Pandora's Lab: Seven Stories of Science Gone Wrong

by Paul A. Offit

On April 20, 1948, Cicely Saunders, a nurse, joined St. Luke’s Hospital for the Dying in East London. Saunders believed that patients with terminal illness shouldn’t have to spend their last few weeks crying out in pain. Rather, they should die a dignified death—one as pain-free as possible. Saunders reasoned that it was better to prevent pain than to treat it. So, in 1967, she founded the hospice movement, providing dying patients with large quantities of addictive, pain-relieving medicines. Saunders’s movement crossed the ocean. In 1984, the United States Congress passed the Compassionate Pain Relief Act, making it legal to treat terminally ill patients with heroin. In 1986, Wisconsin launched the first state-based pain management program for cancer patients. Other states followed. For many patients suffering from terminal illnesses, vigorous pain management was a godsend. But a door had now been opened for doctors to prescribe long-term, high-dose narcotics. Initially, use was limited to patients with terminal cancer. Then a respected doctor from New York City took the liberal use of narcotics one ill-fated step farther.