<p>This is not exactly &quot;Buddhist scripture or commentary&quot; but it's related -- <a href="https://www.researchgate.net/publication/234059814_What_nurses_need_to_know_about_Buddhist_perspectives_of_end-of-life_care" rel="nofollow noreferrer">What nurses need to know about Buddhist perspectives of end-of-life care</a> -- here's an extract but you might read it all:</p>
<blockquote>
<p>Taking into consideration overall well-being
(including the mental state of the patient), nurses
must balance the level of pain relief needed against
the need for alertness in the dying Buddhist. Proper
pain management can be achieved with minimal disruption of alertness by the use of the WHO analgesic
ladder. The choice of non-opioid analgesics (nonsteroidal anti-inflammatory drugs) and weak opioids
should be preferred over strong opioids and neurolytic
block therapy whenever possible, with the aim of reducing adverse side effects (i.e. sedation and cognitive
impairment), thus maintaining alertness of the individual so that effective spiritual practices may continue. However, if severe uncontrolled pain develops,
cognitive impairment (e.g. delirium) may result that
may require the use of strong opiods for effective
relief to achieve the best cognitive function possible
that would support meditative spiritual practices. In
concordance with good practice and recognizing that
the individual needs of each patient will differ,
nurses should continue to monitor the need for pain
relief, and should clearly document the preferences
of such patients with regard to pain relief, particularly
during initial patient assessment regardless of the
setting (patient’s own home, hospice, hospital).</p>
</blockquote>
<p>I believe the &quot;analgesic ladder&quot; means, not prescribing more than needed, and, increasing the prescription over time (when the need/illness increases, and as the tolerance to the drug increases, tolerance making it less effective) -- additional details here: <a href="https://www.ncbi.nlm.nih.gov/books/NBK554435/" rel="nofollow noreferrer">WHO Analgesic Ladder
</a></p>
<p>For some patients I think that unmanaged pain and suffering itself, may cause a &quot;mind to be in a bad state&quot; -- for example delirious or suicidal.</p>
<hr />
<p>This article -- <a href="https://www.accesstoinsight.org/lib/authors/desilva/bl132.html" rel="nofollow noreferrer">Ministering to the Sick and the Terminally Ill</a> -- includes a lot of sutta references.</p>
<p>One of these is <a href="https://suttacentral.net/an5.124/en/sujato" rel="nofollow noreferrer">AN 5.124</a> which identifies qualities of a competent carer -- they include being able to prepare medicine and knowing what's suitable and unsuitable.</p>

CC BY-SA 4.0
2021-05-20T05:34:09.353Z
2021-05-20T05:39:53.230Z
2021-05-20T05:39:53.230Z
ChrisW
<p>If they have bad side effects, then not. If they are helpful or beneficial, then go ahead and give them such medications.</p>

CC BY-SA 4.0
2021-05-24T10:09:46.950Z
All prescription drugs have bad side-effects, almost by definition -- i.e. that's why they are "by prescription only". A doctor is trained to assess whether the benefit is greater than the harm, when and how much to prescribe, what the alternatives are (and what the consequences are of each alternative), etc.
ChrisW
CC BY-SA 4.0
2021-05-24T04:51:30.830Z
2021-05-24T04:51:30.830Z
Stephen Karakashev
<p>My Christian wife is dying and the doctor has prescribed morphine and tranquilizers. She is losing her mind and the drugs may be contributing to that. I don't want her to suffer but I also don't want her mind to be in a bad state for rebirth. Is there any Buddhist scripture or comentary that could give guidance in this situation?</p>

CC BY-SA 4.0
2021-05-20T22:11:33.397Z
The First Noble Truth seems applicable and it leads to the Second.
Joe Corneli
<rebirth><suffering><death><personal-experience>
Should one who follows the Dhamma give drugs to the dying to ease thier suffering?
# Should one who follows the Dhamma give drugs to the dying to ease thier suffering?

(Asked by: username_0 on 2021-05-20)

My Christian wife is dying and the doctor has prescribed morphine and tranquilizers. She is losing her mind and the drugs may be contributing to that. I don't want her to suffer but I also don't want her mind to be in a bad state for rebirth. Is there any Buddhist scripture or comentary that could give guidance in this situation?

**Tags:** rebirth, suffering, death, personal-experience

> **Comments:**
> **username_1**: The First Noble Truth seems applicable and it leads to the Second.  

---

## 2 answers

### Answer by username_2 on 2021-05-20. Score: 2

This is not exactly "Buddhist scripture or commentary" but it's related -- [What nurses need to know about Buddhist perspectives of end-of-life care](https://www.researchgate.net/publication/234059814_What_nurses_need_to_know_about_Buddhist_perspectives_of_end-of-life_care) -- here's an extract but you might read it all:

> Taking into consideration overall well-being
> (including the mental state of the patient), nurses
> must balance the level of pain relief needed against
> the need for alertness in the dying Buddhist. Proper
> pain management can be achieved with minimal disruption of alertness by the use of the WHO analgesic
> ladder. The choice of non-opioid analgesics (nonsteroidal anti-inflammatory drugs) and weak opioids
> should be preferred over strong opioids and neurolytic
> block therapy whenever possible, with the aim of reducing adverse side effects (i.e. sedation and cognitive
> impairment), thus maintaining alertness of the individual so that effective spiritual practices may continue. However, if severe uncontrolled pain develops,
> cognitive impairment (e.g. delirium) may result that
> may require the use of strong opiods for effective
> relief to achieve the best cognitive function possible
> that would support meditative spiritual practices. In
> concordance with good practice and recognizing that
> the individual needs of each patient will differ,
> nurses should continue to monitor the need for pain
> relief, and should clearly document the preferences
> of such patients with regard to pain relief, particularly
> during initial patient assessment regardless of the
> setting (patient’s own home, hospice, hospital).

I believe the "analgesic ladder" means, not prescribing more than needed, and, increasing the prescription over time (when the need/illness increases, and as the tolerance to the drug increases, tolerance making it less effective) -- additional details here: [WHO Analgesic Ladder](https://www.ncbi.nlm.nih.gov/books/NBK554435/)

For some patients I think that unmanaged pain and suffering itself, may cause a "mind to be in a bad state" -- for example delirious or suicidal.

---

This article -- [Ministering to the Sick and the Terminally Ill](https://www.accesstoinsight.org/lib/authors/desilva/bl132.html) -- includes a lot of sutta references.

One of these is [AN 5.124](https://suttacentral.net/an5.124/en/sujato) which identifies qualities of a competent carer -- they include being able to prepare medicine and knowing what's suitable and unsuitable.


---

### Answer by username_3 on 2021-05-24. Score: 0

If they have bad side effects, then not. If they are helpful or beneficial, then go ahead and give them such medications.

> **Comments:**
> **username_2**: All prescription drugs have bad side-effects, almost by definition -- i.e. that's why they are "by prescription only". A doctor is trained to assess whether the benefit is greater than the harm, when and how much to prescribe, what the alternatives are (and what the consequences are of each alternative), etc.  

---

