Palliative care and involvement of anaesthesiology: current discussions

被引:8
|
作者
Kettler, Dietrich [1 ]
Nauck, Friedemann [1 ]
机构
[1] Univ Gottingen, Div Palliat Med, Ctr Anaesthesiol Emergency & Intens Care Med, D-37075 Gottingen, Germany
关键词
involvement of anaesthesiology in palliative care; palliative care and euthanasia; palliative sedation; INTENSIVE-CARE; SEDATION; EUTHANASIA;
D O I
10.1097/ACO.0b013e328337331d
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose of review To summarize various developments related to palliative care, especially related to ethical issues. To emphasize the involvement of anaesthesiology in palliative care. Recent findings Euthanasia has been legalized in Belgium, the Netherlands and Luxemburg (BENELUX countries). A group from Belgium has now proposed using euthanasia in patients in whom palliative care has been deemed 'futile'. This practice of so-called 'integral palliative care' is strongly rejected in a study from Germany. Palliative sedation is an ethically different approach with no intention to kill the patient. The European Association of Palliative Care has proposed a framework for individual guidelines for palliative sedation. The important role of anaesthesiology in palliative care teams is emphasized. Summary Palliative care is a powerful approach to patient care during terminal illness, emphasizing quality of life even if it may shorten the length of life. Traditionally, palliative care has been contrasted with active euthanasia, but a group from Belgium has challenged this concept recently, advocating the use of euthanasia in circumstances in which palliative care has become 'futile'. This new approach led to strong reactions by a group from Germany, stressing that killing on demand in palliative care should under no circumstances be justified. In contrast, palliative sedation is a common method in special cases to reduce intractable symptoms. A new framework for palliative sedation produced by the European Association of Palliative Care may encourage institutions to set up their own palliative sedation guidelines. Worldwide, anaesthesiologists have a significant role in palliative care due to their unique complex expertise mainly in pain therapy and including transient sedation of patients.
引用
收藏
页码:173 / 176
页数:4
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