Doctors' Secret for How to Die Right

reply to post by MystikMushroom


Yeah, they withheld morphine from my dad and my husband both - it is more of a whack-you-out-of-it, I-don't-care thing. And after, often patients don't remember those days at all.

In both cases (both were lung-related), they said it was too risky to suppress the respiration by giving enough morphine to kill the pain.

I've been on a morphine drip myself (for a broken arm) - in the ambulance, AND in the hospital. It didn't kill the pain, just made me loopy. (I didn't have much pain to being with - it was a clean 45-degree snap just above the wrist where my watchband was - I'd been bucked off a horse)...and the more morphine they gave me, the more my toes tingled...but it didn't change the way my arm felt (not too bad.)

Wildtimes, I thoroughly appreciate you posting this thread. Knowing the contents of that article now, none of it surprises me in the least. So many things about "modern" medicine are kept secretive, especially whether doctors themselves would accept the treatments they dish out.
When it comes to the end of ones life, I have never understood the drastic measures taken to prolong the inevitable. It's inhumane to watch someone die in extreme agony, yet we would put down an animal quickly so it did not suffer.
This subject has roused the anger in me of my own experience when my mother passed.
She was hospitalized, after her third fight with cancer. It was in her bones and was spreading. Radiation had left her weak, and in even more pain. We were optimistic though that she had time left, perhaps a year. I was making arrangements for home care.She had though, a DNR order in place with the hospital, in case. I suppose I was in severe denial at that time.
So when the hospital called me that Mom had taken a turn for the worse, I honestly didn't register it.
I got to the hospital, and she was on oxygen, and morphine, nothing else. I was escorted to the doctors office so he could talk to me. Well, I waited. And waited...for about 45 minutes. Finally I got up and walked back to my mothers room...
* tears as I write this even 20 years later...
Her last words to me were, " Well what did you find out?"
Then her eyes fixated, and her breathing stopped. I screamed for the nurse, and then, only then did the doctor show up and said to me, " It's ok she's just dying."
I have never felt such a wave of sorrow and hatred at the same time. Robbed of the few precious moments I could have had with her. So much left unsaid. They left me for a few moments with her, and I went over and opened the window to a cool yet sunny spring day. In my mind I thought her spirit wanted out of there, and that was the only way I knew how.
When he returned to the room, he actually had the audacity to ask me if I wanted an autopsy! What for you ask? Because they wanted to know WHICH ONE OF THE CANCERS was responsible for her death. I had a fit. Then while my mothers body is still warm in front of me the nurse brings in a garbage bag , PLACES IT ON MY MOTHERS BODY and begins to empty the drawers of my mothers things so they can quickly vacate the room.
Because of the horrible indignity and lack of compassion I witnessed, I WILL NEVER, EVER, be taken to hospital, let alone allow any kind of life support. I'd rather crawl into the woods and die under a tree and let my body return to earth the way nature intended.
Nothing about health care, from birth to death is about anything but money, and I'll never believe otherwise.
I remember reading somewhere a long time ago, about a woman who had a somewhat morbid hobby of looking up the obituaries of doctors to see exactly how they died. She had quite a collection. Really interesting when your cardiologist dies of a heart attack or your oncologist, cancer.

Death is the dawning of a new day, come to scatter the darkness and frost of a long, cold night.

Whenever it is "my time" to go, if its quick and relatively painless, Ill wait for it. If its slow and painful, Ill have no problem killing myself in a painless way, of which there are many to choose from. I see no need to suffer needlessly, and dont place any merit in the idea of "the longer I can live the better". If quality of life has plummeted, and you now live to suffer, IMO there are very few reasons to stick around.

Assisted suicide is a good idea, especially for those in great suffering. Some of those schedule 1 drugs that have "no accepted medical benefit" (lol) could be put to good use to give a very sick person both a pain-free death, and the lucidity to communicate with family and friends who are there with them.

In fact I think thats done in some places in Europe from what I heard years ago.

reply to post by AccessDenied


I'm so saddened by your experience.
I'd have left the doctor's 'office' (waiting to talk to him), and told a nurse "He can find me in mom's room."

I'm pretty mouthy when it comes to dealing with hospital staff...

I'm sorry you had to go through that, and sorry for bringing your pain back out in the open.
You did your best...and your mom knows that.

Brightest blessings, AD.

reply to post by AccessDenied


That is a very sad story about you and your Mother. I'm so sorry for you.

MysticMushroom: I'm not bitter at Hospice at all. I was initially, due to ignorance. I wasn't quite sure what their intention was. And upon learning, it's hard to digest. At that point, I thought medicine and whatever chemo was up next, was the answer. Boy was I wrong.

Hopsice never told us what that the morphine would speed things up either. I think maybe they are afraid the family would wig out. Understandably so. Morphine is a "two birds with one stone medicine."

reply to post by CaticusMaximus


Yeah, me, too....not "the longer I can live the better".....
no, "the better I can live, whatever" - live in a permanent coma? No, thanks - though it's weird to know that people spontaneously 'return' from long-term comas unexpectedly. Live as a vegetable on machines, waiting for a 'cure' to be developed? Erm, no, thanks. Let me go.


Thanks for posting your thoughts.

OrphanApology

Why is it that the worst criminals go out painless yet people don't have a choice to do the same themselves?

People DO have that choice.

Sometimes its not "legal" to do so depending on the method, though, and thats what hangs people up... they are programmed to care what is arbitrarily legal and what is not concerning their own sovereign spirit.

But people do have the choice. For instance, Conium (Hemlock) grows wild all over Europe, Asia, and North Africa, and is an "invasive species" in 12 US states but also grows pretty much all over North America. 100mg of leaf material is fatal, which would be like 2 or 3 of the tiny leaves on the plant. Basically the amount of material is so small, Im not sure a person would even be able to detect its weight resting in their hand.

Conium is a paralytic and sedative; pain would not be present. In fact death works essentially the same way with Hemlock as it does with other chemicals; it stops the breathing of the body (same way morphine (and all opiods) function in high doses).

Theres also a correctly aimed bullet.

Or helium.

Or dynamite for the adventurous.

Point being, people do have a choice of ending their own lives painlessly, and in some cases, effectively instantaneously.

Its just the programming of religion and obedience to the law that, IMO, holds people back who would really rather just be out of here.

But yes I fully agree that assisted suicide should be fully available, if only for convenience purposes.

reply to post by wildtimes


I was told by the nurses to wait,and was too young to know any different. If nothing else my suspicions about morphine have been verfied here,as well as the discussion of the rights to end ones life with dignity. This should definitely be discussed more.

OP and I don't agree. What a shock. But this thread has been informative. In my father's last days I had to move him to the local nursing home. There simply was no other choice. All the tests came back that he was close to death, so they gave him oral morphine. But what was strange about it was that the nurse said, "If you think we ought to give him more, just tell us."

I thought it was kind of strange at the time, since I'm not a medical person and really have no idea what morphine is other than I know it was a narcotic. I thought it was good if they would 'ease his pain' and all. I did not ask for more. Within 48 hours he was dead. It wasn't unexpected, of course, but I never thought they would be helping him along--and maybe they didn't. But in hindsight and with this conversation their statement to me makes a lot more sense. I just did not pick up on what they were probably really asking.

And I'm kind of glad I didn't. had I understood their likely real meaning and asked for them to give him more, would I have been effectively pulling the plug? I'm glad I was clueless.

reply to post by schuyler

OP and I don't agree. What a shock. But this thread has been informative. In my father's last days I had to move him to the local nursing home. There simply was no other choice.

Really?
"There simply was no other choice"

?

You could not have taken him home and nursed him yourself?
You "had to move him to the local nursing home"?

And yet you begrudge my mother making a decision to allow family to be there before she TOOK HIM BACK HOME to die peacefully in their bed.

Wow, schuyler.

Yeah, we disagree. What a shock.
:eyeroll:

reply to post by AccessDenied


No worries, dear. You did your best.
I'm so sorry for your hardship.
Don't beat yourself up about it. It's a dialogue that the USA needs to have, but is avoiding.

I better get something in writing about not keeping me alive if something happens that will leave me severely crippled. We have good insurance presently, they will put me through every test that they can. I don't want to be tortured in the end of my life.

I suppose I can wait to die till the medical industry gets it's act together and is completely honest. I guess I will be immortal if that is the case.

reply to post by wildtimes


My mother died of pancreatic cancer.

She was a VERY loved person to everybody she ever met. A sort of inspiration to people around her. She was amazing.

She was also a RN.

When she was on the last stretch, we all knew she was fully aware of what was ahead of her having seen it her whole professional life.

That changed things. We didnt know how to respond to her. How to explain that death was just inevitable. We didnt have to, she knew better than us what was ahead. She was only concerned with the pain and torment she would have to endure until she died.

Well, one day she reached over to answer the phone, but since her hospital bed was a little large she leaned over too far and fell from her bed. She hit her head pretty bad and was put on allot of morphine.

She died shortly after. She didnt suffer even half of what was in store for her. Hospice, pain, gloom...

She didnt deserve that. Once her battle was fought and lost, she deserved to go peacefully.

I am so glad that things happened the way they did. She left in her sleep. Gracefully. She even had a smile.

I think sometimes it is more humane to let people die. My mom wouldnt have deserved our inability to deal with her mortality. She knew she was dying and wanted to just go.

She was deeply spiritual. A radio to God, like all the women in my family were /are.

She wasnt scared in the end. She was just worried about the pain. I am glad she was spared that.

what i have always wondered is why don't they just disconnect the nerves that carry pain when a person is terminal. My sisters Mother-in law died of stomach cancer and the morphine was doing nothing for the pain at the end.

In the UK a lot of hospitals and respite homes are using the Liverpool Care Pathway for the Dying for those who are terminal.

Feel free to read up on it as I would certainly encourage you to but in essence it's about allowing someone to die with as much dignity and in as much comfort as is possible. It's all about palliative care rather than treatment.

My sister died earlier this year and I was grateful she was placed on the pathway as the illness she had was untreatable and extremely painful.
Although she did suffer near the very end I felt the pathway allowed her to still remain human rather than a completely anaesthetised non-being until her death.

reply to post by Pardon?


Hmmm!!
I did just look it up. Seems it's getting mixed reviews - and has recommendations for improvement.

Guidance For Care For The Dying

3.1 The Review panel recognises that, in the right hands, the Liverpool Care Pathway can provide a
model of good practice for the last days or hours of life for many patients. The ambition to
transpose hospice-like standards of care into the hospital setting is admirable: before the
widespread introduction of the LCP into hospitals, the care that patients received was variable
and there were many examples of poor care. But it is clear that, in the wrong hands, the LCP
has been used as an excuse for poor quality care. The LCP’s position is a fragile one while poor
practice continues and considerable deficiencies in its use are not addressed.
3.2 Based on the evidence examined by the Review, much of which came from clinicians, the
Review panel has concluded that the LCP is not being applied properly in all cases. Generic
protocols, as the LCP has come to be seen, intended to be applicable for all patients in the last
hours or days of their lives, in any setting, are the wrong approach. The Review panel strongly
recommends the development of a series of guides and alerts that reflect the common
principles of good palliative care, linking directly to the GMC’s Guidance, and that of the NMC
when it is developed. Implementation of this should be the personal responsibility of clinicians.
The Review panel envisages that, in addition to the core driving palliative care philosophy that
will be common to all guidance, there would be elements of technical guidance specific to
certain disease groups, such as solid cancers, haematological cancers and other blood diseases,
organ failure and cardio-respiratory diseases, neurological conditions, respiratory conditions,
and for patients with dementia. An important requirement for these guidelines is that they be
designed to be readily adapted for local use to meet the needs of individuals.
3.3 The Review panel strongly recommends that use of the Liverpool Care Pathway be replaced
within the next six to 12 months by an end of life care plan for each patient, backed up by
condition-specific good practice guidance.

INDEPENDENT
REVIEW OF THE
LIVERPOOL
CARE PATHWAY

Still, at least they're on the right track.
Thanks for the info!

reply to post by MystikMushroom


This is true. Morphine is used in this way, to slow, and eventually stop breathing if a person is suffering enough. It was always unsoken though. Doctors, nurses and carers are aware.

I used to work in a care home and can tell you that it is in the best interests of the manager ect to keep people alive for the funding, they do not do it for themselves.

I believe it is an act of kindness in most cases. Of course, there are occaisionaly family members that think of wills or nurses that, well, just should not be doing this jobs.

Human nature is both light and dark.

reply to post by wildtimes


It's not perfect but little is.
We had a favourable experience with it (as much as we could given the circumstance) but maybe that was because my sister was in the Marie Curie Centre in Liverpool which was the joint pioneer of the scheme.

Other hospitals haven't been as meticulous or caring in their approach to it I'm afraid.

reply to post by wildtimes


If I "had an irreversible brain disease that left me unable to recognize people or speak - and presumably, also unable to process information and think" then yes, I would want out. Otherwise, I want to decide as I go.

imho - Private and public insurance companies work in concert with the industrialized research community - enforcing cultural triage and treating many/most patients as guinea pigs. Many specialists serve as industry's frontline reps to determine the individual's "value." As most sick people are not seen to have "value," they don't get the best treatment. Rather, they're funnelled into research tracks designed to develop the best treatments for those who are deemed "worthy." It's a crap shoot and a really, really nasty business.


imho

reply to post by soficrow

imho - Private and public insurance companies work in concert with the industrialized research community - enforcing cultural triage and treating many/most patients as guinea pigs. Many specialists serve as industry's frontline reps to determine the individual's "value." As most sick people are not seen to have "value," they don't get the best treatment. Rather, they're funnelled into research tracks designed to develop the best treatments for those who are deemed "worthy." It's a crap shoot and a really, really nasty business.

This in interesting.

Do you have any personal experience to back it up? It wouldn't surprise me, and certainly the current (now-being-changed) system was broken.