Mad Kally

Fair enough.

winstonjen

I was referring to when a patient is taken off a ventilator and 'let die.' If you try holding your breath, it gets extremely painful, and eventually you'll pass out and resume breathing. Imagine the pain for those who can no longer breathe without a respirator. The amount of morphine the would need could well kill them.

Mad Kally

If the patient was alert and oriented enough to know what's happening, taking them off the ventilator would be murder. Usually brain death = death.

There is NO limit to the amout of morphine a patient can take. What would kill us might just take the edge off the pain to a patient.

winstonjen

So you see no difference between pulling the plug on life support and giving them a lethal injection?

In my opinion, consent is the key. If the patient wants to be killed/let die, then it is not murder.

Really? Morphine suppresses breathing and that is how it hastens death.

Mad Kally

I am talking about the tolerance that builds up over time.

winstonjen

I see. I misunderstood what you were saying then. Sorry.

However, there are doctors who perform euthanasia using morphine 'for as long as it takes', and then falling back on the doctrine of double effect excuse. What are your thoughts on that?

Dr Rick

Healthcare providers have a moral and professional obligation to minimize suffering and offer adequate analgesia or pain relief to a dying patient. Very high doses of opiods are sometimes necessary to accomplish this goal, doses sometimes high enough to suppress respirations or cause hypotentsion and potentially hasten death. This is legal and moral as long as the patient or his/her proxy is aware of the risks and consents to accept them, and the intent is not to kill the person but instead to relieve his/her suffering. The alternative, to allow someone to suffer needlessly is an unacceptable violation of our sworn duty and grounds for disciplinary action by licensing boards and/or malpractice litigation.

http://www.postgradmed.com/issues/20...torial_sep.htm

Rick

winstonjen

OK, but what is more important to you - whether something is legal or whether it is moral? What if conservative pro-lifers got their way, and outlawed 'passive' as well as active euthanasia, and they made it illegal to prescribe morphine in mass amounts because it 'may' hasten death, would you obey the law, or what you think is best for the patient?

Personally, the 'sworn duty' should be to respect the autonomy of the patient first. Anything else is secondary.

Dr Rick

That's a false dichotomy; they are both important. Physicians are obligated to do what is moral and what is legal. Failure in either regard is grounds for censure and discipline.

I do not understand what you mean by "passive euthanasia;" euthanasisa is a pro-active process by definition

You aren't the first person to have figured that out.

Rick

Mad Kally

Now really. What are the odds of that happening?

Winston, we have a code of ethics to remember. I would never deliberately break the law by bumping off a patient. My hospice patients don't want to die anyway! How many times have I said that in different threads. I've also reminded you several times that morphine slows respirations and can hasten death. However, their tolerance for morphine and other narcotics builds up at the same time.

My patients do NOT scream in pain and beg to die! Where do you get all this information? One article in a newspaper? I'm really curious.