1Departments of Pain Management and Palliative Medicine
2Palliative Shared Care Team, St. Martin de Porres Hospital, Chiayi, Taiwan, R.O.C.
3Departments of Pain Management and Palliative Care Unit, Chi-Mei Medical Center, Liou-ying Campus, Tainan, Taiwan, R.O.C.
Outline
Palliative Sedation (PS) is a widely used medical intervention by sedatives and analgesics to reduce patient’s consciousness to relieve severely intolerable sufferings and refractory symptoms for the terminally ill. The intent of PS is to relieve the burden of patient and to do so in such a manner so to preserve the moral sensibilities of the patient, the medical professionals involved in their care, and concerned family and friends. This article will review the status of the recent applications, indications, concerns of staff and family, and the process of PS (patient’s assessment, obtaining consent, sedative medications, patient’s monitoring, the role of nutrition and hydration and the administration of previous medications). We also discuss the special applications of PS in palliative care settings, such as, in emergency situations, for respite and for psychological distress. The European Association for Palliative Care has developed a 10-item framework that addresses the key clinical issues to be considered when institutions are developing guidelines for PS. We summarize series studies and our experiences, which will be presented in this article separately.
Palliative sedation, Terminally ill, Intolerable suffering, Refractory symptoms
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