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Related Experiment Videos

Practical guide to palliative sedation.

John D Cowan1, Teresa W Palmer

  • 1Advanced Illness Assistance Team, Blount Memorial Hospital, 907 East Lamar Alexander Parkway, Maryville, TN 37804, USA. jcowan@bmnet.com

Current Oncology Reports
|April 9, 2002
PubMed
Summary
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Palliative sedation (PS) offers relief for refractory symptoms in terminally ill patients. Studies indicate PS does not hasten death, providing comfort without intending to cause death.

Area of Science:

  • Palliative Care
  • End-of-Life Symptom Management

Background:

  • Terminally ill patients prioritize symptom control during the dying process.
  • Standard palliative care manages most end-of-life symptoms effectively.
  • Refractory symptoms like pain, dyspnea, nausea, and delirium can persist despite standard care.

Purpose of the Study:

  • To explore palliative sedation (PS) as a therapeutic option for refractory symptoms in terminally ill patients.
  • To address concerns regarding the impact of PS on patient survival.
  • To differentiate PS from euthanasia.

Main Methods:

  • Review of existing data on the use and outcomes of palliative sedation.
  • Analysis of reported frequencies of PS application in terminally ill populations.
  • Examination of the temporal relationship between PS initiation and patient death.

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Main Results:

  • Palliative sedation is utilized in 5% to 52% of terminally ill patients.
  • Initiating palliative sedation does not appear to cause immediate death.
  • The median survival time after starting PS is reported to be between 1 to 5 days.
  • Midazolam is frequently used for palliative sedation.

Conclusions:

  • Palliative sedation is a viable option for managing intractable symptoms at the end of life.
  • The primary intent of palliative sedation is symptom relief, not hastening death.
  • Palliative sedation is ethically and clinically distinct from euthanasia.