eli5: Patients in hospice care are often unconscious due to high doses of sedative drugs, and are given no intravenous fluids, which leads to death by dehydration. Why is this done? Is there any difference between this and physician-assisted suicide?
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Hi. I’m a hospice nurse. So there’s a ton of misinformation that goes around about hospice care. Let’s start from the beginning of your sentence. “ unconscious due to high doses of sedative drugs”. We only give people medications when there are symptoms. For instance, if a patient is having respiratory distress or in pain at end of life, we will administer morphine. Usually at a very low dose, around 5 mg. Then we will watch and see how effective this medication is, and when it begins to wear off. From there, we can determine if we need to increase the dose and determine how often the medication should be given, such as every 4 to 6 hours. A side effect is being drowsy, but the patient is either in pain and having respiratory distress so this is why it is given. Another commonly use medication is lorazepam. Again this is only given when a patient begins to experience restlessness or agitation. There is something called terminal agitation and restlessness, you can do some research on why this occurs but people typically need lorazepam or Haldol administered. Again we start at the lowest dose, we assess and determine the dosage and frequency needed based on how each person reacts to it. Another side effect of lorazepam is drowsiness. The patient has to determine what they want; comfort care, which is the definition of hospice, OR to live in pain, respiratory distress, or agitation and restlessness. And that’s why hospice is so important, because we help you die comfortably if that’s what you want. The next part of your statement says “ are given no intravenous fluids, which leads to death by dehydration”. This is also not true. As the body begins to shut down, it no longer requires or wants food or fluids. Your organs are shutting down and putting things inside your body, upsets it and makes it very uncomfortable. You can think of it as waking something up that doesn’t want to be woken. You do not die because you’re dehydrated or are starved, you die because your body was dying from whatever disease it had. Hospice care is completely different from assisted suicide. We do not administer high enough dosages to overdose someone, which sort of seems what you’re implying that is done. Assisted suicide is taking medication with the intent to die. Hospice care is taking medication to keep you comfortable during the natural dying process. I hope this helps, and I hope you can help spread the word and advocate, for why hospice is important, because it really makes things difficult when people have a stigma about something that isn’t correct. I have an uncle who literally thinks I kill people for a living. But when you’re on the other side of things, you truly understand the importance of dying comfortably. we’re all going to die sometime, i’ve seen some pretty terrible deaths from patients whose family members held these important medication‘s from them because of their own beliefs. The outcome was still death, and it was extremely uncomfortable and painful.
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