Palliative sedation is a medical technique used to manage pain in seriously ill patients. The technique hinges on the administration of sedatives to reduce a patient’s level of consciousness to a point where the pain caused by his or her medical condition will not cause misery. This may involve complete or partial sedation. Most often, this type of treatment is employed to ease the suffering of terminally ill patients. In some instances, this technique is associated with the practice of euthanasia, although this is not standard, legal, or acceptable medical practice in a majority of countries.
Physicians use palliative measures to eliminate the physical pain and mental suffering caused by medical conditions, even when medical treatment cannot cure the underlying afflictions. Sedation is one option for patients whose medical conditions cause them great pain and hardship. Similar measures may be employed while a patient recovers from certain very serious but not terminal conditions, such as severe burns, which can cause tremendous pain to a conscious individual.
Typically, other methods of pain management are attempted before palliative sedation. Drugs to block pain are often the first type of medical intervention. In other cases, medical treatment or surgery may be used not to cure a condition but to reduce a patient’s discomfort. For example, palliative radiation or palliative chemotherapy, along with surgery to reduce tumor mass, can be used to make a cancer patient more comfortable, even if these procedures cannot cure the underlying cancer.
If other palliative measures fail, a patient or his family may opt for palliative sedation. This procedure involves gradually increasing the dosage of drugs known to cause unconsciousness. The dosage is increased to the point where the patient is able to sleep without pain. Typically, this sedation and other supportive care are then maintained while the terminal illness runs its course, allowing the patient to die without suffering.
The decision to employ palliative sedation is, ideally, left up to the patient. In situations where a patient may no longer be mentally competent, a relative or other individual may act on his behalf if they have been medically empowered to do so. Typically, an attending physician must agree that this palliative sedation is warranted before it is administered.
Palliative sedation is not generally understood to be a form of euthanasia. Euthanasia is intended to avoid prolonged misery by ending life directly. Palliative sedation simply prevents a patient from being conscious and distressed while in the final phases of a terminal illness.
