Home > Riviste > Minerva Anestesiologica > Fascicoli precedenti > Minerva Anestesiologica 2017 December;83(12) > Minerva Anestesiologica 2017 December;83(12):1317-23

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi

 

EXPERTS’ OPINION   Freefree

Minerva Anestesiologica 2017 December;83(12):1317-23

DOI: 10.23736/S0375-9393.17.12091-2

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Palliative sedation: ethical aspects

Guido MICCINESI 1 , Augusto CARACENI 2, Marco MALTONI 3

1 Unit of Clinical Epidemiology, Cancer Prevention and Research Institute-ISPO, Florence, Italy; 2 Palliative Care, Pain Therapy, and Rehabiltation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; 3 Unit of Palliative Care, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy


PDF


Palliative sedation (PS), the medical act of decreasing a patient’s awareness to relieve otherwise intractable suffering, is considered by some commentators to be controversial because of its consequences on residual survival and/or quality of life, and to be inappropriate for treating pure existential suffering. We will argue that PS must be always proportional, i.e. controlling refractory symptoms while keeping the loss of personal values (communication, affective relationships, care relationship) as low as possible, and that imminence of death is necessary too, from an ethical point of view, if a deep and continuous sedation (DCS) is proposed. Moreover, in case of pure existential suffering DCS should only be considered after repeated trials of respite sedation. The use of progressive consent and advance care planning to share the decision with the patient and to involve the family in the decision process as much as the patient desires is another ethical aspect to be pursued. Producing, implementing and sustaining guidelines at the higher scientific and professional level promise to help in improving both clinical and ethical aspects of the practice of PS.


KEY WORDS: Ethics - Palliative care - Deep sedation

inizio pagina