free Republics' warped and obscure humor needs since 1999!)
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To: malkee


This is an issue that needs debated, and patients needs to make their
wishes clear to their families BEFORE they become so ill they can’t
make their own choices. It happens all the time, and it’s wrong.

Absolutely.
And families should make sure of having proper legal documents to
back them up YEARS before a loved one might be slipping into the
“end stage”.

The best time is now. To draw up documents even for family members
that might simply be rendered brain dead from the unforseeable
(but not impossible) event like a traffic accident.


77 posted on 12/30/2009 7:10:41 AM PST by VOA
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To: the long march
You are incorrect to associate a dosage of morphine with induced death. Morphine is an appropriate medical choice for those in sever pain. You do not say what the underlying diseases were that your father and uncle suffered from. To blame pain killers just says that you ae still angry at their deaths and have not come to terms with the mortality of us all.

I beg to differ with you. My father died of stroke, my uncle of cancer. I have come to terms with both of their deaths. I am not angry. I simply believe they could have lived longer were it not for the morphine.
78 posted on 12/30/2009 8:32:13 AM PST by malkee (Actually I'm an ex-smoker--more than three years now -- But I think about it every day.)
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To: ntnychik

This is exactly why I posted this article, and echoes what happened with me. P.S. Watching the Steelers win the Superbowl for the the sixth time was priceless!! I would have wanted to live to see that as well!


79 posted on 12/30/2009 8:37:02 AM PST by malkee (Actually I'm an ex-smoker--more than three years now -- But I think about it every day.)
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To: 70times7

I don’t usually reply but feel the need to on this subject.

I’m an RN who ran a Home Health agency and sat on the Board of our local Hospice. This is a emotional issue and compassionate people, rightfully so, hold strong opinions. But there are a few misconceptions I’d like to correct.

Hospice care is reserved for our family and neighbors expected to die within 6 months. The goal of hospice workers is to meet the medical, emotional and spiritual needs of those in our care. Our nurses dress wounds, help patients figure out how to keep food down, give pain medications and much more. Our Social Workers and Chaplains counsel and pray with clients while helping them access other resources. Therapists help people maintain/improve function. Aides bathe, dress and cook meals for clients.

I have seen some “terminal” patients improve to the point that they are no longer felt to be terminal and discharge from Hospice. I’ve seen many others be able to die at home while holding onto a hospice volunteer’s hand.

I’m sure there are abuses in the Hospice field...there are everywhere. But I believe most Hospice workers are caring and selfless individuals who do their jobs with dedication and compassion.


80 posted on 12/30/2009 8:38:59 AM PST by OregonLady
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