it's going to be titrated where the patient's going to be sedated just enough, so that their suffering becomes tolerable.' And it was away from total sedation, because if it's done properly. 'And the shift was intentional, because the shift was away from terminal sedation, because there's now evidence that it doesn't hasten death. 'I think if you were to do a search in Medline, and look at the publications in the last five years or so, you would see a shift toward palliative sedation,' says Kirk. The treatment has been referred to in the past as 'total sedation' or in some instances, 'terminal sedation.'

Importantly, the NHPCO position paper indicates that 'this statement addresses the use of palliative sedation only for patients who are terminally ill and whose death is imminent.' The article goes on to say, 'For the limited number of imminently dying patients who have pain and suffering that is (a) unresponsive to other palliative interventions less suppressive of consciousness and (b) intolerable to the patient, NHPCO believes that palliative sedation is an important option to be considered by health care providers, patients, and families.' 1 In a special article on the position statement published in the May 2010 issue of the Journal of Pain and Symptom Management, the NHPCO accepts the National Quality Forum's definition of palliative sedation as the 'lowering of patient consciousness using medications for the express purpose of limiting patient awareness of suffering that is intractable and intolerable.' 1 we thought it was a good time to revisit the issue and to offer an updated resource based on those developments.' Because there was new evidence, because there was accelerated discussion in the literature. 'So, if people thought that this hastened death, there were now studies to show that it didn't hasten death. flurry of studies published with empirical data that enabled the discussion to move from kind of a theoretical discussion of what is this to actually, what are the outcomes? 'And in the past five years or so, there was a. 'There was a minority of folks who were thinking that this was equivalent to euthanasia and should be banned, so that the discussion in the health care literature, and especially the palliative care literature, was really starting to accelerate,' Kirk explains. Kirk, PhD, chair of the Palliative Sedation Task Force at NHPCO and assistant professor of philosophy, City University of New York (CUNY) -York College, in Jamaica, NY.īecause of this lack of clarity, as well as a growing body of literature and conversations on the topic, the NHPCO decided to issue the position statement, Kirk tells Medical Ethics Advisor.

One of the primary misunderstandings about palliative sedation is that it hastens death, according to Timothy W. That's because, according to the paper's authors, what is meant by palliative care and palliative sedation, in particular is often misunderstood, even within the medical community. The National Hospice and Palliative Care Organization (NHPCO), in a special article outlining its position statement on palliative sedation, starts by indicating what it believes palliative care actually is.

Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice. 'Palliative care refers to patient- and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. NHPCO offers position statement on palliative sedation

Kirk hasten