The use of pain medication during palliative care has become an important issue in the modern day. Particularly, the administration of opioids has been associated with undesirable adverse effects in end of life care (Bengoechea et al., 2010). Notably, patients with long-term illnesses often require strong pain management medications such as opioids with the core objective of improving the quality of their lives. Excessive pain reduces the quality of life necessitating the administration of opioids to manage the pain effectively. There has been a critical debate regarding the ethics of opioid use during palliative care. There is a common perception that the use of opioids only serves to accelerate the dying process. However, some scholars have highlighted that the association of pain medication with accelerating death is a myth that needs to be disregarded (Peppin, Coleman, & Kirsh, 2011). Particularly, the use of morphine has been associated with hastening the death process.
It is apparent that there is a need for extensive research concerning the adverse effects of opioid use at the end of life patients. Specifically, a critical investigation of the appropriate dosages in the use of opioids during palliative care is of critical importance to disregard the myth (Richardson, 2015). Scholars need to conduct studies that demonstrate the adverse effects of opioids such as morphine during palliative care. The existing evidence demonstrates that the use of opioids may be lethal if there is an overdose (Heneka et al., 2016). For the first usage, physicians administer a low dosage of opioids to manage pain. However, as the boy of the patient becomes accustomed to the use of opioids, there is a limited response in pain relief. The limited response mandates physicians to use higher dosages of morphine or another opioid to control the pain that the patients experience.
The increasing dosages of opioids have become a controversial issue because they have been associated with the acceleration of death. A section of critics believes that opioid use in palliative settings may present the undesirable effects of death (Kazuki et al., 2016). Many patients are less likely to accept higher dosages of opioids because they are afraid of the undesirable effects. Family members may also be worried about the increasing dosages of opioids. There is evidence that high dosages of opioids may affect the breathing system. In some instances, the increased dosages decrease the rate of breathing, making it difficult for the person to wake up (King et al., 2011). In such circumstances, there are chances of the patient experiencing a death due to the irregular breathing patterns.
Many of the recent studies have sought to determine the dosages of opioids that are likely to register abnormal or irregular breathing patterns. There is a need for education on the use of opioids in the palliative care settings. Specifically, nurses and physicians need to recognize the acceptable dosages of opioids that do not register undesirable effects. It is imperative for nurses and physicians to understand the ethics surrounding opioid use at the end of life settings (Whitehead, 2015). Particularly, the nurses and physicians may need to make important decisions regarding whether to administer opioids or not in palliative care settings. Patients also need education concerning the misconceptions surrounding the use of opioids. In such a situation, both the physician and the patients need to make an informed decision surrounding the use of opioids (Lin et al., 2015). Extensive research on this aspect will provide the necessary evidence to determine whether opioid use in palliative care settings is ethical.
- Bengoechea, I., Gutiérrez, S. G., Vrotsou, K., Onaindia, M. J., & Lopez, J. Q. (2010). Opioid Use at the End of Life and Survival in a Hospital at Home Unit. Journal Of Palliative Medicine, 13(9), 1079.
- Heneka, N., Shaw, T., Rowett, D., & Phillips, J. L. (2016). Quantifying the burden of opioid medication errors in adult oncology and palliative care settings: A systematic review. Palliative Medicine, 30(6), 520.
- Kazuki, S., Mitsunori, M., Tatsuya, M., Satoru, T., & Shima, Y. (2016). End-of-Life Medical Treatments in the Last Two Weeks of Life in Palliative Care Units in Japan, 2005-2006: A Nationwide Retrospective Cohort Survey. Journal Of Palliative Medicine, 19(11), 1188.
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- Lin, K. J., Ching, A., Edmonds, K. P., Roeland, E. J., Revta, C., Ma, J. D., & Atayee, R. S. (2015). Variable Patterns of Continuous Morphine Infusions at End of Life. Journal Of Palliative Medicine, 18(9), 786.
- Peppin, J. F., Coleman, J. J., & Kirsh, K. L. (2011). Issues and Critiques of the Forthcoming Risk Evaluation and Mitigation Strategy (REMS) for Opioids in Pain Management. Issues In Law & Medicine, 27(2), 91.
- Richardson, P. (2015). Get the Basics on End-of-Life Medications. ONS Connect, 30(2), 45.
- Whitehead, P. B. (2015). Palliative Pharmacologic Sedation for Terminally Ill Adults. Clinical Journal Of Oncology Nursing, 19(3), 373.