Palliative sedation to alleviate existential suffering at end-of-life: Insight into a controversial practice

Canadian oncology nursing journal = Revue canadienne de nursing oncologique 09/2012; 22(3):195-9, 190-4. DOI: 10.5737/1181912x223195199
Source: PubMed


All terminally ill individuals should have access to palliative care that gives equal importance to all aspects of suffering. In spite of all the efforts made, some of these individuals will, unfortunately, be left with suffering described as "refractory". It would appear that palliative sedation then becomes an option. There is much controversy around this practice, especially when it is used to alleviate suffering of a more existential nature. This article aims first to define the practice of palliative sedation, second to explore the concept of existential suffering in palliative care and third to address the implications for nursing practice.

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Available from: Kim Sadler, Jun 18, 2015
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    ABSTRACT: The purpose of this review is to provide an update on palliative sedation in palliative and end-of-life care. Palliative sedation is the medical procedure used to deal with refractory symptoms in advanced cancer patients when all other specific approaches have failed. Palliative sedation, in the strictest sense of the term, is a proportionate (proportionate palliative sedation, PPS) and intrinsically variable procedure used on an individual basis to relieve refractory symptoms in terminally ill patients, without the intention of hastening death. Completely separate from any other end-of-life decision and not intended to hasten death, palliative sedation has been shown not to have a detrimental impact on survival. To maintain palliative sedation as a legitimate clinical procedure from any ethical or clinical point of view, it must be limited to the restricted area for which it was conceived, that is, relief from refractory suffering as deemed necessary by a patient and by an experienced palliative care team. In this way, there is no risk of associating palliative sedation with other end-of-life decisions. Close collaboration is needed between oncologists and palliative care physicians for this clinical procedure.
    Full-text · Article · May 2014 · Current opinion in oncology