Story, from a girlfriend, care assistant at a high/low care facility. Female resident, dying, vomiting. Unable to tolerate Maxolon by mouth, and documented thus over several days. Doctor declines to prescribe substitute.
A carer leaves cotside down, resident falls out of bed. More pain....

Daughter requests doctor visit. Appointment made. Doctor fails to attend.
Daughter approaches carer (my friend) on evening shift, concerned about her mother, who is in pain and vomiting bile.
My friend gives her the doctor's mobile number.
Doctor prescribes morphine and resident spends her final days in relative peace.

Those who work in aged care will doubtless have a fair idea of what happens next. All hell breaks loose over the head of my friend. Far from pleased that my friend has taken an initiative to alleviate pain, the doctor is incensed that his "confidentiality" has been breached (actually, I believe the doctor would have a hard time proving this in law - if he has made his mobile number available to staff without their explicit agreement it is confidential, then he has made no contract of confidentiality with them).

The registered nurse perspective is that they would have gotten hold of the doctor eventually!
My friend is served (apologetically) a written warning on breach of confidentiality. Fortunately, she has broad shoulders and is content she did the right thing morally and ethically in the circumstances.

This is not the only example of poor pain management of terminally ill at the facility, according to my friend.

Have some doctors become reluctant to prescribe morphine for the terminally ill? Why?

True story. Just another story I thought should be told.