Abstract:
Palliative sedation can be considered as \"the last resort\" in order to treat unbearable, refractory symptoms or suffering in end-of-life patients. The aim is symptom relief and not to induce death as in the case of euthanasia. The treatment might be one of the most challenging therapeutic options in the field of palliative care, involving both ethical and practical issues. Still, studies have shown that it is a safe and valuable treatment and in general does not shorten the life of the patient. Since patients in Switzerland have the legal option of assisted suicide, palliative sedation is an alternative that has become increasingly important. The use of palliative sedation was reported in 17.5% of all patients admitted to palliative care in Switzerland, making the country of those with the highest use of this treatment. The aim of this narrative review is to discuss ethical and practical issues in palliative sedation, with specific focus on experiences from Switzerland. Indications, ethical considerations, drugs of choice and duration are discussed. Decision making should be based on solid guidelines. When used correctly, palliative sedation is an important and useful tool in palliative care in order to provide good symptom relief.
摘要:
姑息镇静可以被认为是治疗难以忍受的“最后手段”,终末期患者的难治性症状或痛苦。目的是缓解症状,而不是像安乐死那样诱发死亡。这种治疗可能是姑息治疗领域最具挑战性的治疗选择之一,涉及道德和实践问题。尽管如此,研究表明,这是一种安全和有价值的治疗方法,通常不会缩短患者的寿命。由于瑞士的患者有协助自杀的合法选择,姑息镇静是一种越来越重要的替代方法。据报道,在瑞士接受姑息治疗的所有患者中,有17.5%使用姑息镇静。使这个国家成为使用这种治疗方法最多的人。这篇叙述性综述的目的是讨论姑息镇静中的伦理和实践问题,特别关注瑞士的经验。指示,伦理考虑,讨论了药物的选择和持续时间。决策应基于坚实的指导方针。如果正确使用,姑息镇静是姑息治疗中重要且有用的工具,以提供良好的症状缓解。