Advertisement

Palliative Sedation and the Goals of Care at the End of Life

  • William F. SullivanEmail author
Chapter
  • 603 Downloads
Part of the Philosophy and Medicine book series (PHME, volume 116)

Abstract

The term palliative sedation covers a range of current practices. Some have argued that the ethical boundary distinguishing palliative sedation from euthanasia is becoming blurred in a number of these practices (Ten Have and Welie 2014; Hauser and Walsh 2009). Recent policy frameworks and guidelines that have been developed by health care institutions or groups of clinicians in different countries are not consistent in terminology or the medical and ethical guidance that they provide (Taboada 2011; Claessens et al. 2008).

Keywords

Palliative Care Health Care Professional Shared Understanding Distressing Symptom Palliative Sedation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

I am grateful for the assistance of Prof. John Heng of King’s University College, London, Canada in researching and writing this chapter. I also acknowledge the helpful comments of an anonymous reviewer of the first draft of this chapter, some of whose ideas I have incorporated.

References

  1. Boston, P., A. Bruce, and R. Schriber. 2011. Existential suffering in the palliative care setting: An integrated literature review. Journal of Pain and Symptom Management 41(3): 604–618.CrossRefGoogle Scholar
  2. Carroll, L., and R.L. Green (eds.). 1998. Alice’s adventures in wonderland. Oxford: Oxford University.Google Scholar
  3. Chochinov, H.M., T. Hack, T. Hassard, L.J. Kristjanson, S. McClement, and M. Harlos. 2005. Dignity therapy: A novel psychotherapeutic intervention for patients near the end of life. Journal of Clinical Oncology 23(24): 5520–5525.CrossRefGoogle Scholar
  4. Claessens, P., J. Menten, P. Schotsmans, and B. Broeckaert. 2008. Palliative sedation: A review of the research literature. Journal of Pain and Symptom Management 36(3): 310–331.CrossRefGoogle Scholar
  5. Greene, W.R., and W.H. Davis. 1991. Titrated intravenous barbiturates in the control of symptoms in patients with terminal cancer. Southern Medical Journal 84(3): 332–337.CrossRefGoogle Scholar
  6. Haberle, T.H., L.A. Shinkunas, Z.D. Erekson, and L.C. Kaldjian. 2011. Goals of care among hospitalized patients: A validation study. The American Journal of Hospice & Palliative Care 28(3): 335–341.CrossRefGoogle Scholar
  7. Hauser, K., and D. Walsh. 2009. Palliative sedation: Welcome guidance on a controversial issue. Palliative Medicine 23(7): 577–579.CrossRefGoogle Scholar
  8. International Association of Catholic Bioethicists. (2011). The use of sedatives in the care of persons who are seriously ill or dying: Ethical distinctions and practical recommendations. Consensus Statement of the 5th International Association of Catholic Bioethicists Colloquium, Philadelphia, PA, USA, July 10–14, 2011. National Catholic Bioethics Quarterly 2012; 12(3): 489–501.Google Scholar
  9. Jansen, L.A. 2010. Disambiguating clinical intentions: The ethics of palliative sedation. The Journal of Medicine and Philosophy 35: 19–31.CrossRefGoogle Scholar
  10. Kadjian, L.C., A.E. Curtis, L.A. Shinkunas, and K.T. Cannon. 2008. Goals of care toward the end of life a structured literature review. The American Journal of Hospice & Palliative Care 25(6): 501–511.CrossRefGoogle Scholar
  11. Maltoni, M., C. Pitureri, E. Scarpi, L. Piccinini, F. Martini, P. Turci, et al. 2009. Palliative sedation therapy does not hasten death: Results from a prospective multicenter study. Annals of Oncology 207: 1163–1169.CrossRefGoogle Scholar
  12. Peereboom, K., and N. Coyle. 2012. Facilitating goals-of-care discussions for patients with life-limiting disease: Communication strategies for nurses. Journal of Hospice and Palliative Nursing 14(4): 251–258.CrossRefGoogle Scholar
  13. Pellegrino, E.D. 2006. Toward a reconstruction of medical morality. The American Journal of Bioethics 6(2): 65–71.CrossRefGoogle Scholar
  14. Quill, T.E., B. Lo, D. Brock, and A. Meisel. 2009. Last-resort options for palliative sedation. Annals of Internal Medicine 151: 421–424.CrossRefGoogle Scholar
  15. Scott, J. 1991. Submission to the Canadian Legislative Committee on Bill C203, Nov 19, 1991, p. 1.Google Scholar
  16. Stone, M.J. 2001. Goals of care at the end of life. Proceedings (Baylor University Medical Center) 14: 134–137.Google Scholar
  17. Sulmasy, D.P. 2011. Sedative palliation or sedation to death? Paper for the 5th International Association of Catholic Bioethicists Colloquium, Philadelphia, PA, USA, July 10–14, 2011.Google Scholar
  18. Sykes, N., and A. Thorns. 2003. Sedative use in the last week of life and the implications for end-of-life decision making. Archives of Internal Medicine 163(3): 341–344.CrossRefGoogle Scholar
  19. Taboada, P. 2011. Palliative sedation: Analysis of clinical realities, trends and existing guidelines. Paper for the 5th International Association of Catholic Bioethicists Colloquium, Philadelphia, PA, USA, July 10–14, 2011.Google Scholar
  20. Ten Have, H., and J.V. Welie. 2014. Palliative sedation versus euthanasia: An ethical assessment. Journal of Pain and Symptom Management 47(1): 123–136.CrossRefGoogle Scholar
  21. Tollefsen, C. 2006. Is a purely first-person account of human action defensible? Ethical Theory and Moral Practice 9: 441–460.CrossRefGoogle Scholar
  22. Verkerk, M., E. van Wijlick, J. Legemaate, and A. de Graeff. 2007. A national guideline for palliative sedation in the Netherlands. Journal of Pain and Symptom Management 34(6): 666–670.CrossRefGoogle Scholar
  23. World Health Organization. [cited Sept 28, 2011]. Available at: http://www.who.int/cancer/palliative/en

Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  1. 1.St. Michael’s Hospital Family Practice Unit, Department of Family and Community Medicine, Faculty of MedicineUniversity of TorontoTorontoCanada
  2. 2.Surrey Place CenterTorontoCanada

Personalised recommendations