Pain Relief & Acceleration of Death - Providing pain medication to terminally ill or dying patients which has the side effect of hastening death is not euthanasia or assisted suicide as long as it is necessary to relieve the patient’s pain and suffering and patient comfort is the primary motive and goal.
Health care professionals have an obligation to relieve pain and suffering and promote the dignity and autonomy of patients in their care. In order to adequately relieve a patient’s pain and suffering, a physician or nurse practitioner may have to prescribe a treatment that may hasten death for a dying patient. Both the ANA and the AMA explicitly condone this. As long as the intent and goal is to relieve pain and suffering and it is reasonable to believe that this level of medication is necessary to relieve/prevent pain and distress in the dying patient, then it is morally permissible to administer treatment that may have the side effect of hastening death.
One may wonder how to prevent this from being abused by those with bad intentions. A good rule of thumb is to ask whether or not there is another reasonable means by which the patient could be kept comfortable which does not have the death hastening side effect? If so, is it as effective? Is it readily available? If the answers to these questions are yes, then one should question the practice. There may be other justifiable reasons for the use of this medication and dosage. But, in order to be an advocate for patients, we must try to prevent abuses, especially in grey areas like this.
Furthermore, every health care professional has the right to refuse to participate in the provision of care that he/she believes to be unethical or against their moral/religious beliefs. However, care must be transferred to someone of equal or higher expertise. No patient should die in pain because no one is willing to provide him/her with adequate pain relief. However, patients may refuse pain medications based on their own values.