Elizabeth Taylor: End of Life Pain Management a Sore Spot for Patients, Families

March 25, 2011— -- Despite her vibrant looks and glamorous lifestyle, Hollywood icon Dame Elizabeth Taylor was no stranger to pain. In her 79 years she suffered from injuries, scoliosis and skin cancer, and endured more than 30 surgeries.

In the months leading up to her death Wednesday, those who knew her said she was wheelchair-bound with dark bruises on her arms.

"I'm happy that she's out of her pain, because she was in a lot of pain," fellow actress and one-time rival Debbie Reynolds told "Access Hollywood."

Taylor died six weeks after being hospitalized at Cedars-Sinai Medical Center in Los Angeles for congestive heart failure -- a condition in which the heart becomes unable to pump blood adequately to the rest of the body.

The details of Taylor's treatment are unknown, but she reportedly told Reynolds she was "really trying" to survive.

Congestive heart failure is generally not painful, although it can cause shortness of breath, according to Dr. Steve Nissen, chair of cardiovascular medicine at the Cleveland Clinic.

Treating Pain at the End of Life

Managing pain and shortness of breath, called dyspnea, at the end of life is a notoriously touchy subject. A possible side effect of the drugs used to relieve pain and anxiety -- opioids and benzodiazepines -- is sedation, which can hasten death.

"It's called the double effect -- the notion that at the end of life we use medications that we think are going to help with symptom management but also have the potential to accelerate the dying process," said Dr. James Fausto, director of the hospice and palliative medicine fellowship at Montefiore Medical Center, and assistant professor at Albert Einstein College of Medicine in New York City.