European Association for Palliative Care (EAPC) framework for palliative sedation: an ethical discussion.
Summary of "European Association for Palliative Care (EAPC) framework for palliative sedation: an ethical discussion."
ABSTRACT:
BACKGROUND:
The aim of this paper is to critically discuss some of the ethically controversial issues regarding continuous deep palliative sedation at the end of life that are addressed in the EAPC recommended framework for the use of sedation in palliative care.
DISCUSSION:
We argue that the EAPC framework would have benefited from taking a clearer stand on the ethically controversial issues regarding intolerable suffering and refractory symptoms and regarding the relation between continuous deep palliative sedation at the end of life and euthanasia. It is unclear what constitutes refractory symptoms and what the relationship is between refractory symptoms and intolerable suffering, which in turn makes it difficult to determine what are necessary and sufficient criteria for palliative sedation at the end of life, and why. As regards the difference between palliative sedation at the end of life and so-called slow euthanasia, the rationale behind stressing the difference is insufficiently demonstrated, e.g. due to an overlooked ambiguity in the concept of intention. It is therefore unclear when palliative sedation at the end of life amounts to abuse and why.
CONCLUSIONS:
The EAPC framework would have benefited from taking a clearer stand on some ethically controversial issues regarding intolerable suffering and refractory symptoms and regarding the relation between continuous deep palliative sedation at the end of life and euthanasia. In this text, we identify and discuss these issues in the hope that an ensuing discussion will clarify the EAPC's standpoint.
Affiliation
Journal Details
This article was published in the following journal.
Name: BMC palliative care
ISSN: 1472-684X
Pages: 20
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20836861
- DOI: http://dx.doi.org/10.1186/1472-684X-9-20
Medical and Biotech [MESH] Definitions
Palliative Care
Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)
Hospices
Facilities or services which are especially devoted to providing palliative and supportive care to the patient with a terminal illness and to the patient's family.
Mouthwashes
Solutions for rinsing the mouth, possessing cleansing, germicidal, or palliative properties. (From Boucher's Clinical Dental Terminology, 4th ed)
Megestrol
17-Hydroxy-6-methylpregna-3,6-diene-3,20-dione. A progestational hormone used most commonly as the acetate ester. As the acetate, it is more potent than progesterone both as a progestagen and as an ovulation inhibitor. It has also been used in the palliative treatment of breast cancer.
Cyproterone
An anti-androgen that, in the form of its acetate (CYPROTERONE ACETATE), also has progestational properties. It is used in the treatment of hypersexuality in males, as a palliative in prostatic carcinoma, and, in combination with estrogen, for the therapy of severe acne and hirsutism in females.
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