Terminal sedation is a form of palliative care for patients in extreme pain near death. The patient is given heavy doses of sedatives and pain medication, and the medical team and family make decisions on their behalf. There are concerns about potential misuse and patient rights.
Terminal sedation is a form of palliative care offered to patients who are nearing death and are in considerable pain. In this type of sedation, also known as palliative sedation, the patient is given a heavy dose of sedatives and pain management medications so that he or she is no longer conscious and in pain. This practice is controversial in some regions and has sparked a very heated debate from a wide variety of perspectives.
Ideally, terminal sedation is initiated after a discussion with the patient or after reading the patient’s advance directives. In addition to offering sedation, the healthcare provider may provide intravenous fluids and nutrition to increase patient comfort, and additional life-saving measures may also be taken. Terminal sedation is offered in the last hours or days of a patient’s life, and only if the patient has intractable pain that cannot be managed by other means. Once the patient has been sedated, the medical team and family members make decisions on the patient’s behalf, as he will be unable to communicate.
While a patient is terminally sedated, they should be closely monitored, because sedatives can depress respiration and heart rate. Drugs must be administered and managed carefully so that sedation does not cross the line of euthanasia. Some medical ethicists have expressed concern that terminal sedation could potentially be used to kill or euthanize patients, especially in the case of patients who may not have lawyers to speak for them.
Some medical conditions can cause extreme pain and suffering. An ironic consequence of the increasing sophistication of medical care has led to situations where patients may live far longer than they would like, sometimes experiencing considerable pain and unhappiness in the process. This type of sedation is seen as an option for patients who would prefer to be unconscious in their final hours and can be discussed with patients and family members in a review of hospice care options.
Palliative sedation is legal in most countries, with a clear distinction between terminal sedation and assisted suicide. However, ethics investigations have uncovered cases where terminal sedation has been used to effectively kill patients, or where it has been used on patients who have been unable to make an active choice to opt for terminal sedation. This rings alarm bells for many patient rights advocates, who want to ensure that people can make their own choices about medical care and treatment options.
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