Using morphine to hasten death is a myth, says doctor

Mar 02, 2007

Using morphine to end a person's life is a myth, argues a senior doctor in a letter to this week's BMJ. It follows the case of Kelly Taylor, a terminally ill woman who went to court earlier this month for the right to be sedated into unconsciousness by morphine, even though it will hasten her death.

Mrs Taylor's request to use morphine to make her unconscious under the principle of double effect is a puzzling choice, writes Claud Regnard, a consultant in palliative care medicine. The principle of double effect allows a doctor to administer treatment that hastens death, providing the intention is to relieve pain rather than to kill.

Evidence over the past 20 years has repeatedly shown that, used correctly, morphine is well tolerated and does not shorten life or hasten death, he explains. Its sedative effects wear off quickly (making it useless if you want to stay unconscious), toxic doses can cause distressing agitation (which is why such doses are never used in palliative care), and it has a wide therapeutic range (making death unlikely).

The Dutch know this and hardly ever use morphine for euthanasia, he writes.

Palliative care specialists are not faced with the dilemma of controlling severe pain at the risk of killing the patient - they manage pain with drugs and doses adjusted to each individual patient, while at the same time helping fear, depression and spiritual distress, he adds.

And he warns that doctors who act precipitously with high, often intravenous, doses of opioids are being misled into bad practice by the continuing promotion of double effect as a real and essential phenomenon in end of life care.

Using double effect as a justification for patient assisted suicide and euthanasia is not tenable in evidence-based medicine, he says. In end of life care, double effect is a myth leading a double life.

Source: British Medical Journal

Explore further: Strategies can help docs lower their tax burden

add to favorites email to friend print save as pdf

Related Stories

Better think positive: Pessimism can block therapy

Feb 28, 2011

Spine surgeon Anders Cohen puts a lot of stock in patients' expectations of pain relief. He prefers to operate only on those who "grab you by the collar and say, `I can't take it anymore.'"

Painkiller patch creates addiction

May 17, 2009

Morphine patches are supposed to reduce use of painkillers, and provide more control over their use in chronic pain conditions. But researchers at the Norwegian University of Science and Technology (NTNU) and St. Olavs Hospital ...

Recommended for you

The human race evolved to be fair for selfish reasons

Sep 19, 2014

"Make sure you play fairly," often say parents to their kids. In fact, children do not need encouragement to be fair, it is a unique feature of human social life, which emerges in childhood. When given the o ...

Non-stop PET/CT scan provides accurate images

Sep 18, 2014

Siemens is improving PET/CT imaging and data quality while reducing radiation exposure. The Biograph mCT Flow PET/CT scanner is a new positron emission tomography/computed tomography (PET/CT) system that, ...

Experts: Chopin's heart shows signs of TB

Sep 17, 2014

The preserved heart of composer Frederic Chopin contains signs of tuberculosis and possibly some other lung disease, medical experts said Wednesday.

User comments : 0