- Mar 30, 2019
This is a very pertinent and “right on” comment, as is the norm with you. However, I do need to comment on the issue of access to morphine, at least in Florida, in the event that a PALS does not wish to continue life prior to the determination that death is imminent.I will "rant" about the fears around death that keep it in a cone of silence even in a terminal disease community, that let you, Kristina [we have corresponded since] think for one moment that jail was a possibility for titrating morphine to full comfort near the end of life.
Present Florida law prohibits physicians from prescribing any opioid for more than three days for.acute pain, though an exception can be made for prescriptions up to seven days. As my GP said, someone could come in with a broken leg and he can’t prescribe more than three days of narcotics. As he ruefully commented, they threw the baby out with the bath water with the new laws in the face of the opioid hysteria.
More importantly, no physician I have interviewed in Florida (five in all) will prescribe morphine outside of hospice, which again gets to the issue of a PALS saying “enough is enough” before the end game is apparent. I know from your posts regarding your husband, you found a physician willing to do so outside of hospice,and I understand his breathing had declined to a point that made such a request more pallitable, but that does not appear to be the case in Florida.
I imagine that leaves many PALS (myself included) fearful of having to endure months of suffering they might not otherwise wish to occur as we wait for hospice to make a determination of six months or less to live. That leaves the unpleasant reality of taking matters into your own hands, which as Katrina described, may not be possible once progression occurs to a certain point.
These are difficult conversations, but the days of finding a willing physician in Florida to work directly with the family instead of through hospice does not appear possible. Kevin
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