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Current practices in managing end-of-life existential suffering
Michelle Di Risio1, Alison Thompson
1Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Current Opinion in Supportive and Palliative Care
|April 11, 2023
Summary
Existential suffering (ES) in palliative care is complex, often intertwined with other pains. Newer interventions like brain stimulation and psychedelics show promise for end-of-life care, though ethical considerations remain.
Area of Science:
- Palliative Care
- End-of-Life Suffering
- Existential Distress
Background:
- Existential suffering (ES) is a significant component of distress in palliative care, impacting patients' end-of-life experiences and requests for hastened death.
- ES can be a distinct form of suffering or co-occur with physical, psychological, and spiritual suffering.
Approach:
- This review examines recent interventions for managing existential suffering (ES) in the palliative care context.
- Focuses on novel modalities and pharmacological agents, including brain stimulation and psychedelics.
- Considers the ethical complexities and definitional challenges surrounding ES alleviation.
Key Points:
- Emerging interventions for end-of-life existential suffering include brain stimulation and psychedelic therapies.
- Pharmacological interventions like palliative sedation and lethal injections for ES are ethically debated and clinically challenging to isolate.
- A clear clinical definition of existential suffering is still needed.
Conclusions:
- Newer modalities offer potential avenues for addressing end-of-life existential suffering.
- Ethical and definitional clarity is crucial for evaluating interventions.
- Broader contextual factors, including institutional and cultural elements, must inform the management of ES in palliative settings.
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