Chapter 2: Explaining common clinical issues

The role of medication

The palliative care expert says
Dr. David Roy dispels persistent myths pain medications can lead to addiction and that opiods, such as morphine, can hasten death.(3:22)Video transcript
The palliative care expert says
Marianne Arab talks about the initial struggle many paramedics have in administering the higher dosages of opioids to palliative patients.(3:22)Video transcript
The paramedic says
Cheryl Cameron explains the shift in thinking paramedics must make particularly in the use and dosages of opioids in palliative care. (3:22)Video transcript

It’s important to ensure the family clearly understands the role of medication. There’s a common misconception that pain medications, including morphine, are used to hasten death. This isn’t the case. 

Medication tolerance

People receiving a medication for prolonged periods often develop a tolerance that may require increasing doses to achieve the same result. For this reason, patients at the end of life may be taking very high doses to control their symptoms. While these would be lethal to anyone else, they’re safe for patients who’ve been taking the medication for some time. They’ll be carefully monitored by their direct care team.

Conversation Prompts

The following three prompts help to avoid misunderstanding and misinformation:

What’s your understanding of how morphine is being used in this situation?

I'm going to give this medication now. My goal is to help him be more comfortable and less agitated. Do you have any questions?

This medication is being given to address symptoms (pain, agitation and shortness of breath), not to hasten or cause death. Your dad won’t die because of the medication; he'll die because of his disease.