We fully agree with Kompanje et al that morphine is not an appropriate drug for terminal sedation. Nevertheless, this is the practice that we encountered when we asked physicians to describe the last time they had administered drugs to keep a patient in deep sedation or coma until death, without giving artificial nutrition or hydration. It cannot be precluded that in these cases sedation was the result of the use of morphine that was primarily administered to address severe pain or other symptoms. We believe that more insight is necessary in the reasons for using morphine to sedate patients before dismissing this practice as wrong in all cases.
Rietjens JAC, van Delden JJM, van der Heide A, Vrakking AM, Onwuteaka-Philipsen BD, van der Maas PJ, van der Wal G. Morphine Is Not a Sedative and Does Not Shorten Life—Reply. Arch Intern Med. 2006;166(18):2047-2048. doi:10.1001/archinte.166.18.2047-b