What about the danger of respiratory suppression with opioids?
The fear of using drug therapy to ease the distress of terminal dyspnea often leads to inadequate symptom control. Health professionals and the public often mistakenly equate use of drugs to ease terminal dyspnea with euthanasia or assisted suicide.
- Ethically, the use of these drugs is appropriate and essential, as long as the intent is to relieve distress, rather than shorten life.
- It is important to realize that the doses of opioids given to treat dyspnea at end of life rarely accelerate the dying process.
- The principle of “double effect” states that it is ethically sound to give a medication to treat a symptom to make a patient comfortable, even if it is possible that this medication might cause harm to the patient.
- There is no justification for withholding symptomatic treatment to a dying patient out of fear of potential respiratory depression.
“Understanding the patient’s wishes for end-of-life symptom control and good communication with both family and other caregivers (e.g. nursing staff) regarding why drugs to relieve distressing dyspnea are administered, is essential to avoid misunderstanding.”