Re: [MOL] Pain-Relieving Drugs do not hasten death in terminal patients. [00259] Medicine On Line

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Re: [MOL] Pain-Relieving Drugs do not hasten death in terminal patients.....

Interesting article, Lillian; in both my dad and my brother's cases they 
told us that increased pain meds would hasten their death. It is something 
of a relief to know that wasn't the case...Thanks.
Your friend,

>From: "Lillian" <>
>To: "MOL" <>
>Subject: [MOL] Pain-Relieving Drugs do not hasten death in terminal 
>Date: Wed, 2 Aug 2000 15:48:00 -0700
>      Pain-Relieving Drugs Do Not Hasten Death in Terminal Patients
>             By Heather Lindsey
>             At the end of life, people who receive increased doses of 
>opioids--morphine-like drugs that relieve pain from diseases like 
>cancer--do not die sooner than those who do not receive the drugs, 
>according to a new study.
>             That means doctors should not be conflicted about the ethics 
>of prescribing the medications, and families need not face a difficult 
>choice between a loved one's quality of life and length of life, experts 
>             "This study helps to disprove the unfounded fear about 
>[opioids] hastening death," said Myra Glajchen, D.S.W., director of the 
>Institute for Education and Research in Pain and Palliative Care at Beth 
>Israel Medical Center in New York. The fear stemmed from the belief that 
>opioids slow breathing, she explained.
>             But opioids rarely slow down the breathing of cancer patients, 
>noted Eduardo Bruera, M.D., chairman of symptom control and palliative care 
>at M.D. Anderson Cancer Center in Houston. Oncologists are frequently faced 
>with the situation of having to give opioids to relieve pain and may fear 
>inducing severe toxic side effects or death, he said. "It's important for 
>them to know that opioids are safe drugs."
>             Euthanasia Not An Issue
>             Because opioids do not shorten life, using the drugs does not 
>raise the issue of the "doctrine of double effect" (DDE), which holds "that 
>a harmful effect of treatment, even if resulting in death, is permissible 
>if it is not intended and occurs as a side effect of a beneficial action," 
>wrote the study authors, researchers at St. Christopher's Hospice in 
>London, England. Their research was published in the July 29 issue of The 
>             Court cases in the United Kingdom have recently questioned 
>whether DDE is sometimes used as a cover for euthanasia, putting people to 
>death painlessly because they suffer from an incurable and painful disease.
>             DDE has traditionally given doctors moral permission to 
>provide treatment that has an overall benefit to the patient even if it 
>results in some negative side effects. "[For example,] if it were the case 
>that opioids were causing a hastened death, you're [still] relieving 
>suffering, so providing the treatment is okay," said Mary Ersek, Ph.D., 
>R.N., research scientist for pain research at the Swedish Medical 
>Center/First Hill in Seattle.
>             Because of the high-profile issue of assisted suicide in the 
>United States, some people believe that DDE is a way of "passing off 
>euthanasia," said Ersek. However, opioids don't have a negative influence 
>on survival while providing pain relief, so DDE becomes a mute point, she 
>             Marked Dose Increases Made No Difference
>             Researchers studied the use of opioids in the last week of 
>life of 238 patients who died in a palliative care unit. Patients' average 
>age was 69 years. Doses of opioids given tended to be relatively low in the 
>last 24 hours of life. People who received marked increases in doses (28 of 
>the 238 patients) did not have a shorter survival than those who did not 
>receive increases or only slight increases.
>We invite you to take a look at our Album.
>   ( Very informational, good tips, Molers pictures, art work and much 

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