Options of Last Resort: Palliative Sedation, Physician Aid in Dying, and Voluntary Cessation of Eating and Drinking.
Publication Title
The Medical clinics of North America
Document Type
Article
Publication Date
5-1-2020
Keywords
Aged; Aged, 80 and over; Communication; Decision Making; Deep Sedation; Drinking Behavior; Euthanasia, Active, Voluntary; Feeding Behavior; Humans; Nurses; Palliative Care; Physicians; Suicide, Assisted; United States
Abstract
Some patients with terminal and degenerative illnesses request assistance to hasten death when suffering is refractory to palliative care, or they strongly desire to maximize their autonomy and dignity and minimize suffering. Palliative sedation (PS), voluntarily stopping eating and drinking (VSED), and physician-assisted death (PAD) are possible options of last resort. A decision to choose PS can be made by an informed surrogate decision maker, whereas intact decision-making capacity is required to choose VSED or PAD. For all palliative treatments of last resort, the risk of harm is minimized by the use of checklists, and establishment of policies and procedures.
Specialty/Research Institute
Palliative Care
Specialty/Research Institute
Biomedical Ethics
