One in four cancer patients suffers unnecessarily painful death because the medical profession is still reluctant to prescribe morphine-mistakenly viewed as a dangerous addictive drug. John McVicar witnessed how his terminally ill mother was denied her right to an easy end and advises us on how to plan our own deathsby John McVicar / February 20, 1996 / Leave a comment
When I was upset as a child my mother consoled me with the words “Never mind, nothing lasts for ever.” Sometimes she would add sotto voce: “Except death.” Death is final, but passing through nature to eternity can be heavenly or hellish. One of the most odious paradoxes of modern medicine is that the same medical practices which are enabling more of us to live longer are also responsible for condemning a significant minority of us to an unnecessarily painful death. The problem is that too many doctors are over-treating the diseases of the dying, often thereby under-treating death’s most malignant symptom, pain. My mother, who died in November, was one of the unlucky ones.
Research published last September by Dr Ilora Finlay, a consultant in the new discipline of palliative medicine, illustrates the problem. She discovered that because so many medics are in thrall to morphine paranoia, one in four cancer patients are given inadequate pain relief. The consequence is that every year “34,000 patients are dying in moderate to severe pain, in some cases excruciating pain.”
This was a study of terminal cancer, where the control of pain with opiates is better established than it is with other killers such as heart disease and respiratory conditions. Among the latter, the percentage who die painfully is higher than the 25 per cent in Finlay’s study. My mother died from chronic obstruction of the airways, caused by emphysema; I believe the agony she experienced at the end was caused by the under-prescribing of morphine.
Morphine-or heroin-is the most powerful pain killer we have; morphine, from which heroin is refined, was named after Morpheus, the ancient Greek god of dreams. The late Jerry Garcia of the Grateful Dead rock group called it “the great comforter”: the sweet dreams of morphine confer the finest “high” and, in the right dosage, can also waft us away to an easy death. If the dead could be grateful, they would surely thank us for letting them slip away on morphine: it’s the champagne of deathcaps.
But morphine is a controlled drug. It is illegal except under prescription, and there are very tight controls on doctors prescribing it. Its attraction to junkies has given it a reputation as the “archetypal dangerous drug,” says Professor Jeff Hanks in a recent issue of the Lancet. But he believes that physicians’ fear about morphine is the result of…