Section Four: Worried about Pain?
1. Can my pain be relieved?
Pain relief can be obtained in almost all situations. After assessing the type of pain and what brings it on, a doctor would normally start with a milder pain medication such as Tylenol and then work up, depending on the response, to a stronger medication taken a regular basis.
The strongest medications include morphine and hydromorphone. When these are introduced in a gradual manner, they achieve effective pain relief without making the patient drowsy and used in this way, they are not addictive. It cannot be too early to introduce these if the severity of the pain warrants it. Although total relief cannot always be achieved, significant relief can be obtained to enhance the quality of life.
2. Can a person remain pain free?
Most palliative care specialists say that severe pain can be controlled almost 100% of the time in most cases. Nothing is 100% and even deep sedation might not always be recommended, therefore there are sometimes circumstances where pain cannot be avoided, but on the whole these are rare, and we should feel confident that comfort care and pain management are reliable.
3. Where can I obtain information about pain relief?
For difficult to control cancer pain, your doctor would have access to a palliative care specialist. They may be within the cancer clinic (pain and symptom management/supportive care). They can also be accessed within the community if it becomes physically difficult to come to the clinic. Within Hamilton, information about the Palliative Care Outreach Team can be obtained from:
Good Shepherd Palliative Care Outreach Team
82 Stinson Street P.O. Box 1003
Hamilton, ON, L8N 3R1;
905 521 1841
4. Is it right to take treatment/pain medication that might shorten my life or make me unconscious?
Depending on WHY I take these treatments, the answer could be ‘yes’ or ‘no.’ The answer will be NO if I take any treatment or medication in order to shorten my life. The answer will be YES if I am doing so in order to deal with pain and suffering at end-of-life, even if there is a possibility that use of a treatment or drug might contribute to dying a day or so before death would occur otherwise. Catholic teaching says the latter is morally permissible.
Providing the intention is to relieve symptoms, one may have to accept undesired side effects, however, when medications to relieve pain are properly titrated, as explained above, they do not hasten death. Properly applied, palliative care seeks neither to prolong life nor hasten death. Relieving the distress of breathlessness may involve the use of medications that can lead to sedation but, once again, the aim is the relief of distress, not to make the patient sedated, even though this may occur as an unintended effect.