Pubdate: Sun, 18 Jul 1999
Source: Houston Chronicle (TX)
Copyright: 1999 Houston Chronicle
Contact:  http://www.chron.com/
Forum: http://www.chron.com/content/hcitalk/index.html
Author: Dan Rather

MORPHINE, LIFE AND DEATH MAKE A TROUBLESOME TRIO

The subject is morphine.

It's not a pleasant subject, but it's an important one. Especially if you,
or someone you know and love, is going through extended pain.

One of the most effective pain relievers ever developed, morphine is an
organic compound extracted from opium.

Sometimes it's used as a light anesthetic or a sedative. Because it can be
addictive and lethal, it can be used legally in this and other developed
countries only under the specific instructions and guidance of a physician.

Unfortunately, it is sometimes used illegally to kill. The most common such
usage involves very old people who are in pain in so-called mercy killings.

Doctors or family members -- or both -- decide that the most merciful thing
to be done for patients is to "take them out of their misery."

Few people like to think about such things. Even fewer will talk about them.
But such killings are facts of life -- and death -- whose frequency we don't
like to admit.

This subject haunts me, the result of my having looked into and investigated
hospices and other places under the general heading of "acute-care centers."

Morphine is a factor that permeates many of these establishments, where
there is so much pain, so much death and near-death around.

And there is a lot of misunderstanding, too, as well as suspicion and misuse
of morphine. Just how much misuse -- how many accidents and incidents of
morphine use for killing -- is impossible to know.

One neurologist at a nationally recognized teaching hospital said,
confidentially, "I come down heavily on the side that morphine is a
wonderful drug, and it is not being misused greatly to deliberately hasten
death in terminally ill people.

"Having said that, the art of medicine requires that doctors not kill
people. But I do it. Other doctors and nurses do it. When someone is going
to die soon, and they are in great pain ... sure, I do it."

Is that legal? "No, and we know it. But it's something strictly between
medical care-givers and a patient and the family.

"And it's not really a national problem. In the right hands, morphine is a
useful tool. A screwdriver is a useful tool, and just because a screwdriver
may have been used to murder someone doesn't mean that screwdrivers are a
national problem."

Many other doctors in this reporter's survey agreed. Some didn't.

What about the police and prosecutors?

Most of those questioned responded with something along the lines of: "We
don't know if it's a big problem or not. And we don't want to know. It's too
murky an area, fraught with too much emotion, too many conflicting views.
So, mostly, we just don't go there unless we are confronted with
overwhelming evidence of deliberate killing."

As a result, central questions about morphine -- what to think about it, how
to think about it -- hang out there. As with so much about life and death,
there are no easy answers.

Rather is anchor of CBS Evening News and a native Texan.

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