Palliative sedation

2019 March 26

This is certainly not about euthanasia: this is about treating suffering.

Every palliative care worker has come across this situation: The patient is in intolerable pain (or breathlessness or agitation) and despite all you do, continues to be so. You look up Oxford Textbook of Palliative Medicine; you google all over the cyber world; yet there is no solution in sight. The patient is in agony; the family is in agony.

Yes; this happens. Palliative care professionals are only human beings. They can get rid of much of the suffering; but not all the time.

When everything fails (refractory symptoms, if you want to get technical) and the patient is near the end of life, we discuss within the team; we discuss with the patient if he is competent to understand and take decisions, we discuss with the family, and with consensus, provide deep sedation to relieve the “intolerable suffering”.

The objective is to relieve symptoms, not to cause death. And this is not something that a palliative care team does every day; this is an exceptional situation.

Read the article titled Reflections on Palliative Sedation by the master, Dr Robert Twycross, on the latest on this ethical dilemma/imperative.

One Response
  1. Pranab Basu permalink
    March 27, 2019

    Thanks to Pallium India organisation for sharing this relevant topic. I know from my own experience how a terminal cancer patient bears intolerable pain a few days before dying. Even morphine can’t relieve the patient from pain, the mental agony reaches the nearest caregiver. So it is practical but hard to resolve the decision to apply sedetives to get rid of pain . I agree with the application of sedetives .

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