Morphine Not A Killer - Specialists
March 2nd 2007
Families who think that large quantities of morphine will allow a peaceful death for terminally ill patients are wrong, specialists warned today. A recent court case saw a woman pleading for doctors to sedate her into "unconsciousness".
But according to Claud Regnard, a palliative care specialist, this was a "puzzling choice".
Writing in the British Medical Journal, Dr Regnard, of the St Oswald’s Hospice, Newcastle upon Tyne, UK, asserts that morphine is "well tolerated" and does not shorten life or hasten death.
Its sedative effects, also, wear off quickly and overdoses simply cause "distressing agitation", he said.
In Holland where euthanasia is legal, morphine is hardly ever used, he said.
"Doctors who act precipitously with high, often intravenous, doses
of opioids are being misled into bad practice by the continuing promotion of double effect as a real and essential phenomenon in end of life care," he said.
The journal Palliative Medicine makes the same point today, reporting a study of 30 patients. This study, according to its authors, shows that morphine can relieve severe pain without preventing breathing.
The study was conducted at the Taussig Cancer Center, Cleveland, Ohio, USA.
Dr Regnard also writes in the journal with Dr Rob George, of University College, London.
Dr George said: "Unlike many other drugs, morphine has a very wide safety margin. Evidence over the last 20 years has repeatedly shown that, used correctly, morphine is well tolerated, does not cloud the mind, does not shorten life, and its sedating effects wear off quickly.
"This is obviously good for patients in pain, but not for those who want to be put into a coma."
BMJ Volume 334, p440, Palliative Medicine 2007;21:77 – 80, 81-86
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