Reference no: EM133241644

Mr Lam is 30 years old and suffers from metastatic bone cancer. He has frequently attended the oncology unit over the past six months, initially for chemotherapy, but he is now likely to die soon. Mr Lam is popular with the nursing staff who have gotten to know him well. In recent days his condition has deteriorated significantly, and he has been moaning in pain and distress. Cancerous growths in his spine are causing him intense pain while metastases in his brain stem threaten death. The goal of Mr Lam's nursing care is now to keep him as comfortable as possible, so he has been prescribed a continuous infusion pump containing morphine. The rate of infusion can be varied by nursing staff but not by the patient. Finally, Mr Lam pleads to the nurses to do something about the pain, saying 'Please, just make it stop'. A review of his chart shows that the rate of morphine can still be increased; however, nurses note that when he falls asleep his respiratory rate drops and they are concerned that any increase in dose may result in respiratory depression. When he wakes up, he is still clearly in pain with the morphine providing inadequate relief. One of the nursing staff says, 'We've got to do something, it's inhumane to leave him like this'.

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