Palliative sedation

Palliative sedation is a medical intervention used to relieve intractable suffering in patients with terminal illnesses. It involves the use of sedative medications to reduce a patient's consciousness to alleviate severe, refractory symptoms that cannot be controlled by other means. This practice is typically considered when other palliative care measures have failed to provide adequate relief.

Indications

Palliative sedation is indicated for patients experiencing extreme suffering due to symptoms such as pain, dyspnea, delirium, or nausea and vomiting that are unresponsive to standard palliative treatments. It is often considered a last resort when all other options have been exhausted.

Medications Used

Common medications used for palliative sedation include benzodiazepines like midazolam, barbiturates such as phenobarbital, and other sedatives like propofol. The choice of medication depends on the patient's condition, the desired depth of sedation, and the potential side effects.

Ethical Considerations

Palliative sedation raises several ethical issues, including concerns about hastening death, informed consent, and the intention behind the sedation. It is crucial to distinguish palliative sedation from euthanasia and physician-assisted suicide, as the primary goal of palliative sedation is symptom relief, not to cause death.

Procedure

The process of initiating palliative sedation involves several steps: 1. Comprehensive assessment of the patient's symptoms and suffering. 2. Discussion with the patient and family about the goals of care and the nature of palliative sedation. 3. Obtaining informed consent. 4. Selection and administration of appropriate sedative medications. 5. Continuous monitoring and adjustment of sedation levels to ensure comfort.

Related Pages

• Palliative care
• Hospice care
• End-of-life care
• Pain management
• Ethics in medicine