I am writing in response to the article by Daniel Wood [“Whose death is it anyway?”, November 18-25], which was drawn to my attention via a cancer patient.
I am concerned that people who read the article and are suffering from cancer might be sufficiently alarmed to stop taking or delay starting pain medications, with great detriment to their well-being. They may also avoid seeking much-needed medical help because of unfounded fear of being euthanized.
There is good evidence from ethically approved and peer-reviewed medical research that opioids given for pain relief do not shorten life.
As a medical professional experienced in the care of cancer patients, I can advise that though a very large single dose of a highly potent opioid such as heroin may suppress respiration sufficiently to cause death in a person who is not used to it or who does not have pain, when opioids are used appropriately for patients with pain due to advanced illness such as cancer, survival is actually longer.
These medications are commenced in low doses, usually in long-acting or slow-release formulations, and the dose can be gradually and safely increased as much as necessary to keep pain controlled, without any respiratory depression.
Even when anxiety or confusion occurs during the course of illness, survival is longer in those who receive appropriately adjusted sedation than in those whose distress is untreated.
Though more research is needed to achieve further improvements in pain and symptom management, people living with advanced illness have much to gain from palliative care. They need not fear opioid pain medications, providing they are taken according to their instructions under the supervision of knowledgeable medical professionals.
> Dr. Pippa Hawley / Palliative Medicine Specialist / Vancouver