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View Diary: Death with Dignity Law Brings No Dignity to Some (272 comments)

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  •  Even doctors unwilling to order a lethal dose (9+ / 0-)

    of a medicine ought to be willing to order increasing doses of the strongest pain medicines, with the goal of relieving pain, even at the risk of getting to a lethal dose.  

    For the rare patient in whom it just doesn't seem possible to get to a pain relieving dose of the strongest medicines, there's an alternative known as 'palliative sedation'.  Basically, it's giving anaesthetic  doses of sedative medicines like sodium pentothal.  I've never actually seen it done; but most hospitals that have developed a policy about it want the patient revived every 24 to 48 hours, if only to ask, "Do you still hurt enough to want to go back to sleep?"  

    With my unconventional sense of humor, I've called it euthanasia on the installment plan, but a lot of doctors and nurses who have reservations about assisting suicide are willing, if not relieved, to go along with palliative sedation.  The practice has been endorsed by the American Association of Hospice and Palliative Medicine; the AAHPM is at most on the fence about medically assisted suicide.  

    We're all pretty strange one way or another; some of us just hide it better. "Normal" is a dryer setting.

    by david78209 on Sun May 10, 2009 at 07:24:16 PM PDT

    •  But drugs are bad, mmmkay? (4+ / 0-)

      You don't want them to get hooked, because they'll become junkies, and they'll break into your house and steal your TV, and probably turn your children gay!  Or something like that.  I lost my train of thought.  What were we talking about, again?

    •  Add to them the Catholic Church. (3+ / 0-)
      Recommended by:
      freelunch, Ahianne, david78209

      Too often people take it upon themselves to be more Catholic than the Pope.  If Catholic teaching is your concern, remember that palliative care, even at the risk of shortening life, is acceptable.  In fact, palliative care may not shorten life;  thrashing around in intense agony is a sure way to break bones, trigger unhealthy stress responses and promote internal bleeding while the body sometimes uses unconsciousness to do its own healing.

      2009: Year of the Donkey. Let's not screw it up.

      by Yamaneko2 on Sun May 10, 2009 at 08:28:01 PM PDT

      [ Parent ]

    •  thanks for the info (3+ / 0-)
      Recommended by:
      Creosote, Fabian, david78209

      I've been on an ovarian cancer listserve for years. We occasionally get into end-of-life topics, and I've known of women who had a horrible end--bad reactions to morphine, or morhpine not relieving the suffering.

      I had never hear of palliative sedation.

      really, really, thank you. I've been having trouble with end-of-life fears lately, and FACTS really help me.

      •  Short of palliative sedation, (1+ / 0-)
        Recommended by:
        Belle Ame

        there are other strong pain medicines that may get around the bad reactions and failures of morphine -- methadone, fentanyl, oxycodone, and others.  

        Most doctors acquire the habit of being cautious and stingy with those medicines fairly early in training.  Generally that's a good habit, but it's easy to forget why it's usually a good habit -- if you remember the 'why', it's not hard to realize that occasionally that 'why' doesn't apply, and break the habit.

        We're all pretty strange one way or another; some of us just hide it better. "Normal" is a dryer setting.

        by david78209 on Mon May 11, 2009 at 07:58:39 AM PDT

        [ Parent ]

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