12-29-2008, 04:45 AM
A mentally competent 76-year-old man is in the
terminal stage of
multiple myeloma. He is unable to move and requires
24-hour nursing
care. Increasing doses of narcotics are needed to
control severe pain.
As a result, when he is pain-free, respiratory
function is impaired and
consciousness is clouded. The patient says he cannot
live with this
degree of pain and asks to be given a lethal injection
of pain
medication. Which of the following is the most
appropriate step regarding the
pain medication?
A
) Reduce the dosage so as not to impair respiration
B
) Administer the dosage necessary to control pain
despite
respiratory impairment
C
) Administer the dosage necessary to control pain
and add a
centrally acting stimulant
D
) Appeal to the family to convince the patient to
tolerate a bit
more pain