Hot Topic (12/29): Is "terminal sedation" ethical?

[Cafe GroupAdmin]

Hard Choice for  Comfortable Death:  Sedation

In almost every room people were sleeping, but not like babies. This was not the carefree sleep that would restore them to rise and shine for another day. It was the sleep before — and sometimes until — death.

In some of the rooms in the hospice unit at Franklin Hospital, in Valley Stream on Long Island, the patients were sleeping because their organs were shutting down, the natural process of death by disease. But at least one patient had been rendered unconscious by strong drugs.

The patient, Leo Oltzik, an 88-year-old man with dementia, congestive heart failure and kidney problems, was brought from home by his wife and son, who were distressed to see him agitated, jumping out of bed and ripping off his clothes. Now he was sleeping soundly with his mouth wide open.

“Obviously, he’s much different than he was when he came in,” Dr. Edward Halbridge, the hospice medical director, told Mr. Oltzik’s wife. “He’s calm, he’s quiet.”

Mr. Oltzik’s life would end not with a bang, but with the drip, drip, drip of an IV drug that put him into a slumber from which he would never awaken. That drug, lorazepam, is a strong sedative. Mr. Oltzik was also receiving morphine, to kill pain. This combination can slow breathing and heart rate, and may make it impossible for the patient to eat or drink. In so doing, it can hasten death.

Mr. Oltzik received what some doctors call palliative sedation and others less euphemistically call terminal sedation. While the national health coverage debate has been roiled by questions of whether the government should be paying for end-of-life counseling, physicians like Dr. Halbridge, in consultations with patients or their families, are routinely making tough decisions about the best way to die.

Among those choices is terminal sedation, a treatment that is already widely used, even as it vexes families and a profession whose paramount rule is to do no harm.

Doctors who perform it say it is based on carefully thought-out ethical principles in which the goal is never to end someone’s life, but only to make the patient more comfortable.

But the possibility that the process might speed death has some experts contending that the practice is, in the words of one much-debated paper, a form of “slow euthanasia,” and that doctors who say otherwise are fooling themselves and their patients.

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What do you think about terminal sedation?

Is it ethical for doctors to sedate patients if doing so hastens death?

Should doctors be involved in ending life?

[survivorinohio]

I have watched my mother, father, grandmother, and my two best friends die this way.  Cancer was the disease but drugs were the means to the end.  I am ok with it.  They were all in a lot of pain and being in pain and feeling agitated is not a dignified death. 

I understood that death was eminent when they entered hospice and so did they.  I dont find it to be unethical or unkind but rather a softer and less painful death. If I became terminal I would enter hospice myself.

[Goodwoman614]

Truth be told, doctors made this kind of call quite often, and still do.  Whether there is an article written about it or not.  My guess is that the more the situation is low on the radar, i.e. in smaller settings as opposed to large hospitals with multiple forms of patient tracking and protocols, the easier it was/is to carry out.

[rosepetal209]

Who else should be involved in ending life? If I am ever in pain and am going to die from what ails me then why should my family have to deal with my pain and suffering until I finally give out on my own? Why should I have to deal with being awake and in pain until my body just gives in to the inevitable?

When an animal is hurt or dying what do we do? We have them put to sleep. Do we do it because we are mean? No! We do it because we know they are suffering and we cant do anything to stop the pain. Its done because we love them. Why are humans not entitled to the same thing we would do for an animal?

There are many terminally ill people that beg for the choice to end their suffering. I think each human has the right to end their life when THEY choose and if they are ever in a situation where they can not choose for themselves then their loving family should be able to. Their family knows them better then anyone else. Sometimes lingering is the worst hell.

 

 

[EireLass]

They've been doing it for a long time. You know, they patient is laying in pain.....the doctor says "Let's kick it up a notch" quietly winks, the family member shakes the doctors hand.....and everyone is at peace.

Yes....I think it's a good idea. 

[cherry41089]

they have done this for a long time, I know in florida they do it too, becuz my grandma works in a nursing home and she say they do it to the patients there all the time. I'm fine with it if the person is in alot of pain and not much can be done for them. if they are just sitting  around waiting for death in alot of pain. then why not speed in up alittle

[Talee]

Quoting survivorinohio:

I have watched my mother, father, grandmother, and my two best friends die this way.  Cancer was the disease but drugs were the means to the end.  I am ok with it.  They were all in a lot of pain and being in pain and feeling agitated is not a dignified death. 

I understood that death was eminent when they entered hospice and so did they.  I dont find it to be unethical or unkind but rather a softer and less painful death. If I became terminal I would enter hospice myself.

Same here...I doubt the morphine drip they gave her was enough but at least it was something...

I am totally ok with this.

 

[Jenneliz]

I just have always found it funny how people dont think twice about piutting their dogs or cats "to sleep" because they "dont want them to suffer" , but when it comes to people, its considered murder. That doesnt make any sense to me.

[partygal19dani]

I agree with the rest of you ladies!!!  I feel that terminal sedation can be the compassionate way to end a person's life in peace and dignity!!!  I am all for it and would want it for myself.

[stormcris]

I have often thought of this as well.

Quoting Jenneliz:

I just have always found it funny how people dont think twice about piutting their dogs or cats "to sleep" because they "dont want them to suffer" , but when it comes to people, its considered murder. That doesnt make any sense to me.

[tericared]

Quoting Jenneliz:

I just have always found it funny how people dont think twice about piutting their dogs or cats "to sleep" because they "dont want them to suffer" , but when it comes to people, its considered murder. That doesnt make any sense to me.

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