Hard Choice for a Comfortable Death: Sedation

NYT ^ | Dec. 26 2009 | ANEMONA HARTOCOLLIS

[spectre]

I was present at the death of a friend where Hospice was involved.

I was witness when the worker flushed the morphine down the toilet.

The coroner had to come to the house before the deceased was removed to certify the cause of death..which was cancer.

sw

[malkee]

I really believe a lot of this has to do with fear of death. People who are afraid of dying may want to be drugged. And family members who are afraid of their relatives experiencing pain may want them drugged. If it wasn’t an option, it wouldn’t be such a difficult decision. Sort of like abortion...

But not exactly, because those experiencing death as a result of drug overdose could and should have some say in the matter. But fatal overdosing should still be illegal. Sorry to be harsh.

[spectre]

When my own dear Mother was in her final hours suffering from kidney failure she was screaming in pain.

When I requested more pain killers, her Doctor told me that he had just given her morphine by mouth 30 minutes earlier and that more meds would only be for "the family" and not for her. WTH did he mean by that? And I told him WE weren't in PAIN, she was.

I can't recall what else I said because I was livid with panic and rage helplessly observing Mom's horrible suffering. Finally, he reluctantly increased her dosage enough to put her in a painfree sleep.

She died several hours later with the look of peace on her face. I did my duty as her daughter. I pray someone is there for me if I ever get that bad.

[70times7]

I don’t think your opinion is harsh at all. I also disagree that fear of death is necessarily involved. I think comparing it to abortion is misguided.

[70times7]

You input is relevant and appreciated. But I am wondering why you replied to me. Did I miss something?

[the long march]

Cirrhosis is most often a result of alcoholism or Hep C. In the late stages ( which obviously this was) the pain is excrutiating. Encephalopathy, kidney failure, and pancreatitis are all common. Rapid deterioation is not all that unusual in a patient whose organs are shutting down.

It is also not unusual for some one very close to death to be very lucid and alert, almost like a final hurrah.

[the long march]

And just because you believe it does not make it so. I hope you never have to go through the type of pain associated with both stroke and cancer. The body goes into shock and starts shutting down when the pain is sufficiently great. Treatment for pain is needed to provide the body a chance to recupperate ( as much as it can).

[malkee]

And just because YOU believe it does not make it so. I too, hope I don't die of stroke or cancer. Generally speaking, people who die of stroke don't experience a great deal of pain, thankfully. It is still an awful way to die. Cancer of course is a different story when it comes to pain.

I did not say cancer patients should not receive morphine, if that is their choice. I said they should not be drugged to death. And not all cancer patients are unable to deal with their pain.

My uncle, for example, who had cancer throughout his entire body, was driving less than a month before his death-- didn't even realize he was ridden with cancer until about 10 days before his death. His body was "shutting down," -- kidneys failing, tongue blackening, etc. This may sound horrible and gross, but the fact is that he was clear-headed and able to converse with me until two days before his death.

I have a friend whose mother died without benefit of morphine. Her body, too, was shutting down before death, to the point that she couldn't go to the bathroom before she died. But she wasn't in unbearable pain. So I do have some experience of this type of thing.

Morphine should only be used to alleviate pain, not to kill people, and not to calm the fears of the patient or his or her family. Again, I apologize if this sounds harsh, but these are MY beliefs.

[ErnBatavia]

We were actually given the morphine in drops to give my stepfather

Ditto with my dad on home hospice; we had live-in caregivers who were instructed to give him a very few drops if he showed signs of discomfort.....if that didn't work (which it did), they were instructed to call hospice immediately.

The system worked well for the two weeks before Pop just drew his last breath; morphine drops only used two or three times.

[the long march]

And since you were not the one whose body was shutting down you have no idea of what their pain level was. Moreover you don’t know what additional drugs were being given to the patient. You sight exactly the type of thing that happens when you spoke of your uncle. Even up to two days before he died he was lucid enough to recognize people and converse. There is a huge range Morphine did not kill your uncle nor did it take him early.

[malkee]

And since you were not the one whose body was shutting down you have no idea of what their pain level was. Moreover you don’t know what additional drugs were being given to the patient. You sight exactly the type of thing that happens when you spoke of your uncle. Even up to two days before he died he was lucid enough to recognize people and converse. There is a huge range Morphine did not kill your uncle nor did it take him early.

And I guess since you were in his body and died and came back to life you do know what his pain level was. I do know what additional medication was given to the patient -- in my uncle's case, none. It is ridiculous to suggest you would have more or better knowledge of his specific case than me. He was perfectly able to articulate his pain level -- and if he had wanted drugs he would have said so, and gone to the hospital much sooner than he did.

[the long march]

I am not trying to anger you. I get that you are upset. That is very clear. I will tell you that as someone who personally deals with the pain issues associated with cancer that some days are better than others. I make very effort to minimize the amount of medication that I take because that is my choice. When the pain is so bad that I am unable to sleep for more than a moment or two for days on end then I take what I need to give my body a chance to gain some traction.

My only point was that a) pain levels are a personal thing (I for one can tolerate a lot of pain) and b) people on the outside can never be sure what another’s pain is ( folks think I am doing wonderfully because I chose to be happy with the time I have).

[potlatch]

Good that you wrote it all out again nit. You did all you could.

[malkee]

I know he was in a lot of pain. I just have a feeling a drug may have hastened his death. I am sorry you are in the situation you are in and I wish you the best this New Year’s Eve.

[the long march]

Hey I am on my feet and still breathin. Everyday I get is gravy so me I am just happy, joyous and free.

Sorry for all you loses. I know how hard it can be.

Happy New yesr to you too. I hope it brings you the desires of your heart