Luppo Kuillman

Facilitating and motivating factors for reporting reprehensible conduct 105 4 Vignette 2. So much morphine, that isn’t palliative sedation … You are working as a physician assistant at the practice of a dispensing physician. One of the patients has metastasized lung cancer. You saw this patient recently because he complained of increasing pain in the right upper quadrant. You then also discussed the patient’s views on euthanasia and palliative sedation. The patient said that he was opposed to euthanasia but did not want to die choking either. He will allow the GP to put him to sleep and then ‘let go softly’. This morning, you receive word that the patient died overnight. When you look at his file, you notice the following entry: A96.01 ‘natural death’; in the pharmacy module, you read that three 1 mL (10 mg/mL) ampoules of morphine have been used. Digging further, you notice that eight 5 mL (20 mg/mL) ampoules – a total of 800 mg – of morphine were written off in the opiate ledger today because they ‘fell on the floor and broke’. This is highly unusual. You strongly suspect that the GP has ignored the legislative obligations concerning euthanasia and palliative sedation. You confront the GP with your findings. The GP says that in this acute situation, there was no time to observe the palliative sedation protocol. On the line below, please indicate to what extent you would be inclined to report this case to the Health Care Inspectorate. Not at all Certainly |_________________________________________________________________________|