That appears correct regarding the claimed usage for the morphine, for breathing, as found in a previous "Exit Protocol" (thrownback.blogspot.com) for one of the other times Terri had to endure starvation and dehydration.
Pain medication, however, such as Naproxen, is prescribed, as indicated below (red type is information added by Cheryl Ford, RN). As far as "peacefully" dying, I would call spasms and seizures anything but peaceful:
3. Monitor symptoms of pain/discomfort. If noted, medicate with Naproxen rectal suppository 375 mg Q8* prn.Wait a minute! George Felos, Michael Schiavo, and all the other advocates of feeding-tube removal have been saying repeatedly that dying by denial of nutrition & hydration is "peaceful" and "painless". They've both said so in interviews and press conferences, such as on Larry King Live. So if dying by denial of nutrition and hydration is, as Michael said, "painless and probably the most natural way to die", then why is medication needed for pain and discomfort?
* * *
7. Multifocal myoclonus or terminal agitation (sometimes caused by electrolyte imbalance). Consider diazepam rectal administration 5-10 mg. May repeat in 4 hours if not resolved then daily - twice daily as needed.
Myoclonus is twitching or spasm of the muscles. Multifocal means "occurring in many different parts of the body". This is usually the result of imbalance in electrolytes, the chemicals, such as salt, potassium, and calcium, which make your bodies internal electrical "batteries" work. Nerve impulses and muscle contractions are governed by electro-chemical reactions utilizing these chemicals. Dehydration causes these chemicals to be out of balance, interfering with normal nerve and muscle function. This can result in nerves and muscles "firing off" uncontrollably, causing spasm. The patient will writhe and become extremely agitated. If you have ever had muscle cramps resulting from strenuous exercise (especially when you have sweat profusely), you have some idea what this feels like. Imagine having this happen all over your body, repeatedly. Diazepam (more commonly known as Valium) is a muscle relaxant.
8. Grand Mal seizure, which is highly unlikely given current conditions and lack of contributing factors (meds). Recommend diazepam 15 mg rectally as indicated in seizure management orders.
In the final stages of starvation and dehydration, the same electrolyte imbalances which can cause muscle spasm can also lead to uncontrolled firing of neurons in the brain, according to a similar mechanism. This results in seizures.
I don't have a question about morphine. When I used it in the last 3 days of my boyfriend's life, it was to help when he said he was having a hard time breathing. Hospice had left it for me to use and I could not bring myself to use it until near the end. But on the last day, he refused it. He refused all medications. Then he went to sleep. And never woke up.
Ephesians 6:12 (King James Version)
12 For we wrestle not against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this world, against spiritual wickedness in high places
Romans 8:38-39 (King James Version)
King James Version (KJV)
38 For I am persuaded, that neither death, nor life, nor angels, nor principalities, nor powers, nor things present, nor things to come,
39 Nor height, nor depth, nor any other creature, shall be able to separate us from the love of God, which is in Christ Jesus our Lord.
Amen and Amen.
Did anyone else notice the list of Terri's "current" medications in the Exit Protocol link? She had Naprosyn ordered for menstrual cramps... How can someone in a "persistent vegetative state" have pain from menstrual cramps?? Also did any catch that snake in the grass Felos saying yesterday that Terri let out a soft "moan" when the tube was removed? He went on to describe that she would make noises when she was touched firmly or repositioned or if something caused her pain... Seems to contradict everything that he and HINO claimed to justify the death by dehydration....