David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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BMC Medical Ethics 3 (1):1-9 (2002)
Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12). Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia.
|Keywords||Palliation Death Sedation Analgesia Double effect Terminal sedation Euthanasia Assisted suicide Consensus guidelines Intensive Care|
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Sam Rys, Reginald Deschepper, Freddy Mortier, Luc Deliens, Douglas Atkinson & Johan Bilsen (2012). The Moral Difference or Equivalence Between Continuous Sedation Until Death and Physician-Assisted Death: Word Games or War Games? [REVIEW] Journal of Bioethical Inquiry 9 (2):171-183.
Dr Sonja Rothärmel (2004). Terminale Sedierung aus juristischer Sicht. Ethik in der Medizin 16 (4):349-357.
Georg Bosshard, Noémi Stoutz* & Walter Bär (2006). Eine gesetzliche Regulierung des Umgangs mit Opiaten und Sedativa bei medizinischen Entscheidungen am Lebensende? Ethik in der Medizin 18 (2):120-132.
Prof Dr H. Christof Müller-Busch (2004). „Terminale Sedierung“. Ethik in der Medizin 16 (4):369-377.
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