Abstract |
Palliative care and hospice should be the standards of care for all terminally ill patients. The first place for clinicians to go when responding to a request for assisted death is to ensure the adequacy of palliative interventions. Although such interventions are generally effective, a small percentage of patients will suffer intolerably despite receiving state-of-the-art palliative care, and a few of these patients will request a physician- assisted death. Five potential "last resort" interventions are available under these circumstances: (1) accelerating opioids for pain or dyspnea; (2) stopping potentially life-prolonging therapies; (3) voluntarily stopping eating and drinking; (4) palliative sedation (potentially to unconsciousness); and (5) physician- assisted death. Patient, family, and clinicians should search for the least harmful way to respond to intolerable end-of-life suffering in ways that are effective and also respect the values of the major participants. A system that allows an open response to such cases ultimately protects patients by ensuring a full clinical evaluation and search for alternative responses, while reinforcing the need to be responsive and to not abandon.
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Authors | Timothy E Quill |
Journal | The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics
(J Law Med Ethics)
Vol. 40
Issue 1
Pg. 57-65
( 2012)
ISSN: 1748-720X [Electronic] England |
PMID | 22458463
(Publication Type: Journal Article)
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Copyright | © 2012 American Society of Law, Medicine & Ethics, Inc. |
Chemical References |
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Topics |
- Analgesics, Opioid
(therapeutic use)
- Deep Sedation
- Humans
- Pain Management
- Palliative Care
- Suicide, Assisted
(ethics, legislation & jurisprudence, psychology)
- United States
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