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I'm not taking a position on this or trying to argue. I'm truly somewhat confused by it all. I'm not sure I agree with this, as I find it, honestly, rather frig

I'm not taking a position on this or trying to argue. I'm truly somewhat confused by it all. I'm not sure I agree with this, as I find it, honestly, rather frightening in practice, but it seems like painkiller administration is a kind of euthanasia loophole, even in places where euthanasia is not legal: Passive euthanasia is the withholding of treatments necessary for the continuance of life. Whether the administration of increasingly necessary, albeit toxic doses of opioid analgesia is regarded as active or passive euthanasia is a matter of moral interpretation, but in order to pacify doctors’ consciences, it is usually regarded as a passive measure. Many people, therefore, regard it as an acceptable facet of good professional practice. https://jramc.bmj.com/content/147/3/367 https://jramc.bmj.com/content/147/3/367

mikeash 8y ago
I have heard of that sort of thing as well. It seems to be a sort of a wink and a nudge situation, where you up their painkiller dose and say, gee, that’s a lot of drugs, I sure hope it doesn’t have any bad effect on them, wink wink nudge nudge! And then: oh no, they died, how completely unforeseen! The facade of what I said is maintained, but the reality is more complex, as usual. This strange denial means things can get difficult in unusual circumstances, such as when your patient is making the national news. It’s hard to wink and nudge when not everyone is playing along.
joshgel 8y ago
Depends on intent. If patient is in pain (and we know because they tell us or because we think they look like they are in pain), we treat the pain. If treating that pain results in them having a shorter life, that's acceptable morally and legally. And I do not consider this active or passive euthanasia since there is a legitimate medical purpose for that medication. If we gave someone an overdose for the purpose of ending their life, that is active euthanasia in the United States (I am unclear if it is different elsewhere and I agree it isn't so clear at the end of that abstract from a British author.)
taneq 8y ago
> it seems like painkiller administration is a kind of euthanasia It absolutely is. A relative of mine had a stroke and was on the way out. The nursing home staff told us they couldn't give him anything to help hasten the end but if you think he's in pain...? [expectant stare] It took a few rounds of this before we twigged and completed the ritual. "Yes, I think he's in pain."
rootw0rm 8y ago
As caregiver for my grandfather, who had end-stage dementia and then pancreatic cancer, I can say this is true. In home hospice care basically instructed us to OD him on morphine to end his suffering.

mikeash 8y ago

I have heard of that sort of thing as well. It seems to be a sort of a wink and a nudge situation, where you up their painkiller dose and say, gee, that’s a lot of drugs, I sure hope it doesn’t have any bad effect on them, wink wink nudge nudge! And then: oh no, they died, how completely unforeseen! The facade of what I said is maintained, but the reality is more complex, as usual. This strange denial means things can get difficult in unusual circumstances, such as when your patient is making the national news. It’s hard to wink and nudge when not everyone is playing along.

joshgel 8y ago

Depends on intent. If patient is in pain (and we know because they tell us or because we think they look like they are in pain), we treat the pain. If treating that pain results in them having a shorter life, that's acceptable morally and legally. And I do not consider this active or passive euthanasia since there is a legitimate medical purpose for that medication. If we gave someone an overdose for the purpose of ending their life, that is active euthanasia in the United States (I am unclear if it is different elsewhere and I agree it isn't so clear at the end of that abstract from a British author.)

taneq 8y ago

> it seems like painkiller administration is a kind of euthanasia It absolutely is. A relative of mine had a stroke and was on the way out. The nursing home staff told us they couldn't give him anything to help hasten the end but if you think he's in pain...? [expectant stare] It took a few rounds of this before we twigged and completed the ritual. "Yes, I think he's in pain."

rootw0rm 8y ago

As caregiver for my grandfather, who had end-stage dementia and then pancreatic cancer, I can say this is true. In home hospice care basically instructed us to OD him on morphine to end his suffering.