Palliative Sedation

The question, "Will you discuss palliative sedation?" has come up several times so I am putting my response in this section rather than the Comments.

Palliative Sedation is a term used by hospice, palliative care and medical professionals. The National Hospice and Palliative Care Organization states it’s position on palliative sedation as follows:

“PALLIATIVE SEDATION - Terminal illnesses can cause distressing symptoms, such as severe pain, mental confusion, muscle spasms, feelings of suffocation, and agitation. Despite skilled palliative care, in some cases these symptoms may not respond to standard interventions. After all other means to provide comfort and relief to a dying patient have been tried and are unsuccessful, doctors and patients can consider palliative sedation. Palliative sedation is the use of sedative medications to relieve extreme suffering by making the patient unaware and unconscious (as in a deep sleep) while the disease takes its course, eventually leading to death. The sedative medication is gradually increased until the patient is comfortable and able to relax. Palliative sedation is not intended to cause death or shorten life.” (Vol. 39 No. 5 May 2010 NHPCO Position Statement on the Use of Palliative Sedation 915)

Over the years my personal experience has been that most people who are dying do not need palliative sedation. If pain was not a part of the disease process then the likelihood of pain as death approaches is slim. The actual dying process does not cause pain. It is the particular disease leading a person to death that causes pain. With today’s medical advancements there is no reason for a person to die in uncontrolled pain. If the disease process has been a pain filled experience and all comfort management options have been unsuccessful then sleep is our friend. Sleep, created by regulated, supervised medications (palliative sedation), is a compassionate alternative to needless end of life suffering. The key to a gentle death is to relax. If we are in extreme pain and suffering we cannot relax and peacefully leave our bodies.

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