In my booklet, Pain At End of Life, I address the issue of narcotics and how they are used in end of life care. There are so many questions and concerns about narcotics. Something more about Does Morphine Hasten Death?. It is just that in one scenario the person is hurting and the other they are not. Either way the person will be non-responsive. The misconception is that by withholding the narcotic the person would be alert and interactive. Either way the person, as death approaches, is non-responsive. By continuing to give the morphine the last hours could be relaxed and relatively comfortable. What if hours of life (a few hours) could be extended by withholding the pain medicine? The result would be physical pain causing agitation and extreme discomfort even though the body is non-responsive. There was no reversing what was physically happening. ![]() In fact his father was actually in the dying process. What if the morphine had killed his father? He had a terminal illness. Now let's explore a controversial thought. The morphine did not kill him, it allowed him to leave this world more gently than if he were suffering physically. Morphine given continually is a must to keep this man relaxed and relatively comfortable. I believe that means he had the potential for pain, lots of pain, in his disease progression. This is why giving pain medicine to someone who is actively dying is rarely the cause of death. When you give any medication at that time it does not get absorbed and become effective in the same way it would in a body that’s functioning normally. Circulation, the blood flowing through the body, is slower and less effective (this is what the bluish color to the hands and feet show. When a person is days to hours before death their body is shutting down. Now let’s address the major concern-hastening death with the administration of morphine (or any narcotic). I am trying to put a lot of detailed information into a few words, but end of life pain management is really an all day or more workshop. In end of life pain management we also need to know that the use of narcotics over time tends to require increasing the amount of the narcotic. We also need to know that whatever was causing the pain is not removed by the narcotic. Just because a person is non-responsive (which most people are before death) does not mean that pain is not there. If pain has been an issue during the disease process then we certainly want to continue to provide adequate pain management until the last breath is taken. We do not need to use a narcotic for comfort. If pain has not been an issue in the person’s disease history then just because death is approaching does not mean the person is in pain. Dying is not painful, disease causes pain. Our society is so drug conscious we tend to equate any use as misuse.įirst, let’s understand end of life pain. The use of Morphine is one of the most misunderstood practices I encounter with families and end of life issues. ![]() What would you say to him to make him understand that he did not kill his father? After his father passed a family member made a comment that he gave morphine until his father died. Dear Barbara, I have a man that regrets giving his father morphine for pain at the end.
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