Pain relief drugs 'do not hasten death'

There have been concerns over pain relief drugs

Giving even relatively high doses of pain relief drugs to terminally-ill patients does not shorten their lives, according to doctors.

Research carried out by doctors in London found that patients who were given higher doses of pain relief drugs, such as morphine, at the end of their lives lived as long as those who had not received increased doses.

The doctors carried out the study following public and professional concern that administering pain relief drugs or opioids might shorten life.

"Concern continues among the general public and health professionals over the use of opioids at the end of life and in particular their possible role in shortening patients' lives," said one of the authors, Dr Nigel Sykes.

They retrospectively examined the use of opioids in 238 patients who had died at St Christopher's Hospice in London.

They found that giving higher doses of opioids to patients did not affect hasten death.

Concern continues among the general public and health professionals over the use of opioids at the end of life

Dr Nigel Sykes, St Christopher's Hospice, London

"Comparison of the patients who received a marked increase in opioids at the end of life with those who received no increase showed no significant difference in survival from admission, frequency of unexpected death, or description of death," they stated.

Euthanasia

The doctors also suggested that their findings meant that other health professionals should not invoke the doctrine of double effect (DDE).

Doctors sometimes invoke the DDE to protect themselves against claims of euthanasia, namely that they have contributed towards a patient's death.

The DDE allows a doctor to administer treatment, even if it may prove harmful or may result in death, once it is not intended and occurs as a side-effect of a beneficial action.

Recent court cases have suggested that the DDE may be used by some doctors as a cover for practising euthanasia.

The authors of the study noted: "Our findings indicate that appropriate use of opiates for symptom control does not shorten life and there is little if any need to invoke DDE."

They add: "The DDE may be a useful principle that can offer reassurance to healthcare professionals facing difficult treatment decisions, but it must be distinguished from euthanasia and its role should not be exaggerated."

A spokeswoman for Pro-life Alliance welcomed the study.

"We don't have any problem with the study. We would have a problem if what is being prescribed is to speed death but if it is being used to give optimum pain relief to the patient then that is fine."

The study is published in the latest issue of The Lancet.