![]() ![]() ![]() I am not one of them,” said Thomas Strouse, a psychiatrist and specialist in palliative care medicine at the UCLA Medical Center. “There are people who believe they are the same. In both cases, the goal is to relieve suffering.īut many doctors who use palliative sedation say the bright line that distinguishes palliative sedation from euthanasia, including aid-in-dying, is intent. The boundary between aid-in-dying and palliative sedation “is fuzzy, gray and conflated,” said David Grube, a national medical director at the advocacy group Compassion and Choices. Policies vary from one hospital to another, one hospice to another, and one palliative care practice to another. The boundary between aid-in-dying and palliative sedation “is fuzzy, gray and conflated.”ĭoctors wrestle with what constitutes unbearable suffering, and at what point palliative sedation is appropriate - if ever. “If you are going to practice palliative care, you have to practice some sedation because of the overwhelming physical suffering of some patients under your charge.” Some doctors are hesitant about using it “because it brings them right up to the edge of euthanasia,” Quill said.īut Quill believes that any doctor who treats terminally ill patients has an obligation to consider palliative sedation. Since there are no laws barring palliative sedation, the dilemma facing doctors who use it is moral rather than legal, said Timothy Quill, who teaches psychiatry, bioethics and palliative care medicine at the University of Rochester Medical Center in New York. ![]() Conference of Catholic Bishops, the church believes that “patients should be kept as free of pain as possible so that they may die comfortably and with dignity.” Palliative sedation, though, has been administered since the hospice care movement began in the 1960s and is legal everywhere.ĭoctors in Catholic hospitals practice palliative sedation even though the Catholic Church opposes aid-in-dying. While aid-in-dying, or “death with dignity,” is now legal in seven states and Washington, D.C., medically assisted suicide retains tough opposition. “At least she got into that coma state versus four to eight weeks of torture,” Freeman said. She died within a week, not the one or two months her doctors had predicted before the sedation. Once they calibrated the dosage properly, she never woke up again. The medical staff at the Long Beach acute care center where Martin was a patient gave her phenobarbital. The goal is to reduce or eliminate suffering, but in many cases the patient dies without regaining consciousness. Under palliative sedation, a doctor gives a terminally ill patient enough sedatives to induce unconsciousness. But Martin did have one alternative to the agonizing death she feared: palliative sedation. Freeman couldn’t bring herself to do it, fearing the legal consequences and the possibility that her sister would survive and end up in even worse shape.Ĭalifornia’s aid-in-dying law, authorizing doctors to prescribe lethal drugs to certain terminally ill patients, was still two years from going into effect in 2016. Martin fantasized about having her sister drive her into the mountains and leave her with the liquid morphine drops she had surreptitiously collected over three months - medicine that didn’t relieve her pain but might be enough to kill her if she took it all at once. Sometimes, she would flee into the California night in her bedclothes, “as if she were trying to outrun the pain,” her older sister Anita Freeman recalled. A woman who had been generous and good-humored turned into someone hardly recognizable to her loving family: paranoid, snarling, violent. Toward the end, the pain had practically driven Elizabeth Martin mad.īy then, the cancer had spread everywhere, from her colon to her spine, her liver, her adrenal glands and one of her lungs. ![]()
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