Going gently

The New York Times has an sensitive and in-depth article about the difficult decision to administer strong sedative drugs to terminally ill patients to ease their suffering at the expensive of potentially quickening their death.

It is, in all but one respect, a very good article, however it does contain a monumentally stupid paragraph:

For pain, the guidelines list opioid drugs, including morphine, methadone and fentanyl.

Doctors say that other drugs used for sedation are ketamine, an anesthetic and sedative popular at rave parties, and propofol, an anesthetic, which was ruled, with lorazepam, to have caused Michael Jackson’s death. In very high doses, sodium thiopental is used as a sedative in the three-drug combination used for lethal injections.

You could link almost any drug (or indeed, any substance – table salt – for example) to some nefarious use or lethal outcome. In fact, some of the most demonised street drugs – heroin and cocaine – have common and legitimate medical uses.

Medicine is always a case of balancing the positive and negatives of any treatment for the benefit of the patient. Context-less examples tell us nothing about this balance.

Other than that, the article is very good and really gets to the core of why end-of-life sedation is such as difficult topic, both emotionally and medically.

Link to NYT article ‘Hard Choice for a Comfortable Death: Sedation’.

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