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Continuous Deep Sedation for Psycho-Existential Suffering: A Multicenter Nationwide Study.
Sayaka Maeda1, Tatsuya Morita2,3, Naosuke Yokomichi2
1Department of Palliative Medicine, Kyoto University Hospital, Kyoto, Japan.
Continuous deep sedation (CDS) for psycho-existential suffering is used in palliative care, often associated with a desire for hastened death. Patients receiving CDS for existential suffering had longer survival times post-initiation.
Area of Science:
- Palliative Care Medicine
- Medical Ethics
- Oncology
Background:
- Continuous deep sedation (CDS) is debated for managing psycho-existential suffering in advanced cancer patients.
- Understanding current clinical practices and patient outcomes is crucial.
Purpose of the Study:
- To investigate the clinical application of CDS for psycho-existential suffering.
- To evaluate the impact of CDS on patient survival.
Main Methods:
- A cohort of 164 advanced cancer patients in palliative care units was analyzed.
- Patients receiving CDS for psycho-existential suffering (with or without physical symptoms) were compared to those receiving it solely for physical symptoms.
Main Results:
- Only 8.5% of patients received CDS for psycho-existential suffering; 0.6% solely for this reason.
- Patients receiving CDS for existential suffering were more likely to desire or request hastened death and had no specific religion.
- Survival time after CDS initiation was longer in patients receiving it for psycho-existential suffering (p=0.021).
Conclusions:
- CDS is utilized for psycho-existential suffering, frequently linked to requests for hastened death.
- Physician discomfort and longer duration of CDS were noted when used for existential suffering.
- Further research is needed to establish effective strategies for managing existential suffering in palliative care.
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