Caring for the dying

Mr. P was admitted for surgery to remove a bowel obstruction. Unfortunately, the surgeons found advanced cancer and closed him up without being able to do anything. The team has told him he will not likely live more than a few weeks. He has been referred to palliative care, and the orders on his chart are for a number of medications to manage his pain and other symptoms.

You are the nurse caring for Mr. P. You notice he is asking more and more frequently for pain medications and sleeping pills. When you do a pain assessment, Mr. P tells you, “No, I don’t really have much pain. I just want this to be over with.”

You press him to explain what he means. “I mean, I’m dying. Why drag it out?” he says.

Questions for consideration and discussion:

1. What should you do? Why?
2. What are the implications for providing Mr. P with the sedation he is asking for?
3. Discuss the difference between providing medication that will relieve Mr. P’s suffering, and providing medication that might hasten his death? What difference does your intention make to whether the action is right or wrong?

Edit: This post was published before medical assistance in dying became legal in Canada. For information on MAID, please see the WRHA’s MAID page.