Comfort or death?

[jslcsansom]

Does anyone ever feel like comfort care could be construed as euthanasia? I have been thinking about this and it almost seems that we are aiding in passing by giving comfort cares since we are essentially giving patients medications until their heart and respirations stop, and I sometimes wonder if patient's families will feel like we are killing their family members. I am curious what others think?

[CT Pixie, BSN, RN]

Never once have I felt guilty or that I was assisting in euthanasia when I gave my actively dying patients their medications. I would feel more quilty if i hadn't and knowing they were in pain and anxious as they passed.

Several family members have questioned me if giving the morphine and/or ativan was going to kill them. I told them, the cancer/organ failure/fill in the blank is what is ultimately the cause of the patient's death. The medication is what would ease the pain and the ease anxiety/fear, and while these meds can slow heart rates, lower BP etc, that the doses the pt was getting in and of themselves would not cause death...that is what the disease was going to do. (while I didn't say it exactly like I just did, I did explain it without sugar coating...the patient was going to die...with or without the meds. The choice was then...did they want the patient in pain and scared as they died)

[Sun0408, ASN, RN]

Would you rather they die in agony?? I have had my fair share of comfort care only, I have also had several family members with met CA everywhere die a very peaceful death with the help of medications. We can not stop them from dying but what we can do make it easier, less painful, less fearful, have less secretions, experience air hunger less.. I could go on but Im sure others will add more..

In short, I am thankful these medications are available I have never felt as tho I assisted in euthanasia. The only time I feel guilty is when some families refuse obviously needed medications. Thank goodness it rarely happens.

[Sun0408, ASN, RN]

My question to you was not to be snarky, its to show the other side. I prefer a peaceful death when all possible. I think as nurses and other PCP somethings get lost and a peaceful death is one of those that should be standard to some extent.. I think it goes much deeper than just death. Sometimes we do things to "save" our pts from death but the reality is, we all will die and just because we can "do something" doesn't mean we should in order to extend life. Quality of life should always be the top priority.

I know I have went off in the deep end here but it is related. The 92 yo male with a massive MI has CABG x3, intubated, cant get off the vent, trached/peged, never to "wake" again ends up in your nursing home til death comes knocking again. This is just one of many examples I personally have. It goes much deeper; family dynamics, personal beliefs, the healthcare team etc all have a hand in this.

[MAISY, RN-ER, BSN, RN]

Anything that allows someone to pass in comfort is a good thing....they wouldn't need comfort care if they weren't going to die.

Medications are not given to kill someone-I am not sure where you are working or how this has been presented to you but Morphine and other drips are used to reduce anxiety, allow better oxygenation and help with pain.

There is nothing more unconscionable to me than a family member that wants to wake mom/dad up......it's bad enough that the family is not educated and often doesn't understand, but to have a nurse question this makes me wonder...