Ask pretty much any old person and he or she will tell you that dying quietly in their sleep is the way they want to go. It's sure true for me.
Unfortunately, dying isn't always that easy. Sometimes it is painful and some of those times it is excruciatingly so or, equally terrible, it involves constant breathlessness. In fact, Joseph Andrews, a physician at a Connecticut hospice, says that breathlessness is the worst thing.
But there is a drug, a strong, often misused drug we have all heard of that can alleviate much of this kind of suffering at the end of life. It's called morphine:
Morphine is seen by many physicians and laypeople as a sort of single-purpose, liquified grim reaper, and understandably so: It is dangerous and addictive,” reports STAT.
“Older physicians in particular were typically not trained to use it, Andrews said, and can resist recommendations to use morphine even for cancer patients with severe bone pain, for fear of killing them.”
End-of-life patients can also be denied this drug because, according to Dr. Andrews, there is a myth that hospice care uses the drug to send the terminally ill on their way a bit faster than nature intended.
That doesn't happen in hospice, Andrews says, but the myth keeps physicians from prescribing morphine or family members from allowing it.
Fortunately, that was not true of my mother's physician when I was caring for her during her final months of life in 1992. We had a good-sized bottle of liquid morphine he had prescribed and I don't recall any warnings from him about how lethal it can be. For a long time she only chose the other pain pills that, although I couldn't be sure, did not seem to alleviate the pain as much as the morphine might.
When I finally had the wit to ask her why she refused to use it, she said she might become addicted and do something illegal.
This, from a woman who perfectly well knew she was dying and who was no longer ambulatory. “Ma, I said, I really don't see you running down the road to rob the candy store; you can't even get out of bed. And who cares if you become addicted.”
No dummy, my mother, she thought this over for a moment and switched to liquid morphine.
Dr. Andrews says he has seen a small amount of morphine completely change the last days or weeks of life for his patients when they or their family agree to it use.
In the case of one of his hospice patients, a man who could barely breathe and had been told his heart would fail within three days, decided to try the drug. Soon after he began using a small dose,
”...the man’s breathing eased, he started a new routine. Twice a day he’d ask his children or grandchildren or nurses to bring his cap and his overcoat and they’d wheel him to the waterfront with his oxygen tank.
“He’d stay as long as the gathering cold and darkness allowed. He saw the tides flow and the leaves fall and gulls and boats pass. In early December he began sleeping more, and then he slept entire days away, and then he died.
“But that November reprieve, 'It was one of the best morphine stories I can remember,' Andrews said. 'He had a great run.'”
You can tell your physician, family members, medical proxy or, better, all of them what your wishes are about such drugs for pain at the end of life. I'm doing that and if circumstances make morphine usable in my case and if it works as Dr. Andrews describes, I have a better chance of dying in my sleep.
It's worth your time to read the short report on this at STAT.