Morphine use for a hospice patient


#1

Does the Catholic Church condone morphine use on a hospice patient for the purpose of shortness of breath? The patient always askes for oxygen for shortness of breath. The morphine is being administered as a sleeping aid. The patient is not in any pain.


#2

I can’t answer that, but a good source of information would be the National Catholic Bioethics Center.

https://www.ncbcenter.org/


#3

The Church doesn’t have a teaching on every treatment or medication. But morphine is an effective treatment for dysapnea and is prescribed for many patients in hospice. It was prescribed for my mom and I administered it along with ativan anytime she had a respiratory crisis.


#4

I have had relatives who were in the hospice section of Catholic hospitals and also a Catholic nursing home and yes they do allow the use of morphine there.
If they allow it in the hospitals and nursing homes, that is a very clear answer,


#5

And off-label uses are TOTALLY fine. I had a surgery while pregnant and I was given benedril to help me sleep because the amount of pain medicine they usually give was not safe for the baby. As long as it’s not doing harm, Catholic teaching has no problem with “off label” use.


#6

The hospice patient is going to pass away, I presume. As long as the treatment is just for any sort of palliative care or pain relief, which would include helping someone sleep, the Church is fine with it in that circumstance. The church only objects when the drug given is to end the patient’'s life early.


#7

Tis

To be admitted into the hospice programs, a thorough review of the medical records is required plus an interview with the patient when that is possible and with the patient’s family. Usually a doctor will refer to a hospice program also.


#8

My mother was terminally ill and I went through the process, I’m aware of it. She did not last long enough to be an actual hospice patient however.


#9

I’m a little confused by the phrasing of this question. Are you suggesting the patient is objecting to the treatment, and would prefer an alternate treatment? Because that’s an issue of professional ethics, not morality. Or are you suggesting the drug is being administered for some nefarious purpose other than alleviating shortness of breath and that the patient is being misled?

Patients may often think they need one course of treatment rather than another because they don’t fully understand the mechanisms of other treatments. As long as physicians obtain properly informed consent, then I can’t see how there would be any moral issue in providing any drug for shortness of breath.


#10

The Catechism teaches moreover that even if the use of painkillers risks shortening the patient’s lifespan, it can be morally acceptable. Like many medical treatments, it can be properly viewed as a matter of prudential judgement to balance the benefits and the risks.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.


#11

Morphine decreases the respiratory drive: period


#12

Yes, thanks for that clarification. I was thinking in terms of a big overdose to end life all at once, not the possible cumulative effects over time of a palliative dose.


#13

I don’t know if there are cumulative risks associated with palliative morphine. Maybe there are, but I just don’t know. The risks I envisioned are the steady, ongoing, low-level risk that may be associated with decreased respiratory drive, and also the risk of inadvertent overdose.


#14

Morphine is for pain. It is used in hospice care for pain and also for respiratory distress.
O2 is also used for respiratory distress.
You can use them both at the same time.
Dying persons may have respiratory distress characterized by rapid breathing. if they’re still conscious, this is extremely uncomfortable. Morphine will help ease the discomfort of respiratory distress, and help slow down the respirations.
In general, morphine isn’t given if respers are less than 12/min (unless the person is clearly in pain–but if their respiration rate is that low, they’re probably not showing signs and symptoms of pain).

I gave my hospice patient morphine because he was due for another dose. He was moaning and grimacing and respers in the upper 20s.
When I went back later to assess him, he was dead.
Did the morphine kill him? Probably not. Can I totally swear 100% on ten Bibles that it didn’t kill him? Of course not.
But the most likely scenario was that his end stage kidney disease killed him and not his low dose of morphine.

Be at peace


#15

And actually, hospice patients on low dose morphine actually have a slightly longer life span (think: a couple days) because the stress hormones from pain and the exhaustion of respiratory distress cause their own wear and tear on the body.


#16

I was wondering about that, or specifically whether morphine as a sleeping aid, as the OP described, might actually increase lifespan. I’m not surprised that it does.


#17

Morphine as a sleep aid is problematic, but not for moral reasons.
It makes you sleepy at first , but patients often find the sleepy effects decrease over time.
Or else, the person placed on hospice and receiving their first morphine sleeps for the first time in a while because they don’t have pain keeping them awake.
But treatment of insomnia in a hospice setting is something the patient should discuss with their health care professional.


#18

Yes, and we should hasten to remind any readers out there that Catholic Answers Forums is not an appropriate forum to seek or offer medical advice.


#19

Conversely, severe agonizing pain can hasten death. Severe pain puts the body through enormous strain.


#20

No problems for pain and ccomfort as long as dosage is not high enough to be the cause of death.


DISCLAIMER: The views and opinions expressed in these forums do not necessarily reflect those of Catholic Answers. For official apologetics resources please visit www.catholic.com.