Euthanasia Issues...
True Dignity Through Pain Management
Why should I have to die in pain if 1 don’t want to?
You shouldn’t have to. Thanks to recent medical breakthroughs, practically anybody can have his or her pain completely relieved and die in comfort and dignity without being put to death like a pet.
But if l have to live in a drugged coma, I might as well be dead.
That’s just it. You don’t have to feel drugged. With modem pain-control techniques3 you should be comfortable and dear-headed, even with cancer all through your bones - like my brother had when he died.
If that’s true, then why do so many people die in pain?
There are several reasons. Many doctors and nurses in this country have not been trained in modern pain-control techniques; they mean well, but just don’t know how to keep people both comfortable and clear-headed. Patients and their families are often afraid to take effective doses of drugs. Insurance plans frequently don’t cover Hospice or other comfort measures, occasionally, pharmacies refuse to fill prescriptions large enough to be effective.
What can I do to get the care I need?
The first thing to do is to find a doctor who knows about pain control. A good doctor should ask how bad your pain is, and believe you. He or she should ask you when and how often it happens, what factors make it better, what makes it worse.
He or she should know that not all pains are the same: bone pain, organ pain, nerve pain can be quite different. Your doctor should try to figure out which is causing your pain, because different kinds of pain often need different kinds of treatment.
What if my doctor doesn’t know much about pain?
Your doctor may be willing to refer you to a pain specialist or pain clinic, if you ask. If not, the nurses at your local Hospice usually know who’s good and who isn’t, and often will be willing to refer you. If you are in pain, you need a doctor who knows what he or she is doing.
What if my treatment stops working?
Sometimes pain will change in severity or pattern because it is coming from a different place; this may call for reassessment, or for a change in treatment. Knowing where the pain is coming from and why, is an important key to effective relief.
There is a wide range of choices for controlling pain. Most pain can be controlled by oral medications. Medicine should be given "by the ladder’ - starting from aspirin and moving up step by step to morphine - and "by the clock" - not after it starts to hurt. (It takes a lot more medicine to get pain under control than to keep it under control).
You and your doctor should know that there is no maximum dose of morphine. You can safely take as much as your pain requires. You build up until the pain is gone; then take maintenance doses "by the clock" to keep the pain away.
* You needn’t fear overdosing, because pain neutralises the respiratory side-effects of morphine.
* You and your family needn’t fear addiction for it Is extremely rare in this setting, and basically irrelevant.
* You needn’t suffer pain now In order to "keep the drug effective" for later; tolerance can be safely overcome by increasing dosage as high as is needed.
* And you needn’t fear feeling "drugged"; there is a wide margin of safety between the dose of drug which kills your pain, and the dose which makes you feel "high" . Both doses go up as the pain gets worse, so you should never find yourself feeling groggy. If you do, you will need to cut back a little, to the dose that controls your pain without making you feel "drugged".
What about side-effects?
Your doctor should anticipate, and treat, side effects like constipation and nausea, which can be prevented most of the time. Drowsiness is normal for the first few days of real comfort, as the body catches up on its sleep.
What if I can’t take pills?
Individuals who cannot eat often require rectal, intravenous or subcutaneous pain medicine; sometimes the simplest technique is to drip pain medicine around the involved nerves through a small reservoir which rests under the skin. In rare cases, more exotic means are needed to control pain, including local nerve blocks, X-ray or chemotherapy.
What else can I do?
In order to help your doctor, it is vitally important that you give an honest account of your pain. Don’t try to "please" by understating your pain. If you do, you may end up suffering unnecessarily. If your need for pain medicine changes, don’t be shy. Your doctor Is there to Fine tune" your care, and would rather hear from you as often as necessary than to find you suffering in silence. His or her sense of professional accomplishment comes from knowing that you are comfortable and doing well; doctors know that keeping everything adjusted property takes a lot of communication and time. We expect to hear from you when changes need to be made.
So don’t despair. Pain can almost always be controlled. Pain is never a reason to die, nor to ask your doctor to kill you. If you feel that you truly want to die, you could be depressed; that should be checked, because depression can almost always be successfully treated. Call your doctor, or your local Hospice for advice and help. With compassionate Hospice-style care, you will almost certainly regain you desire to live.
Pain Management, Patient Dignity and Euthanasia
What is "Death with Dignity"? People who advocate physician-assisted suicide or direct euthanasia ("mercy killing") tell us that death is the Compassionate answer to the suffering of terminal illness. But we have seen that modem care techniques like Hospice relieve physical and emotional suffering so well that people in Hospice hardly ever want "the right to die". They prefer to live with dignity and to die a natural death.
Maintaining true dignity for the dying requires that we, as caregivers, value patients as people even as their bodies and capabilities decline. Often the last few hours, or days, of life are the most valuable to patient and family alike, as old hurts are healed, old wrongs forgiven, unspoken love expressed. Offering euthanasia as a short-cut to dying could steal the most precious moments of life.
No society in history has had the possess to provide every person with and natural death. If other societies options have considered it uncivilised intentional killing, how can we embrace it?
RIGHT TO LIFE AUSTRALIA
P.O. Box 70
EAST BRUNSWICK VIC 3057
Ph. (03) 9387 7098