morphine pca with a basal rate of 3 or 4? Sounds good to me! Thanks to medicine, we have finally got to the point where death no longer has to be painful. Most patients will tell you it's not dying that scares them, it's the pain involved.
What needs to change is people's attitude towards the physician's role. Many patients are suffering because of what 'we the living' expect of our physicians, ie that they do whatever they can to save life. Sometimes physicians can't save a life. The living need to understand this. When a physician wants to help his patient by relieving pain, even if it hastens death, he should be allowed to do that. (I believe the supreme court case between oregon and the dea dealt not with assisted suicide, but with the prescribing of large amounts of narcotics to treat pain that also hasten death---not assisted suicide, at least that's how JAMA presented it).
As long as the public preception of physician's is that they do whatever to save a life, no matter what the outcome, pallitive and hospice care cannot move forward. If it takes tarnishing the profession's angelic image, then that's what needs to be done. A physician's responsibility is not towards the family or the public, but towards his individual patient (exept in cases of infection diseases and public health, and a family's piece of mind does not take priority over a patient's suffering.) Sorry, I've been in nursing too long 😳