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Rapid Responses to:
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Electronic letters published:
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif){kind=icon}
Comfort Care in a Pandemic?
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Arik R Olson, MD Mount Sinai Hospital
Send rapid response to journal:
arikolson{at}yahoo.com Arik R Olson
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I read Dr. Starr’s Influenza in 1918: Recollections of the Epidemic in Philadelphia with interest. Many people suffered horribly during that epidemic including both the patients and the medical staff who felt they had little help to offer. I was struck by the description of the senior physician who gave an order for “digitalis for a dying patient in dosage many times what I had been taught was maximal.” I had the impression that the senior physician had written this order in an attempt to comfort a dying patient, and that the order had not been carried out as it was clear it would have hastened the patient’s death. I wondered if morphine was available in their makeshift hospital. I believe most physicians practicing today would side with Dr. Starr in feeling that a treatment given solely to hasten a patient’s death is not ethical, though this remains a topic of some debate in our society. Many physicians experienced in palliative care are unlikely to support efforts to hasten death, preferring treatments which could be given to comfort a patient dying of influenza without hastening death, such as a low dosage of an opiate given on an around the clock basis. Dr. Bartlett’s presented impressive data on the mortality and attack rates of the H5N1 virus. If a pandemic of H5N1 influenza were to occur there would be many patients who could not be saved. In a pandemic many patients would likely remain outside of the hospital system. I hope that we incorporate training in and availability of palliative treatments for patients who are dying both in and out of hospitals into our preparedness plans and position statements on pandemic influenza. Conflict of Interest:None declared |
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