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Palliative Sedation

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Sedation and Analgesia for the Pediatric Intensivist

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Abstract

The primary aim of palliative sedation is to relieve distress and suffering at the end-of-life. Palliative sedation is indicated for patients who have refractory symptoms at the end-of-life that are not adequately managed by standard medical therapies. Historically, this practice has been described as “terminal sedation,” and it is sometimes conflated with the concept of euthanasia, especially since physician aid-in-dying has become a legal practice in several states in the US (Oregon Death With Dignity Act, OR REV. STAT §127.800–127.995, 2015; Hedberg and New. Ann Intern Med. 167:579–583, 2017). In this chapter, the current guidelines and general practice principles of palliative sedation will be described. Ethical considerations will be reviewed; symptom management and applicable medications will be described; and the development of practice standards will be discussed. Finally, clinical and patient/family considerations will be discussed.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Critical Care Medicine, Division of Bioethics and Palliative Care, Seattle Children’s Hospital and University of Washington School of Medicine, Seattle, WA, USA

    Eileen Rhee

  2. Department of Pediatrics, Division of Critical Care Medicine, Integrated Pediatric Pain and Palliative Care, University of California San Francisco, San Francisco, CA, USA

    Efrat Lelkes

  3. Department of Anesthesiology and Critical Care Medicine, Pediatric Advanced Care Team, The Children’s Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Wynne Morrison

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  1. Eileen Rhee
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  2. Efrat Lelkes
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  3. Wynne Morrison
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Correspondence to Eileen Rhee .

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Editors and Affiliations

  1. Associate Professor of Pediatrics, Emory University School of Medicine, Department of Pediatrics, Division of Pediatric Critical Care Medicine, Children’s Healthcare of Atlanta at Egleston, Atlanta, GA, USA

    Pradip P. Kamat

  2. Professor of Pediatrics/Pediatric Critical Care, University of Louisville, “Just For Kids” Critical Care Center, Norton Children’s Hospital, Louisville, KY, USA

    John W. Berkenbosch

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Rhee, E., Lelkes, E., Morrison, W. (2021). Palliative Sedation. In: Kamat, P.P., Berkenbosch, J.W. (eds) Sedation and Analgesia for the Pediatric Intensivist. Springer, Cham. https://doi.org/10.1007/978-3-030-52555-2_22

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  • DOI: https://doi.org/10.1007/978-3-030-52555-2_22

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