Let’s just be clear. There is no evidence that when used properly opioids and sedatives shorten life in anyway. Can we please stop asking someone who never deals with dying what his opinion ishttps://twitter.com/c7rky/status/1010149895464980480 …
Let me say up front that this is not my area of experience, but from observing the conversations of others on the subject over the years, I was under the impression that these drugs can indeed shorten life, even when used appropriately. Am I wrong about that?
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It is my area of expertise and yes you are. I agree there is a cultural perception even amongst HCPs it does and it is simply not true and we must stop propagating that myth
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Common doses of morphine in a syringe driver is 5-10mg is 0.2-0.4mg/hr and equivalent to 60mg codeine twice a day which no one would bat an eyelid at. Yes they need skill in there use just like any drug but in themselves are not harmful.
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Yes you are https://www.ncbi.nlm.nih.gov/m/pubmed/11312042/ … (I know there are more upto date articles but this is the only one I have book marked as it’s not my area of expertise either)
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Gosport is going to emulate Shipman & make pain & agitation management so much harder at the end of life, similar to reports of its recreational use & using Ketamine in hospitals which we therefore do less than we could IMHO
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Interesting, thanks Rebecca. Happy to be corrected. Nobody wants anyone to suffer. This all boils down respecting patient consent and trust in HCPs for me. Both of which seem to have suffered during the years I've been taking an interest.
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I don’t disagree a lot of my job is spend restablishing that trust which is why gosport makes me SO angry but we must separate the two and not conflate proper use with what must surely be considered possibly murder.
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That's a tough job you have there. Once trust is lost, it's almost impossible to re-establish, ime. I don't know how widespread the practices at Gosport will turn out to be - with one exception - the cover up. That's very common & also happens to be the part that angers me most.
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It’s unacceptable (the cover up). In my experience i do not see those practices. Whenever we think someone is dying we discuss it as an mdt involving the family and patient. Agree the right way to proceed. It’s not something done lightly.
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That would work for me. Consent is my personal soapbox subject. As long as you're agreeing it with me & I have genuine (clinically appropriate) choice, then I'm a happy camper. On cover-ups, sadly the unacceptable has long since been the accepted norm for NHS. An indelible stain
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