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Brechas percibidas entre los deseos y la práctica en la sedación al final de la vida para el sufrimiento
Sayaka Maeda1, Tatsuya Morita2, Kengo Imai3
1Department of Palliative Medicine, Kyoto University Hospital, Kyoto, Japan.
Journal of pain and symptom management
|August 24, 2025
Resumen
Muchos pacientes con cáncer desean la sedación profunda continua (CDS) para el sufrimiento existencial, pero rara vez se administra. Esto pone de relieve una brecha en la atención al final de la vida para el manejo de la angustia psicológica profunda.
Área de la Ciencia:
- Cuidados paliativos
- En el campo de la oncología
- Ética médica
Sus antecedentes:
- La sedación profunda continua (CDS) es un tratamiento controvertido al final de la vida para el sufrimiento psicoexistencial.
- Su utilización y el deseo del paciente de CDS en este contexto siguen siendo poco conocidos.
Objetivo del estudio:
- Determinar la prevalencia de pacientes con cáncer que desean CDS para el sufrimiento psicoexistencial en los cuidados paliativos japoneses.
- Investigar las condiciones del paciente, el sufrimiento y las intervenciones en el momento del deseo de CDS.
Principales métodos:
- Encuesta a nivel nacional de hospicios certificados y unidades de cuidados paliativos (PCU) en Japón.
- Datos recopilados sobre la administración de CDS, el deseo del paciente de CDS y el estado del paciente.
Principales resultados:
- El 0,2% de los pacientes fallecidos recibieron CDS por sufrimiento psicoexistencial; el 2% expresó su deseo de recibirlo.
- Tres cuartas partes de los PCU informaron pacientes que deseaban CDS, a menudo relacionados con el sufrimiento existencial y el deseo de muerte prematura.
- Sólo una cuarta parte de las PCU administraron CDS para esta indicación.
Conclusiones:
- Existe una disparidad significativa entre el deseo del paciente de CDS y su implementación clínica para el sufrimiento psicoexistencial.
- Los equipos de cuidados paliativos se enfrentan a desafíos para abordar las complejas necesidades de los pacientes y guiar las decisiones éticas.
- Se necesitan más investigaciones y directrices clínicas para cerrar la brecha en la atención al final de la vida para la angustia existencial.
Palabras clave:
sedación profunda continua hasta la muerteel deseo de acelerar la muerteFin de la vida útilLa éticala eutanasiaDeseo una muerte temprana.Más Videos Relacionados
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