Many doctors have been reluctant to administer heavy doses of pain killers to terminally ill patients for fear that the patient will die from an overdose, according to the National Hospice and Palliative Care Organization (NHPCO), Alexandria, VA. This has been taken as an argument for euthanasia or assisted suicide, but is not justified:

• Giving drugs to relieve pain and suffering even if a foreseen but unintended effect is to shorten life is not euthanasia (Catholic Health Alliance of Canada).
• Doctors have found that heavy doses of opioids (e.g., morphine) to dying patients in great pain do not inevitably or cause death.

Needless suffering

The NHPCO conducted a study of hospice patients published in the December 2006 issue of the Journal of Pain and Symptom Management. It found the doctors’ fears are groundless and cause needless suffering:

• The study suggested that effective use of opioids actually poses little risk of hastening death.
• Under treatment of pain is a far more pressing concern than the risk of hastened death in people with advanced disease.
• Available research indicates that physicians should be encouraged to use opioids effectively to relieve suffering at the end of life.
• The 725 people in the study died at different lengths of time after being given different doses of pain killers, but the different doses seemed to have no effect on how ling each person lived.

A 1997 NY Times article by Gina Kolata quoted Dr. Balfour Mount, a cancer specialist at McGill University in Montreal and now Emeritus Professor of Palliative Medicine, who said it is “a common misunderstanding that patients die because of high doses of morphine needed to control pain.”

When morphine kills, it does so by stopping breathing. The same NY Times article quoted Dr. Joanne Lynn, director of the Center to Improve Care of the Dying at George Washington University School of Medicine, as saying that when doctors gradually increase a patient’s dose of morphine, the patient becomes more tolerant of the drug’s effect on respiration than of its effect on pain. As the pain worsens and higher doses are administered, there is little effect on the patient’s breathing.

The bottom line:
It’s not necessary to legalize euthanasia to give doctors the legal ability to administer heavy doses of pain killers to dying patients.

See also:  Palliative Care Threatened by Euthanasia and Assisted Suicide (Bill C-384)