does giving someone morphine hasten death

He survived for another 5 days in the hospital, requiring a few doses of intravenous hydromorphone for comfort. The patient continued to be obtunded and unarousable, but his respiratory rate and effort improved. She believed he was close to death and contacted his family, who came to see him. The following morning, the palliative care attending saw the patient at 7:00 AM and found him obtunded, with shallow respirations and a low respiratory rate. The nurse administered the scheduled dose of intravenous hydromorphone. She asked him, 'Are you having any trouble breathing?' He responded, 'A little bit,' but he remained drowsy. The patient appeared to be sleeping but woke up when the nurse came in the room. On the night shift, the bedside nurse went to see the patient at 3:00 AM to administer the next scheduled dose of hydromorphone. Wanting to ensure the patient's comfort, the inpatient team wrote for a standing dose of intravenous hydromorphone every 4 hours. He seemed more at peace after making the decision and was able to spend time with his family. His diuretics, statins, beta-blockers, and other treatments for his heart failure were stopped. While he was still hospitalized, comfort measures were initiated. His life expectancy was believed to be weeks to months, based on his comorbidities and frailty. In discussions with the patient and his son, the patient expressed that he would like to focus on comfort and pursue hospice care.

During this admission, he improved slightly with treatment, but his overall prognosis remained poor. It was his third admission in the previous 4 weeks. Recognize the principle of double effect and the implications for potential medication errors.Īn 83-year-old man with chronic kidney disease and end-stage congestive heart failure (CHF) with a severely reduced ejection fraction was admitted for an exacerbation of his CHF.Describe key principles regarding the use of opioids in palliative care.State that medication errors and errors in communication are common in palliative care.Recognize errors may be difficult to identify in palliative care.Learn more about hospice and palliative care from Cura HPC today. If you would like to speak with a hospice or palliative care specialist, the professionals from Tulsa’s Cura HPC are here to help. For this, morphine is often a useful tool. The purpose of hospice or palliative care is not to bring about death, but to alleviate as much pain and discomfort as possible from the dying process. Doses are given in relation to the person’s breathing needs and levels of discomfort. The doses of morphine given to the dying are of relatively low and do not directly hasten death. This is an important time to remember that correlation does not imply causation. Part of this misconception is from experiences where death was immediately preceded by a dose of morphine. There is an erroneous idea that morphine hastens the dying process. Some families of the dying or even the dying themselves may have some reservations against using morphine and other painkillers to decrease breathlessness. In order to provide relief from these symptoms, opiates such as morphine may be used to help alleviate both anxieties as well as the shortness of the breath.

As somewhat of a catch 22, the anxiety surrounding dyspnea can exacerbate the symptoms and make breathing even more difficult. While not necessarily painful, symptoms of dyspnea are uncomfortable and can greatly induce feelings of distress or anxiety. Also known as dyspnea, short or labored breathing is a common experience among those in the dying process. While this is true, morphine and other related opiates (such as codeine, hydromorphone, or fentanyl), have another purpose: to decrease the shortness of breath among the dying. The purpose of morphine and other painkillers throughout the dying process may seem fairly clear - to relieve pain.

Does giving someone morphine hasten death