Question

A 72-year-old man with metastatic prostate cancer has severe bone pain not controlled with regular oral Morphine. He is increasingly drowsy and has little appetite. His prognosis is estimated as weeks. His family ask you to increase Morphine “until he does not wake up any more”. What is the most appropriate response?

Accepted Answer

Explain that analgesia should be titrated to relieve pain while avoiding intentional life-shortening, and consider a specialist palliative care referral

Answer

Increase Morphine rapidly to induce unconsciousness to relieve family distress

Answer

Stop Morphine to avoid respiratory depression

Answer

Sedate him heavily with Midazolam solely at the family’s request

Answer

Refuse any discussion about symptom control

Practice question