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Topic: Terminal sedation

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Euthanasia

Palliative care

Doctrine of double effect

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	Terminal - Open Encyclopedia (Site not responding. Last check: 2007-10-29)
		In rail transport, a terminal is a passenger rail station where rail service begins and ends; the end of the line.
		A pipeline terminal is a storage facility at the downstream end of a pipeline transport, typically serving as a buffer between delivery and use.
		Terminal symbol in BNF is an indivisible entity.
	open-encyclopedia.com /Terminal (299 words)

	Terminal - Wikipedia, the free encyclopedia
		Terminal illness, a progressive disease that is expected to cause death
		Terminal sedation, the practice of inducing unconsciousness in a terminally ill person for the remainder of the person's life
		Terminal symbol, in formal grammar, is a symbol that cannot be further divided
	en.wikipedia.org /wiki/Terminal (275 words)

	The Center for Bioethics and Culture Network :. Article Display (Site not responding. Last check: 2007-10-29)
		Terminal sedation is defined as the administration of drugs to keep the patient in deep sedation or coma until death, without giving artificial nutrition or hydration.
		But when the terminal sedation is applied in non terminal stages, and no fluids are applied, the distinction between terminal sedation and euthanasia becomes very thin if real at all.
		Both sides agree that if terminal sedation is to be considered as a special form of terminal care it should be applied only in the very last stages of life (life expectancy of days, at most a week), in a very careful way since the titration of the doses of sedative is not so simple.
	www.thecbc.org /redesigned/research_display.php?id=155 (1407 words)

	Euthanasia Topics text 07
		Terminal sedation, on the other hand, forms a part of palliative care which is considered to be normal medical care.
		Although the death is unavoidable, the objective of terminal sedation is not to end the life of the patient but rather to mitigate pains and other symptoms.
		According to Kompanje, the terminal phase of the elderly and patients with chronic illnesses tends to be prolonged.
	home.tiscali.nl /~taudin/English/Euthanasia_in_the_netherlands/Euthanasia_Topics/Euthanasia_Topics_text/Euthanasia_Topics_07_text.html (1133 words)

	World Federation of Right to Die Societies: faqs
		Terminal sedation usually refers to when a consenting patient is sedated to the point of unconsciousness to relieve otherwise untreatable pain and suffering, and is then allowed to die of dehydration or other intervening complications.
		It is for this reason that terminal sedation has sometimes been called "slow euthanasia." Although the overall expressed goal of terminal sedation is to relieve otherwise uncontrollable suffering, life-prolonging therapies are withdrawn with the intent of hastening death.
		Terminal sedation is ethically considered to be a combination of aggressive symptom management (sedatives to treat unbearable symptoms) and withdrawal of life-sustaining therapy (fluids, nutrition, and other treatments).
	www.worldrtd.net /faqs/factsheets?id=39 (567 words)

	World Federation of Right to Die Societies: news
		Terminal sedation is the use of high doses of sedatives to relieve extremes of physical distress.
		Terminal sedation should be distinguished from the common occurrence of a dying patient gradually slipping into an obtunded state as death approaches; this occurrence is a combination of the metabolic changes of dying and the results of usual palliative treatments.
		Terminal sedation is also distinct from the sedation that occasionally occurs as an unintended side effect of high-dose opioid therapy, which is used to relieve severe terminal pain (37).
	www.worldrtd.net /news/world?id=436 (4704 words)

	Euthanasia (Site not responding. Last check: 2007-10-29)
		Terminal sedation is a combination of aggressive palliative care (sedatives to treat unbearable symptoms) and withdrawal of life-sustaining therapy (fluids, nutrition, and other treatments), and may thus be considered legal and acceptable, as belonging to normal medical practice, even in jurisdictions and cases where euthanasia and PAS are not.
		It should be noted that doctors routinely and legally provide medical treatment to the terminally ill involving the use of large quantities of pain-killing drugs, primarily to relieve the patient's pain, but in doses that may suppress bodily functions and thus shorten the life of the patient.
		As of 2002, it is estimated that nearly 100 terminally ill patients have committed doctor assisted suicide since the law went into effect in 1997.
	www.sciencedaily.com /encyclopedia/euthanasia (1723 words)

	lifeissues.net \| Should Sedation Be Terminal?
		Thus, terminal sedation has evolved from being a last resort for relieving the pain of the dying to a method of permanently relieving nonphysical psychological or spiritual distress.
		Also "terminal sedation should be distinguished from the common occurrence of a dying patient gradually slipping into an obtunded state as death approaches; this occurrence is a combination of the metabolic changes of dying and the results of usual palliative treatments.
		Terminal sedation is also distinct from the sedation that occasionally occurs as an unintended side effect of high-dose opioid therapy, which is used to relieve severe terminal pain.
	www.lifeissues.net /writers/val/val_23sedationterminal.html (3197 words)

	death with dignity * study finds religion shapes views of terminal sedation (Site not responding. Last check: 2007-10-29)
		Terminal sedation may be confused with physician-assisted suicide, which is illegal in every state except Oregon, but a 1997 Supreme Court ruling decreed the practice is permissible, making it an alternative to physician-assisted suicide.
		Whereas assisted suicide is performed with the intent of killing the terminally ill patient, terminal sedation uses strong analgesics and sedatives to alleviate pain and other symptoms without the intention of killing the patient, although the result may be death.
		"In the matter of terminal sedation, you as a physician must acknowledge the risk and probability of death is something to consider anytime high doses of analgesics or sedatives are used," Kaldjian said.
	www.deathwithdignity.org /fss/news/yale.12.08.04.asp (524 words)

	Ethics & Medicine: TERMINAL SEDATION, TERMINAL ELATION, AND MEDICAL PARSIMONY[dagger] (Site not responding. Last check: 2007-10-29)*
		Intuitively, terminal sedation is usually understood as an active intervention on behalf of a physician during the last phases of terminal illness.
		Sedation is a universal medical practice with no intrinsic connection to terminal care and to the dying process.
		The patient is sedated to a desirable degree and for a specific length of time, towards the end of which his or her need for further sedation is reevaluated.
	www.findarticles.com /p/articles/mi_qa4004/is_200410/ai_n10297986 (1395 words)

	Nancy Valko, RN: Terminal Sedation
		Terminal sedation is done with the full knowledge that no further active treatment will be done and that patients, as rapidly as possible, will now die as a result of their underlying disease process.
		Terminal sedation as commonly practiced is without doubt an imposed death, i.e., intentional medical killing.
		Sedating the patient in these rare circumstances manages the symptom of agitation, delirium or (in combination with pain medications) severe pain but does not cause death as in "terminal sedation" which is a long-term process resulting in death by dehydration, fluid volume deficit and circulatory collapse.
	www.hospicepatients.org /n-valko-terminal-sedation.html (1902 words)

	Responding to Intractable Terminal Suffering..., Annals 7 Mar 00
		In contrast, terminal sedation involves an explicit decision to render the patient unconscious to prevent or respond to otherwise unrelievable physical distress.
		Terminal sedation should be used only in the most difficult cases, which are typically marked by intense discussion of the clinical and ethical issues on the part of the physician, the clinical team, the family, and the patient.
		A level of sedation that eliminates signs of discomfort (such as stiffening or grimacing spontaneously or with routine repositioning and nursing care) is maintained until the patient dies.
	www.acponline.org /ethics/quill.htm (4653 words)

	[No title]
		If the patient is truly actively dying, and is then terminally sedated, the patient quite often does not have time to dehydrate, even though fluids are not being given, and the patient dies as a natural result of the terminal illness.
		The medical director stated that in such a case, terminal sedation was appropriate and the patient could be sedated into a coma simply because nobody else was in the home to care for the patient and because the patient did not want to die in a facility.
		Hospices that violate the sanctity of the patient's and family's trust by terminally sedating a patient without consent or against his or her will are doing the greatest damage to the hospice industry itself, because the families of the dying remember forever what happened in their hospice experience.
	www.chninternational.com /terminal_sedation_1.htm (1370 words)

	The Right to Terminal Sedation (Site not responding. Last check: 2007-10-29)
		Terminal sedation is the administration of barbiturates (often with opioids) deliberately to produce and continue unconsciousness.
		While the right to terminal sedation with dehydration is widely recognized as a basic right of the terminally ill in intractable suffering, there is much evidence that at the practical level this right is almost invariably denied.
		The supposed availability of terminal sedation was the corner-stone on which Justice O’Connor erected her concurring opinion holding PAD not necessary and thus not a Constitutionally protected "liberty interest".
	www.hemlocknj.org /term_sed.html (2004 words)

	[No title]
		Sedation is generally indicated when pain and distress cannot be controlled by any other means either due to limited timeframe or risk of excessive morbidity.
		The goal of sedation is to relieve obvious pain and suffering of the child by adding drugs to induce sleep, but does not intend to hasten death.
		It is important to recognize that sedation alone does not provide analgesia, and a level of opioid analgesia that provides the most comfort possible should be continued while the child is sedated.
	www.childcancerpain.org /content.cfm?content=pharm25 (313 words)

	Terminal Sedation (Site not responding. Last check: 2007-10-29)
		Sedation when given with the sole intention of relieving suffering at the end of life has become an accepted but highly controversial aspect of palliative care.
		Wide cultural variations were found, particularly with respect to sedation for delirium: the use of sedation for this symptom varying from 15% in Durban to 60% in Madrid.
		Irwin argues that the practice of terminal sedation amounts to euthanasia "because the comatose patient often dies from the combination of two intentional acts by a doctor - the induction of unconsciousness, and the withholding of food and water.
	www.catholicdoctors.org.uk /CMQ/Feb_2002/terminal_sedation.htm (1742 words)

	Terminal Sedation
		Terminal sedation was said to be the same as assisted suicide, only a more "gruesome"(99) method of doing so than a quick lethal dose of drugs.
		Tribe called sedation a means to "chemically kill someone."(100) However the Court rejected attempts to equate an intended death with the risk of an unintended death that may accompany sedation.
		By distorting both the practice of sedating patients and the principle of double effect, assisted suicide advocates are attempting to persuade the public that it is unreasonable to continue to prohibit such deaths.
	www.valdosta.edu /~jmmcgahe/article2.htm (3595 words)

	Proper Pain Medication Is Not Illegal
		Terminal sedation is available for patients whose pain or other symptoms cannot be relieved without sedation or, in some cases, for patients who simply do not want to experience the last days of their lives.
		Terminal sedation is a consciously induced coma during which feeding and nutrition are foregone by the patient.
		Terminal sedation is perhaps the compromise alternative to physician-assisted suicide.
	www.mywhatever.com /cifwriter/library/39/baz967.html (759 words)

	Dutch doctors choose sedation rather than euthanasia -- Sheldon 329 (7462): 368 -- BMJ
		As sedation is considered normal medical treatment, doctors are not legally obliged to report their actions as they must in euthanasia.
		But terminal sedation is now seen as an alternative to euthanasia for many patients.
		One reason patients preferred terminal sedation was because they considered it to be less disturbing to the natural process of dying.
	bmj.bmjjournals.com /cgi/content/full/329/7462/368-e (459 words)

	Euthanasia / Assisted Suicide :: Fears over 'unregulated euthanasia' (Site not responding. Last check: 2007-10-29)
		In contrast to euthanasia, terminal sedation is not aimed at ending a patient's life but the administering of drugs is often part of palliative care to combat pain, fear and distress.
		The answers indicated that 52 percent had applied on occasion terminal sedation and in a large majority of these cases, the sedation was administered partly to hasten a patient's death.
		Terminal sedation does not need to be reported to authorities, but euthanasia does.
	www.religionnewsblog.com /8165-Fears_over__unregulated_euthanasia_.html (584 words)

	Dutch Doctors See Terminal Sedation as Alternative to Euthanasia
		While some see terminal sedation as an alternative to euthanasia, critics have called it "slow euthanasia," claiming that is like a slow-motion form of homicide.
		For ethicists, where sedation is concerned, the issue becomes whether the physician's goal is to relieve pain or to hasten death.
		Valko notes that terminal sedation is also rapidly gaining ground in the U.S. She points to an article written by Dr. Erich Lowry called, "Terminal Sedation, Self-starvation, and Orchestrating the End of Life," which appeared in a 2001 edition of the Archives of Internal Medicine.
	www.lifenews.com /bio323.html (586 words)

	Terminal Sedation
		The sedation would relieve extremes of physical distress, with the medication rendering the person unconscious to alleviate suffering and not intentionally to end life.
		Terminal sedation involves a conscious decision to render the individual unconscious to relieve the unbearable physical distress.
		Interestingly enough, opponents of physician-assisted suicide cite terminal sedation as a preferable alternative because death is not directly or intentionally caused by the physician.
	www.therubins.com /legal/terminal.htm (846 words)

	Terminal sedation -- Facts, Info, and Encyclopedia article (Site not responding. Last check: 2007-10-29)
		In practice (though not by definition) this implies that the patient is not receiving any nutrition or other (additional info and facts about life-sustaining therapy) life-sustaining therapy while sedated.
		There is controversy as to whether terminal sedation should be considered a form of (The act of killing someone painlessly (especially someone suffering from an incurable illness)) euthanasia, or only a form of (additional info and facts about palliative care) palliative care.
		Death results from (The process of extracting moisture) dehydration and/or from the pre-existing disease process, just as if the patient had refused food, water, and treatment while remaining awake.
	www.absoluteastronomy.com /encyclopedia/t/te/terminal_sedation.htm (277 words)

	Terminal Sedation from Salon.com
		The furthest reach of palliative care is terminal sedation: drugging a patient into unconsciousness and keeping him that way until he dies, usually days or weeks later.
		Terminal sedation is practiced openly and without much controversy, and it does not seem to carry a high incidence of complication.
		Opponents of assisted suicide generally support terminal sedation and stress the distinction between the two.
	www.hospicepatients.org /saloncom-04-19-00-terminalsedation.html (1134 words)

	[No title]
		The legislature 6 further finds that the artificial prolongation of life for 7 persons with a terminal condition may secure only a precarious 8 and burdensome existence, while providing nothing medically 9 necessary or beneficial to the person.
		If it is the opinion of the 12 attending or the consulting physician that a patient's judgment 13 may be impaired as a consequence of the patient's terminal 14 carcinomatous condition, resulting in depression or a psychiatric 15 or psychological disorder, either physician shall refer the 16 patient for counseling.
		No medication to end a patient's life 17 shall be prescribed until the person performing the counseling 18 determines that the patient is not suffering from a psychiatric 19 or psychological disorder, or depression causing impaired 20 judgment.
	www.capitol.hawaii.gov /session1999/Bills/HB418_.htm (2372 words)

	lifeissues.net \| Terminal Sedation
		This paper highlights the dangers of terminal sedation - a controversial aspect of palliative care.
		The author shows how advocates of euthanasia in the UK and elsewhere are exploiting the practice of "terminal sedation" and considers their allegations.
		According to Hardy there is now concern "that sedation as the best means of symptom control in the dying patient may be underused because of the fear of employing 'terminal sedation"(9) - in other words because of concerns about euthanasia.
	www.lifeissues.net /writers/cra/cra_01terminalsedation.html (1615 words)

	Moral and Legal Issues Surrounding Terminal Sedation and Physician Assisted Suicide - Storming Media
		This is because patients who suffer from terminal illnesses are forced to make difficult choices at the end of their lives.
		Currently, a terminally ill patient has three options in dealing with the extreme physical pain of his or her illness.
		The final option most terminally ill patients have to deal with extreme pain is to end their life.
	www.stormingmedia.us /42/4286/A428604-226-19t.html (267 words)

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