Sunday, December 27, 2009

The surprising prevalence of medical euthanasia

The NYT has a fascinating article on the apparently quite common practice of physicians essentially euthanizing their patients, with a combination of opioids and benzodiazepines (the same combination that kills so many movie stars, and what Ohio now uses on death row inmates when their first lethal injection doesn't work). The article is interesting throughout, but here's the takeaway:

There is little information about how many patients are terminally sedated, and under what circumstances — estimates have ranged from 2 percent of terminal patients to more than 50 percent. (Doctors are often reluctant to discuss particular cases out of fear that their intentions will be misunderstood.)

Reminds me of this episode of House, where Wilson tells the nurse the override code for the morphine dispenser, but loudly enough so that the patient can hear the code. He then delivers to himself a lethal dose of morphine, and Wilson gives a speech (or at least tries to) at a medical conference about how all doctors do it, but few are brave enough to admit it.

Something else that I find interesting – and this is probably mostly for legal liability reasons – is that doctors and patients seem to be restricted in being blunt about what they're doing, instead cloaking it all in codewords:

Although throughout the half-hour meeting the staff had never explicitly asked to continue sedating Mr. Oltzik, his daughter now gave them tacit permission: “We understand that the inevitable is here, but we wish him to go in peace and to find solace in that,” Ms. Ladin said.

This might be nice for some people, who don't want to face the reality of what's happening, but for others – especially those who the article says "were surprised their loved ones died so quickly, and wondered if the drugs had played a role" – it seems like this euphemistic attitude is far from ideal.

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