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Morphine Is Not a Sedative and Does Not Shorten Life—Reply
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In reply
We fully agree with Kompanje et al that morphine is not an appropriate drug for terminal sedation. Nevertheless, this is the practice that we encountered when we asked physicians to describe the last time they had administered drugs to keep a patient in deep sedation or coma until death, without giving artificial nutrition or hydration. It cannot be precluded that in these cases sedation was the result of the use of morphine that was primarily administered to address severe pain or other symptoms. We believe that more insight is necessary in the reasons for using morphine to sedate patients before dismissing this practice as wrong in all cases.
Furthermore, we found that some physicians believe that dispelling refractory symptoms in patients with a life expectancy longer than 2 weeks sometimes warrants the use of terminal sedation. In such cases, life may be shortened because the patient no longer . . . [Full Text of this Article]
AUTHOR INFORMATION
Judith A. C. Rietjens, PhD;
Johannes J. M. van Delden, MD, PhD;
Agnes van der Heide, MD, PhD;
Astrid M. Vrakking, PhD;
Bregje D. Onwuteaka-Philipsen, PhD;
Paul J. van der Maas, MD, PhD;
Gerrit van der Wal, MD, PhD
RELATED LETTER
Morphine Is Not a Sedative and Does Not Shorten Life
Erwin J. O. Kompanje, Lia van Zuylen, and C. C. D. (Karin) van der Rijt
Arch Intern Med. 2006;166(18):2047.
EXTRACT
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RELATED ARTICLE
Terminal Sedation and Euthanasia: A Comparison of Clinical Practices
Judith A. C. Rietjens, Johannes J. M. van Delden, Agnes van der Heide, Astrid M. Vrakking, Bregje D. Onwuteaka-Philipsen, Paul J. van der Maas, and Gerrit van der Wal
Arch Intern Med. 2006;166(7):749-753.
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