Medical staff who over-administer pain relief to dying patients could be denying them a “good death”, the Catholic Church in England and Wales has said.
Insufficient pain relief can cause “considerable” physical, emotional and spiritual suffering, according to a guide published yesterday by bishops on spiritual care of the dying.
But rendering patients unconscious or semi-conscious in their last days through overtreatment or inappropriate levels of pain relief could deprive a patient of a chance to say their goodbyes, they warned. “This could deprive people of the opportunity to make a good death, setting things right as much as they can, making peace, saying their goodbyes,” the document noted.
“It will rarely be the case that pain cannot be controlled without deep sedation. Nevertheless, it may be that there is a compromise to be made between comfort and lucidity, and different people will want to compromise at different levels.”
The document, drawn up by experts in medicine and ethics, speaks of the “shock” of death and the need for spiritual care of the dying and those close to them.
“So much of our thinking and dealing with death is governed by fear as well as compassion,” it noted. “It is not surprising, therefore, that we develop defences for dealing with this moment. Our culture, which so often presents us with the fiction of death in films and television, paradoxically, colludes with our defences.”
The document said that if a patient is known to be a “person of prayer” or faith, it could be of “immense support” to them if medical staff felt able to pray with them or read a passage of scripture to them.
But it said praying should not be done with any intention of converting or “thrusting one’s beliefs” on to a patient.
Bishop Tom Williams, auxiliary bishop of Liverpool and chairman of the healthcare reference group of the Catholic Bishops’ Conference of England and Wales, said: “Our hope is that this small guide will be of practical use to healthcare professionals caring for those who are dying . . . this draft [document] would welcome comments particularly from healthcare professionals and chaplains. We would like this guide to be as clear, practical and helpful as possible.”