Ethics

Sometimes when our patients are "on their way out", so to speak, we are given orders to administer morphine and ativan on a continuous infusion.  These drugs are used to keep our patients comfortable.  A subtle side affect is that the morphine and ativan will decrease the patients respiratory effort.  It's hard to walk that tight rope between comfort and euthanasia.  A small decrease in the rate would leave the patient writhing in pain and an increase would kill them.  What happens when death is the only comfort?  It's hard to watch someone lying in pain.  Increasing the rate would really only speed up the inevitable, and the patient would be a lot more comfortable, but can you kill someone?