University expert justifies use of morphine to treat pain and dyspnea in terminally ill patients
Dr. José Mario López Saca states that the clinical programs of study performed to date reveal that morphine and other opioids do not kill patients but the symptoms.
Dr. José Mario López Saca, partner of the Palliative Medicine team of the Clínica Universidad de Navarra, defended that "the use of morphine in terminally ill patients to treat pain and dyspnea is widely justified". This internal medicine physician participated in a workshop of the Master's Degree of Bioethics of the School of Medicine in which he emphasized that "the review of the clinical programs of study carried out to date reveals that morphine and other opioids do not kill the patients but rather the symptoms".
He also argued that "in the clinical setting, although opioids have been shown to be effective in treating pain and dyspnea, there is fear of using them because of uncertainty about their safety in the patient at the end of life, and the ethical principle of double effect (one good and one bad) is used to justify their use".
In his opinion, since the 1980s morphine has become the most widely used drug to treat dyspnea in terminally ill patients with great clinical benefit. It also reduces the sensation of suffocation and anxiety they experience. Likewise, "all the programs of study on survival and opioids in the last 25 years report that the judicious use of morphine does not shorten the life of patients," said the expert, who is also partner of the Institute for Culture and Society of the University of Navarra (Atlantes Program).
Another aspect analyzed by López Saca was the possible effect of opioids on tumor growth and on immunity. "The programs of study carried out to date are in animal models and many contradict each other (some speak of improvement of the immune system and others of worsening). Even if future programs of study were to demonstrate that opioids promote the growth and spread of cancer, this negative effect would be offset by the positive effects of adequate relief of pain and dyspnea, reducing comorbidity and, therefore, avoiding a shortening of life," the doctor defended.
Children medication: scientific and ethical aspects
During the workshop another of the topics discussed was that of babies or children medicine for therapeutic purposes, "produced through in vitro reproduction techniques that serve as donors of hematopoietic material to treat a sick sibling," as explained Ana Patiño, from the department of Pediatrics of the Clínica Universidad de Navarra.
Patiño referred to the scientific and ethical aspects underlying its creation, such as the technology used or the preimplantation genetic diagnosis -which makes it possible to identify and select embryos based on their identity Genetics and immunological identity, thus achieving genetically selected pregnancies-, and explained the main ethical issues such as the instrumentalization of the human being that occurs in this case, as well as the destiny of the embryos produced in the process.
The workshop of update in Bioethics counted with the participation of jurists, specialists from the Clínica Universidad de Navarra and other experts such as the Bishop of Bilbao, Mario Iceta Gavicagogeascoa, Doctor in Medicine and Surgery from the University of Navarra.