Der Schmerz

, Volume 24, Issue 4, pp 342–354 | Cite as

Sedierung in der Palliativmedizin*: Leitlinie für den Einsatz sedierender Maßnahmen in der Palliativversorgung

European Association for Palliative Care (EAPC)
Übersichten

Zusammenfassung

Die European Association for Palliative Care (EAPC) betrachtet die palliative Sedierung als wichtige und notwendige Behandlungsoption für ausgewählte Patienten, die unter sonst therapierefraktären Symptomen leiden. Die Anwendung dieser Maßnahme erfordert entsprechende Sorgfalt als auch klinische Erfahrung („good clinical practice“). Eine Nichtbeachtung der potenziellen Risiken kann schädigendes und unethisches Handeln nach sich ziehen, welches die Glaubwürdigkeit und die Reputation der verantwortlichen Therapeuten und Institutionen als auch der Palliativmedizin insgesamt beeinträchtigen kann. Verfahrensorientierte Leitlinien tragen dazu bei, medizinisches Personal zu schulen, Standards für die optimale Versorgung zu setzen und die wichtige Information zu vermitteln, dass palliative Sedierung genau dann eine akzeptierte und ethisch gerechtfertigte Vorgehensweise darstellt, wenn sie in bestimmten angemessenen Situationen eingesetzt wird. Die EAPC ist bestrebt, die Entwicklung solcher Behandlungsstandards durch ein 10-Punkte-Rahmenprogramm im Sinne einer Leitlinie zu fördern, welches auf bereits bestehenden Standards, auf wissenschaftlichen Untersuchungen und auf Reviews beruht.

Schlüsselwörter

Palliativ Sedierung Leitlinie 

Sedation in palliative medicine: Guidelines for the use of sedation in palliative care

European Association for Palliative Care (EAPC)

Abstract

The European Association for Palliative Care (EAPC) considers sedation to be an important and necessary therapy option in the care of selected palliative care patients with otherwise refractory distress. Prudent application of this approach requires due caution and good clinical practice. Inattention to potential risks and problematic practices can lead to harmful and unethical practice which may undermine the credibility and reputation of the responsible clinicians and institutions as well as the discipline of palliative medicine more generally. Procedural guidelines are helpful to educate medical providers, set standards for best practice, promote optimal care and convey the important message to staff, patients and families that palliative sedation is an accepted, ethical practice when used in appropriate situations. EAPC aims to facilitate the development of such guidelines by presenting a 10-point framework that is based on the pre-existing guidelines and literature and extensive peer review.

Keywords

Palliative Sedation Framework 

Notes

Danksagung

Wir möchten uns bei den vielen Fachgutachtern der EAPC und den Kollegen aus der Palliativmedizin bedanken, die an der Entwicklung dieses Dokuments mitgewirkt haben, ganz besonders bei: Martin Chasen, Nessa Coyle, David Currow, Charles Daniel, Mervyn Dean, Susan Derby, Marie Fallon, Betty Ferrel, Frank Ferris, Timothy Kirk, Judith Lacy, Reidar Lie, Sara Lieber, Charles Loprinzi, Johan Menten, Amitai Oberman, Ora Rosengarten, Claud Regnard, Gil Bar Sella, Pesach Shvartzman, Jim Shalom, Charles Sprung, Florian Strasser, Christina Ullrich und Charles von Gunten. Besonderer Dank geht an die Mitverfasser, die Vorstandsmitglieder der EAPC, die wesentlich zur Entwicklung des Manuskripts beigetragen haben, die den endgültigen Entwurf kritisch überprüft und letzte Empfehlungen zur Veröffentlichung ratifiziert haben. Neben Lukas Radbruch (Vorsitzender) gehören dazu: Augusto Caraceni, Tine De Vlieger, Michaela Berkovitch, Pam Firth, Katalin Hegedus, Maria Nabal, Sheila Payne, Andre Rhebergen, Esther Schmidlin, Per Sjogren, Carol Tishelman, Chantal Wood und Franco DeConno.

Frau Victoria Fisher (http://www.allgermantranslations.com) danken wir für eine unabhängige, ehrenamtliche Übersetzung des Textes ins Deutsche, der als Vergleich und für die Erstellung des Textes eine große Hilfe war.

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • B. Alt-Epping
    • 1
  • T. Sitte
    • 1
  • F. Nauck
    • 1
  • L. Radbruch
    • 1
  1. 1.Abteilung PalliativmedizinUniversitätsmedizin GöttingenGöttingenDeutschland

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