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Morphine use in the dying
Question from Annette Armstrong on 7/6/2013:

What is the church's standing on using morphine at the end stages of dementia. I am concerned as my mother has no painful disease such as cancer. But due to advanced dementia and difficulties swallowing has not eaten more than a tablespoon or two of food at meals. She has become so thin and dehydrated I was told by a Hospice nurse that she needed to have morphine. I was not sure my mother needed it as she didn't seem uncomfortable. We have been in the hospital for 5 days for dehydration and a septic infection. She has begun to breathe very heavy and labored. I need help knowing if I should allow a narcotic at this point.

Answer by Judie Brown on 7/9/2013:

Dear Annette

Morphine can be easily abused and while I am waiting for a couple of experts to weigh in on your question there are two articles I think you should read. Here are the links:

http://www.catholicculture.org/culture/library/view.cfm?recnum=9389

http://www.illinoisrighttolife.org/NCBC_EM_June2013%20The%20Rise%20o f%20Stealth%20Eut hanasia.pdf

As you will see, there are those who believe that using morphine to "relieve" symptoms can be an actual avenue to causing early death on purpose. Caution is required.

And, ANNETTE, here is a response from a physician who, you will note, invites you to call him if you have further questions:

I could answer her question more easily by talking to her. In general, the Church approves - actually commends the treatment of suffering, Morphine and opioids in general have a role to perform in this regard. ERD (5th Ed. 2009) no. 61 addresses this. However, note that it relies upon the PDE (double effect principle) and is in need of revision. This is - as you know - morphine used appropriately at end-of-life to treat symptoms e.g. pain and dyspnea, does not shorten life; in fact, it often increase overall survival. The Catechism (CCC) no. 2279 contains the same teaching. Unlike the secularists, suffering does not undermine human dignity. As Christians, our response is guided by love, presence and perseverance with our fellow sufferer, who remains an child of God, fully worthy of our respect. In solidarity and communion compassion is suffering with the other and caring for them which is to alleviate the source(s) of their suffering.

John Paul II taught us that suffering is due to evil in the world, our having fallen. Put another way, suffering is a lack of the good. Pain, physicians know, is the lack of normal tissue or put another way, inflamed and irritated cells, tissues and nerves. Our treatment is directed at the suffering person who has this lack of normal organic materials, leading to the pain. In this circumstance our action is to try and restore the normal physiology, cure the disease or cancer leading to these abnormal tissues, etc. Often and when this is not possible, we should act to at least block the offending chemicals in this dis-eased tissues signaling pain. On this basis our response is good, and it is moral. What is immoral is to end the suffering of this child of God by directly (by intention) killing them. The two main indications, then, for morphine are pain and dyspnea (shortness of breath.)

I hope this helps. She can call if I am able to assist further.

RA Capone, M.D., F.A.C.P. rcapone15@comcast.net 724-875-3934 (m)

Judie Brown

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