Euthanasia

[syrenn]

"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

So whats the problem? If someone is dying... put them to sleep and end their pain.

They are dying.... giving them something to help end that painful process......

 

[Iridescence]

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.

While I do not dismiss or discredit what you post, there were examples given in the book that remind me of real life experiences in which provoke too much doubt to completely agree with what you post. When a body is obviously rotting... and yet 'the politically correct' thing to do is KEEP life support ON, it is inhumane and torturous. Granted, it does seem to be a blurred line, as many posting here does not agree that is euthanasia, but apparently some experienced doctors indeed DO.

Perhaps the whole issue NEEDS the distortions and confusions to come to surface so that they can be addressed on an individual basis so that DNR and whatever other necessary papers can be written out with specific desires and entrusted to the most dependable person available. IT is good that there be differences in opinions, it potentially provokes more specific instructions with those differences in mind. **Updating such said paperwork... keeping track records of health fluctuations and doctor records.** Paperwork alone can not always be the only source of expressed wishes. As Immie pointed out (and some others) sometimes intentions are not with the individual's best in mind.

I know... I am repeating what I post, it's just such a massively important subject that could ultimately make a huge difference in our healthcare 'crisis'.

 

[syrenn]

We don't know that, and we don't know what instructions he had from the doctor or nurse. If the morphine orders were for PRN, (per required need), then it is up to the caregiver. No harm, no foul.

Drock described it as "giving more and more morphine"

Now I don't know where you come from but that phrase did not describe a by the directions dosing.

Read the explanation in the post just below from a board certified hospice MD and you'll better understand.

Good.... read the highlighted area....THEY overdose the patient...

i suggest you read your own quote.

 

[Dr.Drock]

My wife is going in for her one year cancer check up today. She had breast cancer last year.

Hope all turns out well.

Crazily enough my stepmom had it when she was 19, she's like 52 now and has been good ever since.

 

[geauxtohell]

Sorry but the description of the scenario was that of an overdose.

We don't know that, and we don't know what instructions he had from the doctor or nurse. If the morphine orders were for PRN, (per required need), then it is up to the caregiver. No harm, no foul.

Wrong... PRN still has it limits. You are given the allowable amount for a given time period....as needed. A good deal of the time..what is given to relieve pain...is not enough to relieve the pain.

A PRN order means diddly squat when one is sent home with a bottle of morphine or any other heavy duty narcotic be it in pill or liquid form.

Why is that so hard to understand?

If a person is sent home with pain medicaitons and chooses to take their own life with it, then what buisness is that of the rest of the world? They choose suicide rather than suffering. It was still their choice and action.

A person can OD on a virtually every other medication in their cabinet too, to include tylenol.

Why does that change with morphine?

 

[Sky Dancer]

There is a difference between assisted suicide, euthanasia and giving a dying patient enough pain medication to allow them to die peacefully.

I know a caregiver who shot her patient because the patient asked her to. The patient was mentally ill, and physically ill and medications did not work for her.

This is wrong.

This is what some people here would do. The ones who have problem killing others.

Of course that's wrong. Outside of the sociopath nurse that intentionally OD'd about 100 old ladies that were relatively healthy, that's an extreme case. Both in using the gun and in not considering the patient's mental condition. I mean, in real life we commit people with suicidal ideations, we don't "respect their wishes".

I disagree with euthanasia. On the other hand, you have people on this board who have no frigging clue about anything who would withhold morphine from people in agony. I'll bet they've never had to listen to someone wail in agony as they are dying.

That's equally stupid. We don't have to be rigid on this issue. We can respect treating pain and understand a consequence of that might be death or the shortening of life.

The issue is never going to be clear cut. So health care providers are going to continue to have to do the best they can.

Also, any patient has the right to refuse care. So for the cavelier "no morphine" crowd. Rest assure, you can put down "NO NARCOTICS!" in writing and it will be respected and suffer your way into the great beyond.

Just stop trying to drop your fucking moral code on the rest of us who don't wish that for our families.

I'm not. I completely agree it's a family decision on a case by case basis.

Some people kill their loved ones out of their own selfishness because they can't allow their loved ones to die naturally.

Intent, motivation makes a difference.

There are certain people so hot to kill I wouldn't want them near me when I'm dying.

 

[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

So whats the problem? If someone is dying... put them to sleep and end their pain.

They are dying.... giving them something to help end that painful process......

It's a fine line of semantics that doctors walk so they can't be accused of intentionally committing euthanasia.

A Dr says he's administering huge doses of narcotics or opiates to relieve pain knowing damn well that the secondary effect very well may be death but since he says his intent is not to cause death he is ethically and legally shielded.

 

[Sky Dancer]

My wife is going in for her one year cancer check up today. She had breast cancer last year.

Hope all turns out well.

Crazily enough my stepmom had it when she was 19, she's like 52 now and has been good ever since.

Thanks for your kindness. Everyone in her family has died of cancer.

 

[Sky Dancer]

My wife is going in for her one year cancer check up today. She had breast cancer last year.

I wish you guys the best.

She's on my mind this morning.

 

[Skull Pilot]

Wrong... PRN still has it limits. You are given the allowable amount for a given time period....as needed. A good deal of the time..what is given to relieve pain...is not enough to relieve the pain.

A PRN order means diddly squat when one is sent home with a bottle of morphine or any other heavy duty narcotic be it in pill or liquid form.

Why is that so hard to understand?

If a person is sent home with pain medicaitons and chooses to take their own life with it, then what buisness is that of the rest of the world? They choose suicide rather than suffering. It was still their choice and action.

A person can OD on a virtually every other medication in their cabinet too, to include tylenol.

Why does that change with morphine?

it doesn't. It's the naive belief that morphine isn't used to hasten death that is the issue I'm arguing.

 

[Sky Dancer]

Drock described it as "giving more and more morphine"

Now I don't know where you come from but that phrase did not describe a by the directions dosing.

Read the explanation in the post just below from a board certified hospice MD and you'll better understand.

Good.... read the highlighted area....THEY overdose the patient...

i suggest you read your own quote.

You disagree with everything I say just to be obnoxious. The doctor stated that it is NOT euthanasia to give a patient morphine prn. It is has to do with intent. In your case, it would be euthanasia because you're out to kill the patient because YOU think they're suffering and can't stand to see it.

You have to have a big heart to attend the dying. You have to open yourself to the reality of the dying process.

 

[syrenn]

And this is what happens...we've removed all sense of responsibility of family from the process of death. Not only do they no longer bear the financial burden for the most part, they don't have to provide care any more, either. And the result of that is when they DO see pain, suffering, and the advent of death, they freak out..."KILL THEM OFF KILL THEM OFF OH THE HUMANITY!"

Grow up. Dying is a part of death. You don't get to hurry it along, or make the decision for other people that it's their time.

I hope you wont die a long slow painful death then. Pray for catastrophic event.

KG is completely ignorant of what really goes on in hospices, hospitals, and ICUs and likes to demonstrate it for the rest of us.

The "family" hasn't been removed. Rather, we know have innovations that allow us to bring people back and prolong life far beyond the point of where it was in the past.

That's a good thing, but it's a dual edged sword. This is the other side of the enlargement.

yeah..i know.

 

[geauxtohell]

While I do not dismiss or discredit what you post, there were examples given in the book that remind me of real life experiences in which provoke too much doubt to completely agree with what you post. When a body is obviously rotting... and yet 'the politically correct' thing to do is KEEP life support ON, it is inhumane and torturous. Granted, it does seem to be a blurred line, as many posting here does not agree that is euthanasia, but apparently some experienced doctors indeed DO.

Most doctors do not. Not to diminish the author, but he's a psychiatrist. Until it was personal, his scope of practice didn't involve caring for patient's with medical problems (unless I missed that he was in internist). I mean, psychiatrist's defer to medicine to manage blood pressure (I don't know why. It's a whole other topic I suppose).

There are other issues that aren't strictly euthanasia that I agree with. Specifically the brain dead that remain on a ventalator and artrificial respirator until they invariable die of sepsis because their family won't remove care.

Perhaps the whole issue NEEDS the distortions and confusions to come to surface so that they can be addressed on an individual basis so that DNR and whatever other necessary papers can be written out with specific desires and entrusted to the most dependable person available. IT is good that there be differences in opinions, it potentially provokes more specific instructions with those differences in mind. **Updating such said paperwork... keeping track records of health fluctuations and doctor records.** Paperwork alone can not always be the only source of expressed wishes. As Immie pointed out (and some others) sometimes intentions are not with the individual's best in mind.

I agree. I recently lost my grandmother. My family members found her as she was fading. She had a strict DNR/DNI. Later one of my family members was upset that they didn't do compressions. I was able to point out that it was against my family member's wishes for her to do compressions and that provided comfort. Everyone needs a DNR or a DNI. However, that requires people do the responsible thing and plan for their death. That's usually a hard sell.

I know... I am repeating what I post, it's just such a massively important subject that could ultimately make a huge difference in our healthcare 'crisis'.

If you are interested in this, I recommend reading Bill Colby's books about the Nancy Cruzan case and his subsequent books. He has an interesting take on the matter.

However, that involves the removal of care and not euthanasia. The semantics are important between withdrawing care, euthanasia and physician assisted suicide.

 

[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

So whats the problem? If someone is dying... put them to sleep and end their pain.

They are dying.... giving them something to help end that painful process......

It's a fine line of semantics that doctors walk so they can't be accused of intentionally committing euthanasia.

A Dr says he's administering huge doses of narcotics or opiates to relieve pain knowing damn well that the secondary effect very well may be death but since he says his intent is not to cause death he is ethically and legally shielded.

No, it's not. It's intent. When my dog was dying I gave him pain meds. I was trying to let him die naturally. I did not have an aversion to his condition or a selfish motivation to put myself out of suffering.

 

[syrenn]

And this is what happens...we've removed all sense of responsibility of family from the process of death. Not only do they no longer bear the financial burden for the most part, they don't have to provide care any more, either. And the result of that is when they DO see pain, suffering, and the advent of death, they freak out..."KILL THEM OFF KILL THEM OFF OH THE HUMANITY!"

Grow up. Dying is a part of death. You don't get to hurry it along, or make the decision for other people that it's their time.

Watch someone die a slow death from cancer or dementia, then we will talk.
It isn't about killing them, it is about not making them suffer anymore.

Working in medicine changes your views doesn't it? I agree... after you have been there and done it first hand....then you can talk.

 

[geauxtohell]

A PRN order means diddly squat when one is sent home with a bottle of morphine or any other heavy duty narcotic be it in pill or liquid form.

Why is that so hard to understand?

If a person is sent home with pain medicaitons and chooses to take their own life with it, then what buisness is that of the rest of the world? They choose suicide rather than suffering. It was still their choice and action.

A person can OD on a virtually every other medication in their cabinet too, to include tylenol.

Why does that change with morphine?

it doesn't. It's the naive belief that morphine isn't used to hasten death that is the issue I'm arguing.

Oh. I agree with that to an extent. It's accepted that morphine hastens death. The patient and family is made to understand that. It's also accpeted that it's use is to prevent suffering.

It is the final consensus that it's a balancing act that doesn't operate with 100% efficiency.

As long as people understand that, there is no arguement.

That is not "euthansia" per se. The intent is not to kill the patient. It's too control their pain.

 

[Sky Dancer]

And this is what happens...we've removed all sense of responsibility of family from the process of death. Not only do they no longer bear the financial burden for the most part, they don't have to provide care any more, either. And the result of that is when they DO see pain, suffering, and the advent of death, they freak out..."KILL THEM OFF KILL THEM OFF OH THE HUMANITY!"

Grow up. Dying is a part of death. You don't get to hurry it along, or make the decision for other people that it's their time.

Watch someone die a slow death from cancer or dementia, then we will talk.
It isn't about killing them, it is about not making them suffer anymore.

Working in medicine changes your views doesn't it? I agree... after you have been there and done it first hand....then you can talk.

You work in medicine and kill your patients?

 

[koshergrl]

And this is what happens...we've removed all sense of responsibility of family from the process of death. Not only do they no longer bear the financial burden for the most part, they don't have to provide care any more, either. And the result of that is when they DO see pain, suffering, and the advent of death, they freak out..."KILL THEM OFF KILL THEM OFF OH THE HUMANITY!"

Grow up. Dying is a part of death. You don't get to hurry it along, or make the decision for other people that it's their time.

Watch someone die a slow death from cancer or dementia, then we will talk.
It isn't about killing them, it is about not making them suffer anymore.

Working in medicine changes your views doesn't it? I agree... after you have been there and done it first hand....then you can talk.

What on earth makes you think I haven't? My father died of a particularly awful cancer (throat) and mother in law died of alzheimers. I cared for both.

 

[MikeK]

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.

You certainly are entitled to that opinion. But I believe the majority will disagree with it because it conflicts with the most basic concept of mercy.

 

[Sky Dancer]

Watch someone die a slow death from cancer or dementia, then we will talk.
It isn't about killing them, it is about not making them suffer anymore.

Working in medicine changes your views doesn't it? I agree... after you have been there and done it first hand....then you can talk.

What on earth makes you think I haven't? My father died of a particularly awful cancer (throat) and mother in law died of alzheimers. I cared for both.

She thinks she's the only one who knows anything.