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Thread: Ethical decision making with end of life care: Mayo Clinic review

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    Super Moderator cougarnurse's Avatar
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    Ethical decision making with end of life care: Mayo Clinic review

    Do your doctors have a problem with recommending Hospice because of this? http://www.medicalnewstoday.com/articles/203348.php

    In a review article published in the October issue of Mayo Clinic Proceedings, Mayo Clinic physicians differentiate the ethical and legal permissibility of withholding or withdrawing life-sustaining treatments and accepted comfort measures, specifically palliative sedation, from that of physician-assisted suicide or euthanasia.

    Physician reviewers find that palliative sedation has an important place on the continuum of appropriate palliative care. "At the end of life, patient goals often shift to comfort, and removal of burdens and relief of suffering become paramount," says lead author, Paul Mueller, M.D., General Internal Medicine , Mayo Clinic. "Many physicians are uncomfortable removing life-sustaining therapy or providing comfort-directed medication because of confusion about the ethical soundness of such treatments. In contrast to physician-assisted suicide or euthanasia, withdrawal of or withholding life-sustaining treatment and administering palliative sedation are ethically sound options."

    Palliative sedation is appropriate therapy for refractory and unacceptably severe suffering. "As with any other therapy, the patient or surrogate should be informed of potential adverse effects, including loss of social interaction and potential for life-threatening aspiration or respiratory depression. Palliative medicine teams should be involved, if possible, in any case in which palliative sedation is considered," says Dr. Mueller.

    "We hope that by increasing familiarity with the ethical basis for these practices we will encourage their appropriate application," he adds.

    Source:
    Rebecca Eisenman
    Mayo Clinic

  2. #2

    Informative and relevant

    Quote Originally Posted by cougarnurse View Post
    Do your doctors have a problem with recommending Hospice because of this? http://www.medicalnewstoday.com/articles/203348.php

    In a review article published in the October issue of Mayo Clinic Proceedings, Mayo Clinic physicians differentiate the ethical and legal permissibility of withholding or withdrawing life-sustaining treatments and accepted comfort measures, specifically palliative sedation, from that of physician-assisted suicide or euthanasia.

    Physician reviewers find that palliative sedation has an important place on the continuum of appropriate palliative care. "At the end of life, patient goals often shift to comfort, and removal of burdens and relief of suffering become paramount," says lead author, Paul Mueller, M.D., General Internal Medicine , Mayo Clinic. "Many physicians are uncomfortable removing life-sustaining therapy or providing comfort-directed medication because of confusion about the ethical soundness of such treatments. In contrast to physician-assisted suicide or euthanasia, withdrawal of or withholding life-sustaining treatment and administering palliative sedation are ethically sound options."

    Palliative sedation is appropriate therapy for refractory and unacceptably severe suffering. "As with any other therapy, the patient or surrogate should be informed of potential adverse effects, including loss of social interaction and potential for life-threatening aspiration or respiratory depression. Palliative medicine teams should be involved, if possible, in any case in which palliative sedation is considered," says Dr. Mueller.

    "We hope that by increasing familiarity with the ethical basis for these practices we will encourage their appropriate application," he adds.

    Source:
    Rebecca Eisenman
    Mayo Clinic
    Thanks for this post. It is so timely and relevant. We went through issues like this with my mother in 2004. A couple of years ago I gave a lecture about "double effect" to a group of Masters students...who were terrified of ever having to be involved in a decision to give medication that might end a life while being necessary to end suffering. It NEVER is easy, but should ALWAYS be compassionate.

    The SyckestRN

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    Super Moderator cougarnurse's Avatar
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    Thanks, Steph! If you think about it, any pain med can 'send one over the edge'. Pain is pain, and would anyone want to suffer?

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