"Terminal Dyspnea and Palliative Care" (November 2001) was generally excellent. However, I am concerned that readers might be misled: opioids and benzodiazepines are indicated not only in the terminal phase of dyspnea and in patients for whom a do-not-resuscitate (DNR) order has been written. Rather, they are cornerstones of the treatment of dyspnea in both hospice and palliative care. 1

Often in our hospice program, patients with dyspnea are given oral morphine and lorazepam. Although many of our patients elect to have DNR orders written by their providers, others continue to seek aggressive treatment during exacerbations of their ilnesses. Patients with chronic dyspnea use these drugs to relieve symptoms for months and, in some cases, years.

Kathleen O'Laughlin, MS, RN, CHPN

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