| Dear
Aprakrita Prabhu, Please accept my humble obeisances. All glories to Srila Prabhupada. Thank you for writing about your question concerning morphine. In The Final Journey, I write about the myths pertaining to morphine. I hope you consider that section carefully. I have cared for many dying Vaisnavas and out of all of them only one devotee did not take any pain medication because she simply did not have any pain. The idea in hospice is that the physical pain of the patient MUST be relieved first before he or she can be peaceful and think about Guru and Krsna. If a trained hospice professional nurse or doctor is giving the morphine--or any pain medication--in a proper way, meaning the medication is given for the correct disease (morphine does not take away every type of pain and therefore is not recommended for every illness) and the medication is given at the right dose and the right times, etc. then there is no fear of the patient becoming addicted or becoming too confused so he will not remember Krsna. The first few days to a week of taking any pain medicine, including morphine, a patient may feel more drowsy and sleep more often, but after that short time he or she will most likely develop a tolerance to it and will become more awake and lucid. If the patient remains very drowsy after a week or so then ask your hospice nurse or doctor if the pain medication should be possibly decreased just a little bit--just so the patient is more aware of his or her surroundings but that the pain does not return so it is again intolerable. Ask yourself how someone who is dying and in severe pain can think about Krsna when all he is thinking about is being in physical pain? As I said, first the physical pain must be relieved then the spiritual and emotional support can take place. Remember, not every hospice patient needs or gets morphine. There are many other types of pain medicines as well. Some not as strong and some even stronger than morphine. But, again, if they are given correctly by a trained hospice professional who knows pain and symptom management and how and when and why to give the medicine, then the patient will be conscious enough to remember Krsna. Also, if soft massage, aromatherapy, guided imagery, etc. (complementary therapies taught in The Final Journey) are used then it is possible that the patient may not require as much of the pain medication than if these therapies were not used. For example, if the patient likes to have a soft, light massage using a light oil or lotion that has lavender in it which is used for relaxation, then perhaps the massage combined with a smaller dose of pain medication just might take the patient's pain away so it is more tolerable. Every patient has their own level of pain tolerance so they should tell you what is working and when more medicine is needed. But, I suggest you read the chapter on Complementary therapies and see if any of these help your mother to feel more comfortable. I will never suggest that massage, or any other complementary therapy should be used instead of pain medicine in a very serious disease situation, but massage and other therapies suggested in The Final Journey may help to assist the patient in feeling a bit more comfortable, thus possibly being able to decrease the pain medicine with the doctor's permission. During the last two to three days of a hospice patient's life he usually goes into a coma-like state called the "actively dying stage." You can read about this in The Final Journey. The patient will not be able to speak or respond to you but can still hear you. (Hearing is the last sense to leave us) So if your mother enters this actively dying stage during the final few days of her life, tell her about Krsna, read Prabhupada's books to her, talk about how her children will continue with devotional service after she is gone, etc. Tell her eveything you need to tell her and she will hear you even though she won't be able to speak. It may help you to know that several senior devotees (sannyasis and gurus) who left their bodies within the past few years were on some type of allopathic pain medicine--some even stronger than morphine. They were as pain-free as possible given their illness, peaceful, but could still hear the chanting of the devotees in the room at the end of life. I personally cared for one of them who was on a strong pain medication every two hours via injections. It helped him to think about Krsna rather than the tremendous pain his disease caused. Again, if these medicines are given correctly, always staying aware of the patient's ability to be as painfree as possible while remembering Krsna, then these medications and other complementary therapies can actually help a devotee have a more peaceful departure from this world. Of course, the patient always has the option to say no to any medicines offered to them. That is their right. I hope this answers your question. If I can help you in any other way kindly let me know. Your servant,
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