Hacker News Reader

Comment by draugadrotten | Hacker News Reader

The doctor said to my relative, "Here is the morphine injection device. If you press this button once, you will get a small dose of strong morphine. If you are in severe pain you can press it twice. Never press it more than three times, as you would die for sure at five or six presses." He had terminal cancer, severe pains and he died peacefully thanks to the hint.

View on HN

This is the same deniability strategy used by Prohibition-era 'grape drinks': "After dissolving the brick in a gallon of water, do not place the liquid in a jug away in the cupboard for twenty days, because then it would turn into wine." [1]

[1] http://drinks.seriouseats.com/2013/05/wine-and-prohibition-w...

Normally, the morphine injection systems have a hard limit preventing you from overdosing; if you press it before the timer has elapsed, it'll beep at you (and record the press so doctors can get a sense of whether you want more painkiller than you're getting and how long the doses seem to be working for you), but it won't administer.

I never stopped to think about it before you shared this story, but in hindsight it's not surprising to me that feature can be overridden. I bet the manufacturer has even put in just enough safety interlocks to make it hard to do accidentally, but not enough to prevent it outright. You know, because sometimes doctors may need to tweak it on a per-patient basis...

Another factor is a 600lb patient is going to need a regular does that would kill a 120lb patent. So, from a manufactures perspective it's not obvious what a 'lethal' does is.

I feel badly for people that cannot obtain the medicines to do this without "establishment" help. Having seen relatives go through a long period of decay, it really is horrible. Not only suffering for the person, but the destruction of memories for the rest of the family.

If it was someone very close to me, I'd personally acquire the medicines needed. It's not that hard to find a supplier of powerful opiates, even if you have to buy diamorphine on the street. Opiate overdose appears to be a very nice way to go.

Not having been in this situation, and (potentially relevant) being in the UK, are the family/patient really allowed to administer drugs like this?

It seems to me that administering potent drugs such as morphine would be controlled by medical staff who have the knowledge around safe doses.

If you're on hospice, you're typically at home, with a caregiver coming by once or twice a day to see how you're doing, clean up, etc., and to check on the automatic IV drip machines. These machines come with a remote that lets the patient request additional pain meds, and they're supposed to have limits on how often the button can be pressed in a certain time period. But if you're on hospice, with stage IV pancreatic cancer or other no probability of survival and extremely painful illness, those limits are sometimes not set.

Source: A friend's mom was a hospice nurse who ended up going into hospice herself.

When my grandmother was in hospice care at home, there were bottles of liquid morphine in her refrigerator. Her family was free to administer it as needed, for pain.

Is this like a syringe or a machine? I thought those machines would limit the output

Must be something the staff can adjust. I had a morphine button once, and they told me it was impossible to overdose on it. Wasn't worth it over a knee operation!

I'd imagine it's something like this; https://en.wikipedia.org/wiki/Syringe_driver

It probably varies, but I would guess that there is a lot of leeway, particularly in machines for hospitals, and they can likely be configured to only reject dosage levels grossly above the maximum feasible for any weight without jeopardizing the plausible deniability the doctors want.

It was a machine. I think the other posters may have already described configuring it for plausiable deniability. It was no secret that this was a possibility, my relative told me and several others about a week before he finally used the opportunity. The end was good - as much as you can call dying of cancer good. It was indescribably hard to see him die, but it was even harder to see him suffer in agony being slowly eaten from inside by this terrible disease. I cried then and I cry now but more time would only have meant more suffering. I can't even call it a suicide. It had nothing to do with suicide, he didn't want to die. He wanted to stop the pain and there was no other way. Ending his life was the final pain relief.

But suicide is sometimes that - no other way to stop the pain.

> Is this like a syringe or a machine? I thought those machines would limit the output

Isn't it amazing that in trying to make sure nothing bad happens we make it impossible for good things to happen?

Well, don't take that too far; if there weren't a limiter, the probability for accidental malpractice would be very high indeed (especially since the requester button is often in the hands of a medically-untrained patient).

But it's good to know the limiter can be disabled when that is deemed necessary.

Reply on news.ycombinator.com