Does Morphine = Euthanasia in the Dying? Barbara Karnes, RN

Does Morphine = Euthanasia in the Dying?

A great question. You have actually touched on a line of thinking that a lot of people have about the use of narcotics at end of life: that the narcotic is used to end life sooner than if dying were allowed to follow its natural course.

I too have seen heavy doses of morphine given to end a life of suffering prematurely----but not often or on a regular basis. Most medical professionals approach intense pain...

Dear Barbara, I have seen many dying "euthanized" or given fairly heavy duty morphine drips to allow "dying in peace". I've also seen doctors recommend it to "hasten" the painful process of dying. Most people do not believe that death is not painful. I've also seen patients who ask for morphine to hasten the process.

That's my question... should a dying person be offered that choice and would it be considered medically legal?

A great question. You have actually touched on a line of thinking that a lot of people have about the use of narcotics at end of life: that the narcotic is used to end life sooner than if dying were allowed to follow its natural course.

I too have seen heavy doses of morphine given to end a life of suffering prematurely----but not often or on a regular basis. Most medical professionals approach intense pain at the end of life by giving what they deem appropriate to relieve the pain. Our objective is to relieve pain not end a life.

More common in my experience is the patient asking, not in the hours before death because they are generally non-responsive, but in the months before death to help them end their life. My answer, and I think I can speak for most healthcare professionals, is “I cannot do anything to help end your life. I can do everything in my power and knowledge to keep you comfortable”.

Now to your actual question “should a dying person be offered that choice (the choice to have enough narcotic given to end their life) and should it be considered legal? With our assisted death laws in several states it now is legal to voluntarily end your life sooner.

In the days to hours before death, legally offering the patient the option to end their suffering by an excessive dose of narcotic is really not viable because most people are non responsive. They are not in a mental place to make any kind of rational decisions. The patient will not be able to say yes or no to such an offer. Now the family can, BUT most of us are not strong enough emotionally to live with the decision to end our loved ones life prematurely, even if it is just by days or hours. That is the main reason I am against making it a legal option to end someone’s life prematurely in the name of comfort. There are too many ways that legal ability can be misused.

However, I am a firm advocate of giving however much narcotic is necessary to lessen a person’s pain. Sometimes the only viable option is to give enough narcotic to create a sleep state (induced coma) but not enough to stop breathing.

Something More about "Does Morphine = Euthanasia in the Dying":

Pain management of the dying is a complicated, emotional piece for the families of a loved one who is dying. Clarity on the subject is available in The Final Act of Living. Advance Directive information is available in the final section of the book also.

 

10 comments

Kim

I am here for the same reason as the others. My mother passed two weeks ago after less than a week on hospice. I am confused about the morphine option. I am not at peace with it and I don’t have my answers yet.
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BK Books replied:
Hi Kim, To get your questions answered start with contacting the hospice administrator. Tell this person your concerns and ask for an explanation of morphine and it’s relationship to your mother’s death. If you do not feel satisfied your next step is to go to Medicare.gov and file a complaint. I’m sorry this uncertainty has been added to your grief. My blessings are with you. Barbara

I am here for the same reason as the others. My mother passed two weeks ago after less than a week on hospice. I am confused about the morphine option. I am not at peace with it and I don’t have my answers yet.
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BK Books replied:
Hi Kim, To get your questions answered start with contacting the hospice administrator. Tell this person your concerns and ask for an explanation of morphine and it’s relationship to your mother’s death. If you do not feel satisfied your next step is to go to Medicare.gov and file a complaint. I’m sorry this uncertainty has been added to your grief. My blessings are with you. Barbara

barbara

Hi Kris, I am so sorry to hear of your father’s dying experience. I hear way too many of these experiences. You might write your father a letter and tell him what you are feeling. Write from your heart, all the love, sadness, concern as well as anything you have ever wanted him to know. When you are finished burn the letter and scatter the ashes to the wind. Know in your heart he will receive your love. My blessings to you. Barbara

Hi Kris, I am so sorry to hear of your father’s dying experience. I hear way too many of these experiences. You might write your father a letter and tell him what you are feeling. Write from your heart, all the love, sadness, concern as well as anything you have ever wanted him to know. When you are finished burn the letter and scatter the ashes to the wind. Know in your heart he will receive your love. My blessings to you. Barbara

Kris

Carole: I had an identical experience as you did and I am finding it hard to move past the guilt and regret I am feeling. My father was worsening in his illness for sure, but he was still getting up to go to the bathroom and showering himself. Hospice came in on a Friday and he was gone by the next Wednesday. He fought us as we tried to give him the morphine. I am haunted with the feeling that we killed him, first by making the decision to put him on hospice, and then by following their directives. I know my father is in a better place, but he didn’t get a say, even when he tried to resist, we were told to give it to him. I am devastated by my father’s death, not that he died, I know he’s in a better place and he had been ill for a long time, but in the WAY he died. It was not peaceful, and I can’t get over it. I would like to know if there are others that have had the same experience and how, if possible, they moved past it. Thank you for sharing!

Carole: I had an identical experience as you did and I am finding it hard to move past the guilt and regret I am feeling. My father was worsening in his illness for sure, but he was still getting up to go to the bathroom and showering himself. Hospice came in on a Friday and he was gone by the next Wednesday. He fought us as we tried to give him the morphine. I am haunted with the feeling that we killed him, first by making the decision to put him on hospice, and then by following their directives. I know my father is in a better place, but he didn’t get a say, even when he tried to resist, we were told to give it to him. I am devastated by my father’s death, not that he died, I know he’s in a better place and he had been ill for a long time, but in the WAY he died. It was not peaceful, and I can’t get over it. I would like to know if there are others that have had the same experience and how, if possible, they moved past it. Thank you for sharing!

Renee Durio

My mother suffered a stroke and was unresponsive. After several hours hospice nurse began a regiment of morphine. Mom was clearly not in pain. Her organs were shutting down. She was dying. However, she was still breathing and in no pain. I started to intervene and will always wish that I had. Why wouldn’t they let nature take it’s course? Why not let her die on her own. I am very distraught that I let them do this. A comment was made by nurse. “It’s really taking a lot of morphine for this one.” I believe it was wrong. I am a well educated person and was there every second. I believe she overstepped her authority.

My mother suffered a stroke and was unresponsive. After several hours hospice nurse began a regiment of morphine. Mom was clearly not in pain. Her organs were shutting down. She was dying. However, she was still breathing and in no pain. I started to intervene and will always wish that I had. Why wouldn’t they let nature take it’s course? Why not let her die on her own. I am very distraught that I let them do this. A comment was made by nurse. “It’s really taking a lot of morphine for this one.” I believe it was wrong. I am a well educated person and was there every second. I believe she overstepped her authority.

Gail Berdahl

My Husband gave up his will to live in pain anymore.He asked to go home & due.I contacted Hospice & they arranged everything so he could come home & have his last wish granted. The Hospice team was Amazing & the care they all gave to my Husband of 30 years was astounding.Thank God for Hospice.Iv’e never felt so cared for & supported while my loved one passed.They called often to check on me after the death.I was not concerned about the Morphine my Husband was getting, it helped his pain.Thank You again to our Hospice Team,they are Angels on earth.♥.

My Husband gave up his will to live in pain anymore.He asked to go home & due.I contacted Hospice & they arranged everything so he could come home & have his last wish granted. The Hospice team was Amazing & the care they all gave to my Husband of 30 years was astounding.Thank God for Hospice.Iv’e never felt so cared for & supported while my loved one passed.They called often to check on me after the death.I was not concerned about the Morphine my Husband was getting, it helped his pain.Thank You again to our Hospice Team,they are Angels on earth.♥.

J R

I’m extremely grateful for hospice and their use of morphine. Just a few days ago, we brought my mother in law home to hospice after stopping dialysis. She slept through the first night, but in the morning was in incredible discomfort- she had so much fluid in her throat, she couldn’t swallow, and she spent hours gasping for air and gurgling, and though she could barely speak, she managed to get out “i wanna go now”. She was so distraught.

The hospice nurse calmly said that she could help. She gave her one large dose of morphine, and she quickly took in her last breath, and was gone. Finally at peace. It was purely an act of mercy and compassion for the dying, and also for us as her family. I firmly believe that if this nurse hadn’t done that, she would have suffered on and on and on, in fear and panic and agony, being unable to breathe through the fluid gurgling in her throat and lungs. And being left to endure that just isn’t right. In some instances of prolonged or very intense suffering , it’s the only right thing to do.

I’m extremely grateful for hospice and their use of morphine. Just a few days ago, we brought my mother in law home to hospice after stopping dialysis. She slept through the first night, but in the morning was in incredible discomfort- she had so much fluid in her throat, she couldn’t swallow, and she spent hours gasping for air and gurgling, and though she could barely speak, she managed to get out “i wanna go now”. She was so distraught.

The hospice nurse calmly said that she could help. She gave her one large dose of morphine, and she quickly took in her last breath, and was gone. Finally at peace. It was purely an act of mercy and compassion for the dying, and also for us as her family. I firmly believe that if this nurse hadn’t done that, she would have suffered on and on and on, in fear and panic and agony, being unable to breathe through the fluid gurgling in her throat and lungs. And being left to endure that just isn’t right. In some instances of prolonged or very intense suffering , it’s the only right thing to do.

Amparo

I have lost three of my love ones of colon, liver, and lung canser seeing them suffer of this deceased is very sad and stressful and painful. They all chose morphine.when they we’re alive.l myself believe the same way. I choose to die a peaceful death don’t want no machines keeping me alive.thank God for hospice

I have lost three of my love ones of colon, liver, and lung canser seeing them suffer of this deceased is very sad and stressful and painful. They all chose morphine.when they we’re alive.l myself believe the same way. I choose to die a peaceful death don’t want no machines keeping me alive.thank God for hospice

Carole Inman

Two years later, we are still living with the regret of turning over my mom’s care to hospice. We feel they terminally sedated her with morphine, and hastened her death. Believe me, I loved my mom, and it’s a horrible guilt trip and a heavy emotional load to carry. Our intentions were pure at the outset, when we agreed to the hospice referral. We wanted my mom to die a relatively comfortable death, and that is the rationale (and how could we argue with it?) the hospice nurses used whenever we questioned the amount of morphine or how rapidly it was being increased. “You DO want your mother to be comfortable, don’t you?” Only a heartless ogre would disagree! I hear what you say, that this rarely happens, but that is not what our experience has been. We now know of several cases just within our own circle of family and friends where a steady flow of morphine drops under the tongue took previously functioning patients (admittedly sick, yes, but not in the throes of death) down in just a matter of days. It is happening far more often than you may think, or want to believe. Please read about the Frisco, Texas Novus hospice company owner who directed his nurses to overdose patients to “hurry” them along. I wish I could believe all the hospice propaganda, but I’ve seen too much with my own eyes. There may be times/patients who might actually welcome the sweet relief of morphine induced euthanasia, but that should be THEIR decision, not the hospice company’s.

Two years later, we are still living with the regret of turning over my mom’s care to hospice. We feel they terminally sedated her with morphine, and hastened her death. Believe me, I loved my mom, and it’s a horrible guilt trip and a heavy emotional load to carry. Our intentions were pure at the outset, when we agreed to the hospice referral. We wanted my mom to die a relatively comfortable death, and that is the rationale (and how could we argue with it?) the hospice nurses used whenever we questioned the amount of morphine or how rapidly it was being increased. “You DO want your mother to be comfortable, don’t you?” Only a heartless ogre would disagree! I hear what you say, that this rarely happens, but that is not what our experience has been. We now know of several cases just within our own circle of family and friends where a steady flow of morphine drops under the tongue took previously functioning patients (admittedly sick, yes, but not in the throes of death) down in just a matter of days. It is happening far more often than you may think, or want to believe. Please read about the Frisco, Texas Novus hospice company owner who directed his nurses to overdose patients to “hurry” them along. I wish I could believe all the hospice propaganda, but I’ve seen too much with my own eyes. There may be times/patients who might actually welcome the sweet relief of morphine induced euthanasia, but that should be THEIR decision, not the hospice company’s.

Barbara Karnes

Julia, I can’t say that what you propose (that families are deliberately overdosing their “loved ones” to hasten their deaths) never happens but I can say it is rare. While there are problems and confusion about the use of morphine at end of life, purposely overdosing to cause death is not one of them.

Julia, I can’t say that what you propose (that families are deliberately overdosing their “loved ones” to hasten their deaths) never happens but I can say it is rare. While there are problems and confusion about the use of morphine at end of life, purposely overdosing to cause death is not one of them.

Julia Cate

The problem with the morphine, to easy the pain of death is that family members and those that have Power of Attorney over another human, abuse this authority. Loved ones that are not ready to end their life, are being abused, death hastened, for their own personal gain.

The problem with the morphine, to easy the pain of death is that family members and those that have Power of Attorney over another human, abuse this authority. Loved ones that are not ready to end their life, are being abused, death hastened, for their own personal gain.

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