Euthanasia

[geauxtohell]

A book by M. Scott Peck titled Denial of the Soul has become one of the most thought provoking books I have read to date. It is regarding spiritual and medical perspectives on euthanasia and mortality.

I agree with his stance that euthanasia is not being given the consideration it deserves. He says it is as though it is being lost among the myriad of other issues that have come out of the closet or been on the table for some time. The issue of euthanasia may be more critical than all the others. He further states that we may need to reach a national consensus about it before all the other issues can be more satisfactorily resolved. I sincerely and passionately agree with him.

There is a profound wisdom in the way he addresses the good and the bad of euthanasia. "He is a physician, psychiatrist, and a theologian so he is uniquely suited to address the complex issues and paradoxes that have come from medicine's technical ability to perpetuate the mechanisms of life..."

Should we prolong life? Should we war against the natural process of dying? What would you, as an individual, prefer? To be kept alive... or to be allowed to die? At what point is enough? It is a very important subject and though life can be a marvelous gift, it seems it is also a curse. Bodies rotting from the inside out while being kept alive is not the way most any one would want to pass on.

This kind of thing... it's potential very well does represent a type of heaven vs. hell. The body rotting, the mind missing... Doctors and family members need to know what an individual's desire is, and it must be written in writing to be taken seriously in most every case. To give specific detailed instructions about such one needs to be up-to-date as possible on the medical procedures. Keeping a Medical Power of Attorney even if it seems that one is perfectly healthy in the later part of life is not a bad suggestion.

In this book he even brings up (perhaps predictably) assisted suicide and such. Is there ever a point or a case in life that such is more humane than attempted treatment? All too often, I am personally reminded of what has been shown to us about how the Priests had to torture and prosecute the mentally ill, the demonic, the possessed, claiming to know best. To drive the beasts out of the psyche. Sometimes the cures are far more harsh than the illness, the disease.

So what of it? Is euthanasia not given the attention it deserves? Should we focus on better defining what death truly is? Should we have 'blanket rules and guidelines' regarding such or should we determine such on an individual basis?

I hope others will find this as provoking as I have... as I have yet to return the overdue book to the library, I plan to renew it a third time. There is so much to absorb. *hearts*

Euthanasia as someone else deliberately ending someone's life to alleviate suffering is abominable, reprehensible, immoral, illegal, and sickening. It should never be embraced by the medical community.

Allowing people the option to end their own life by their own hand is a different matter. Oregon's "Death with Dignity" is the best example of a workable law that actually makes sense.

 

[Skull Pilot]

"I want to assure you that giving morphine prn to an actively dying patient is most definitely not "euthenasia" in any way, shape or form. PRN doses of opioids are usually ordered in a dose that is immediate release, short-acting and at insufficient dose levels to "hasten a death". The intent of the morphine is to alleviate the symptoms associated with the dying process. I have seen some patients who come to me actively dying with poorly controlled symptoms. Their uncontrolled pain causes them to produce increased adrenaline, which in turn can actually cause the patient to "linger". At this point, I will inform the families of this and let them know, that with their permission, we will give the patient a little bit of morphine to get the patient comfortable, and that once they get comfortable---that will allow them to "let go". It is not the medicine that is killing them--it is the underlying disease. We cannot change the final outcome--death; however, we can change the way it happens (ie, die comfortably, instead of die in pain)."
Spiritual Beliefs and End of Life Care - Page 2- Nursing for Nurses

You are forgetting that in Drock's scenario the morphine was not given by a doctor and again the phrase more and more denotes that increasing dosages were given.

Morphine depresses respiration and in high enough doses causes respiratory arrest.

If morphine was withheld then he may have lingered for days in agony before the disease killed him. Morphine in high doses hurries it along.

Did you ever think that a doctor has to describe an overdose of morphine in the way you quoted so as to keep his license since intentionally overdosing a patient to relieve suffering is illegal?

You know there are websites disagreeing with you? I have looked it up, and many say it doesn't speed up death.
Now in my opinion, and I give morphine to dying hospice patients at work, I think it does. I think it is also a good thing. Instead of taking a week, it can take a few days or even a few hours. The last resident I gave morphine too was just lingering, I started her on morphine around 7pm, and she was gone by 7am the next day.

were you giving lethal doses or minimal timed doses?

There's a difference you know.

 

[Luissa]

And if the intent causes death it is euthanasia.

The Medical Board has ruled otherwise. This situation is one reason it is so important to have hospice involved. If you want someone you love to die naturally and without pain, morphine is necessary in many cases. The MD I just quoted spoke to the adrenaline surge in pain prolonging life. Do you want to prolong your loved one's life when he or she is in that much pain?

The medical board is comprised of doctors protecting their own collective asses.

Since intentionally overdosing a patient is illegal they are just using flowery language to keep their licenses.

And I'm all for euthanasia but at least call a spade a spade here and realize that when a doctor sends you home with enough morphine to kill a horse that he realizes people will end the suffering of their loved ones by overdosing them.

I really didn't think you were that naive.

I will have to check, but I know with the hospice patients I have taken care of in their home, they have had a drip and did nothing themselves. In other cases they are given a lock box, and the hospice nurse is en charge of it.
At my work, it is all pre measured, kept in a lock box in the fridge, and we have to follow a mar.

 

[geauxtohell]

You are forgetting that in Drock's scenario the morphine was not given by a doctor and again the phrase more and more denotes that increasing dosages were given.

Morphine depresses respiration and in high enough doses causes respiratory arrest.

If morphine was withheld then he may have lingered for days in agony before the disease killed him. Morphine in high doses hurries it along.

Did you ever think that a doctor has to describe an overdose of morphine in the way you quoted so as to keep his license since intentionally overdosing a patient to relieve suffering is illegal?

You know there are websites disagreeing with you? I have looked it up, and many say it doesn't speed up death.
Now in my opinion, and I give morphine to dying hospice patients at work, I think it does. I think it is also a good thing. Instead of taking a week, it can take a few days or even a few hours. The last resident I gave morphine too was just lingering, I started her on morphine around 7pm, and she was gone by 7am the next day.

were you giving lethal doses or minimal timed doses?

There's a difference you know.

But there is not a defined line. There is a big difference in attempting to control pain with the realization it might hasten death and intentionally overdosing a patient. The difference is in intent.

It's a very fine line and it is very difficult for health care providers to walk and ultimately fruitless to try and rake people over the coals unless you have a slam dunk case.

 

[Luissa]

You are forgetting that in Drock's scenario the morphine was not given by a doctor and again the phrase more and more denotes that increasing dosages were given.

Morphine depresses respiration and in high enough doses causes respiratory arrest.

If morphine was withheld then he may have lingered for days in agony before the disease killed him. Morphine in high doses hurries it along.

Did you ever think that a doctor has to describe an overdose of morphine in the way you quoted so as to keep his license since intentionally overdosing a patient to relieve suffering is illegal?

You know there are websites disagreeing with you? I have looked it up, and many say it doesn't speed up death.
Now in my opinion, and I give morphine to dying hospice patients at work, I think it does. I think it is also a good thing. Instead of taking a week, it can take a few days or even a few hours. The last resident I gave morphine too was just lingering, I started her on morphine around 7pm, and she was gone by 7am the next day.

were you giving lethal doses or minimal timed doses?

There's a difference you know.

Really? Had no clue.

The amount we can give to a patient could kill a normal person, but I have never had to give that much, they usually died before it got to that point. You have to understand, their tolerance is up by the point, usually.

 

[Sky Dancer]

I have a dear friend who is a Hospice Nurse Practitioner. She was a midwife in her younger years. She sees the similarities in Hospice work and midwifery.

Both being born and dying are a kind of labor.

 

[geauxtohell]

The Medical Board has ruled otherwise. This situation is one reason it is so important to have hospice involved. If you want someone you love to die naturally and without pain, morphine is necessary in many cases. The MD I just quoted spoke to the adrenaline surge in pain prolonging life. Do you want to prolong your loved one's life when he or she is in that much pain?

The medical board is comprised of doctors protecting their own collective asses.

Since intentionally overdosing a patient is illegal they are just using flowery language to keep their licenses.

And I'm all for euthanasia but at least call a spade a spade here and realize that when a doctor sends you home with enough morphine to kill a horse that he realizes people will end the suffering of their loved ones by overdosing them.

I really didn't think you were that naive.

I will have to check, but I know with the hospice patients I have taken care of in their home, they have had a drip and did nothing themselves. In other cases they are given a lock box, and the hospice nurse is en charge of it.
At my work, it is all pre measured, kept in a lock box in the fridge, and we have to follow a mar.

And as the patient suffers, the morphine dose/PCA gradually goes up on the MAR until a tipping point is most likely reached.

It's not Euthanasia. It's doing your best to control pain.

 

[Skull Pilot]

You know there are websites disagreeing with you? I have looked it up, and many say it doesn't speed up death.
Now in my opinion, and I give morphine to dying hospice patients at work, I think it does. I think it is also a good thing. Instead of taking a week, it can take a few days or even a few hours. The last resident I gave morphine too was just lingering, I started her on morphine around 7pm, and she was gone by 7am the next day.

were you giving lethal doses or minimal timed doses?

There's a difference you know.

Really? Had no clue.

The amount we can give to a patient could kill a normal person, but I have never had to give that much, they usually died before it got to that point. You have to understand, their tolerance is up by the point, usually.

I understand tolerance but no matter how high one's tolerance to a drug, given enough one will succumb.

 

[Sky Dancer]

"I want to assure you that giving morphine prn to an actively dying patient is most definitely not "euthenasia" in any way, shape or form. PRN doses of opioids are usually ordered in a dose that is immediate release, short-acting and at insufficient dose levels to "hasten a death". The intent of the morphine is to alleviate the symptoms associated with the dying process. I have seen some patients who come to me actively dying with poorly controlled symptoms. Their uncontrolled pain causes them to produce increased adrenaline, which in turn can actually cause the patient to "linger". At this point, I will inform the families of this and let them know, that with their permission, we will give the patient a little bit of morphine to get the patient comfortable, and that once they get comfortable---that will allow them to "let go". It is not the medicine that is killing them--it is the underlying disease. We cannot change the final outcome--death; however, we can change the way it happens (ie, die comfortably, instead of die in pain)."
Spiritual Beliefs and End of Life Care - Page 2- Nursing for Nurses

You are forgetting that in Drock's scenario the morphine was not given by a doctor and again the phrase more and more denotes that increasing dosages were given.

Morphine depresses respiration and in high enough doses causes respiratory arrest.

If morphine was withheld then he may have lingered for days in agony before the disease killed him. Morphine in high doses hurries it along.

Did you ever think that a doctor has to describe an overdose of morphine in the way you quoted so as to keep his license since intentionally overdosing a patient to relieve suffering is illegal?

You know there are websites disagreeing with you? I have looked it up, and many say it doesn't speed up death.
Now in my opinion, and I give morphine to dying hospice patients at work, I think it does. I think it is also a good thing. Instead of taking a week, it can take a few days or even a few hours. The last resident I gave morphine too was just lingering, I started her on morphine around 7pm, and she was gone by 7am the next day.

I agree with you. I don't think morphine "hurries it along" but relieves the pain adrenaline rush that prolongs dying. I suppose it's possible that someone who is a real meditation practitioner may not want any sedating drugs while dying, in order to die consciously, but I've never personally known anyone that advanced. I have heard stories about masters of meditation and their abilities in the dying process.

There is even a meditation practice that one can master to consciously eject the living consciousness out of the boy. It's called p'howa.

 

[Iridescence]

However, there is a difference between Euthanasia and Assisted Suicide.

Obviously you recovered from your experience in the hospital. If Euthanasia were legal, whoever is the beneficiary of your life insurance policy could have pulled the plug on you on day six of your hospital stay and we would not have the pleasure of your presence here with us.

That is the problem with Euthanasia. I have mixed feelings about Assisted Suicide. I have no mixed feelings about Euthanasia. Euthanasia is an out for the greedy and the murderous.

Immie

Immie, your opinion about euthanasia may only reveal to you your own heart... Perhaps for future reference it may be best to not post such negative things.

Accordingly to my father, who I am a Medical Power of Attorney to, he would be offended and hurt if I were to reject his life insurance policy BUT NO MORE offended or hurt than I would be if he choose to have someone else to take care of him in his last days that was less equipped than I am. I would not deny him his companions but I would HOPE to be one of his favored caretakers. The money isn't much more than a way to provide the means to me. Sadly, even the most devoted and well-meaning medical practitioners have found that the best medical care does cost the most money, but it won't change the heart of matter for those of us who are from nothing and who can be resourceful enough to accomplish much with little.

There is a major difference between Euthanasia and Assisted Suicide. Therein, lies your problem. With Euthanasia, you are choosing to kill without the consent of the victim. That is homicide.

A person who has a DNR and/or has stated to his/her family that they do not want to be a vegetable or on life support has made the choice themselves and relies on the family to follow his/her wishes. Your description of your relationship with your father is as I have stated in this paragraph and is different than mercy killing which is what Euthanasia means.

My father died of cancer. He made it perfectly clear he did not want heroic measures taken to save his life. He didn't want to be a vegetable. He died in a Hospice house quietly and apparently pain free. Again, there is a difference between allowing someone to die with dignity and choosing to "put them out of their misery" without their prior consent.

Immie

Since working closer with my father (and another young lady works my off days) he has bounced back mentally to his youthful years. Not that he doesn't have days that he feels sick, but he has less of those days. He loves the company, and for a man who favored being single... that says a lot. The other lady even brings friends over some times seemingly just to encourage him to be his bad self. *hearts* This time with my father has taught me also to be a better wife... AND for THAT there is no amount of money that could mean more to my life, our home, and our family's productivity.

 

[Luissa]

You know there are websites disagreeing with you? I have looked it up, and many say it doesn't speed up death.
Now in my opinion, and I give morphine to dying hospice patients at work, I think it does. I think it is also a good thing. Instead of taking a week, it can take a few days or even a few hours. The last resident I gave morphine too was just lingering, I started her on morphine around 7pm, and she was gone by 7am the next day.

were you giving lethal doses or minimal timed doses?

There's a difference you know.

But there is not a defined line. There is a big difference in attempting to control pain with the realization it might hasten death and intentionally overdosing a patient. The difference is in intent.

It's a very fine line and it is very difficult for health care providers to walk and ultimately fruitless to try and rake people over the coals unless you have a slam dunk case.

We had an in service at work, after a few died, and our nurse said what we give some people would kill a normal person. I always wondered if that is true.
I always figured it was, especially since by the time they have reached that point they have been on so much other stuff. You should see the amount of codeine this one lady takes, along with having a fentanyl patch.
If I took the amount she does, I would probably end up the hospital or at least sleep for a few days.

 

[Sky Dancer]

It is very hard for loved ones to allow their dying family member to go naturally. Death is not always a pretty picture. A person can be in the "labor of dying" for several days. A person can appear to be dying, and bounce back some.

Nothing is cut and dried. That's hard for people who think in black and white moral absolutes.

 

[Skull Pilot]

It is very hard for loved ones to allow their dying family member to go naturally. Death is not always a pretty picture.

Dying naturally would mean no medical care, no drugs etc.

Very few people die naturally anymore.

 

[Luissa]

were you giving lethal doses or minimal timed doses?

There's a difference you know.

Really? Had no clue.

The amount we can give to a patient could kill a normal person, but I have never had to give that much, they usually died before it got to that point. You have to understand, their tolerance is up by the point, usually.

I understand tolerance but no matter how high one's tolerance to a drug, given enough one will succumb.

With my experience, hospice really controls the amount someone gets. Last summer I took care of a guy who was dying from lung cancer. He only could have a certain amount of caregiving hours, and had no family so he was on a drip. It is a little pack that they wear on their arm. In other cases, they had lock boxes and only the hospice nurse gave the med. They also have to follow a MAR, just like we do.

They are not just going to leave morphine around for anyone to get.

 

[syrenn]

I was with my father when we removed him from life support. It was a gut wrenching decision but we had no choice. It took an hour and a half for him to eventually die

I have also been with several pets that we have had to put down. The process takes a few seconds and they just pass away

I think we are more humane with our pets than with those we love

I agree.

 

[Skull Pilot]

Really? Had no clue.

The amount we can give to a patient could kill a normal person, but I have never had to give that much, they usually died before it got to that point. You have to understand, their tolerance is up by the point, usually.

I understand tolerance but no matter how high one's tolerance to a drug, given enough one will succumb.

With my experience, hospice really controls the amount someone gets. Last summer I took care of a guy who was dying from lung cancer. He only could have a certain amount of caregiving hours, and had no family so he was on a drip. It is a little pack that they wear on their arm. In other cases, they had lock boxes and only the hospice nurse gave the med. They also have to follow a MAR, just like we do.

They are not just going to leave morphine around for anyone to get.

In the scenario that prompted this discussion we were not using hospice as an example.

 

[geauxtohell]

We had an in service at work, after a few died, and our nurse said what we give some people would kill a normal person. I always wondered if that is true.
I always figured it was, especially since by the time they have reached that point they have been on so much other stuff. You should see the amount of codeine this one lady takes, along with having a fentanyl patch.
If I took the amount she does, I would probably end up the hospital or at least sleep for a few days.

It's true, but people habituate physiologically to morphine very quickly. if I took a dose of the oxycodone that Sickle Cell Patients take daily (and are perfectly lucid with) I would be knocked out cold. It doesn't really mean much to say: "would have killed a normal person" in trying to compare appropriate doses. For people that aren't opiate niave, you dose to try and control the pain level.

BTW, fentanyl is 1000X more powerful then heroin. After two months in the ER, the patient I saw in the most pain was someone withdrawing from fentanyl.

That includes the stabwounds and gunshot wounds.

People don't realize how potent that stuff is. Unless I were dying and in severe pain, I would never let someone slap that shit on me.

 

[Dr.Drock]

Skull and Sky you both make good points. None of us can say for certain if he would've died at the exact same time or even the exact same day without the morphine.

However IF he would've lingered on another handful of hours or a day in excruciating pain because the option of a lethal dose of morphine was taken away I would take serious moral issue with that.

You also have to understand, sometimes their tolerance is also a lot higher by that point. They can withstand more morphine than a normal person.

We get what is called E kits, and everything is pre measured, which I like. No way, would I want to be en charge of measuring out liquid morphine, even if the person is dying.

Thanks, you provide good insight.

In my particular instance my dad had little dropper type syringes full of morphine and this time he gave him WAY more than any other time. And this was a far advanced terminal patient so he'd had a lot before so you're right I'm sure his tolerance was up, however with the amount he gave him I'm not sure how any human no matter their tolerance could've lived through it without a medical procedure to undo it.

 

[syrenn]

You obviously don't know what the word "force" means. Nobody is forcing them to do anything. Dying can take place at any time and in any form. The fact that it makes you uncomfortable is no excuse to murder people.

It would seem that others opinions on the subject is what makes you uncomfortable.

The issues are simple.. you wold prefer to have people suffer long terrible painufll deaths. Others do not think that is humane.

 

[geauxtohell]

You are forgetting that in Drock's scenario the morphine was not given by a doctor and again the phrase more and more denotes that increasing dosages were given.

Morphine depresses respiration and in high enough doses causes respiratory arrest.

If morphine was withheld then he may have lingered for days in agony before the disease killed him. Morphine in high doses hurries it along.

Did you ever think that a doctor has to describe an overdose of morphine in the way you quoted so as to keep his license since intentionally overdosing a patient to relieve suffering is illegal?

You know there are websites disagreeing with you? I have looked it up, and many say it doesn't speed up death.
Now in my opinion, and I give morphine to dying hospice patients at work, I think it does. I think it is also a good thing. Instead of taking a week, it can take a few days or even a few hours. The last resident I gave morphine too was just lingering, I started her on morphine around 7pm, and she was gone by 7am the next day.

I agree with you. I don't think morphine "hurries it along" but relieves the pain adrenaline rush that prolongs dying. I suppose it's possible that someone who is a real meditation practitioner may not want any sedating drugs while dying, in order to die consciously, but I've never personally known anyone that advanced. I have heard stories about masters of meditation and their abilities in the dying process.

There is even a meditation practice that one can master to consciously eject the living consciousness out of the boy. It's called p'howa.

Morphine certainly hastens death. However, in patients that are terminal, death is inevitable. So they can either die as comfortably as possible or you can let them die while screaming in agony.

It's just a standard among care providers: "I will provide pain control, even if it shortens life, I will never intentionally shorten life."

It's legally defensible too.