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Singapore medical journal ; : 220-227, 2016.
Artigo em Inglês | WPRIM | ID: wpr-296427

RESUMO

Lipuma equates continuous sedation until death (CSD) to physician-assisted suicide/euthanasia (PAS/E) based on the premise that iatrogenic unconsciousness negates social function and, thus, personhood, leaving a patient effectively 'dead'. Others have extrapolated upon this position further, to suggest that any use of sedation and/or opioids at the end of life would be analogous to CSD and thus tantamount to PAS/E. These posits sit diametrically opposite to standard end-of-life care practices. This paper will refute Lipuma's position and the posits borne from it. We first show that prevailing end-of-life care guidelines require proportional and monitored use of sedatives and/or opioids to attenuate fears that the use of such treatment could hasten death. These guidelines also classify CSD as a last resort treatment, employed only when symptoms prove intractable, and not amenable to all standard treatment options. Furthermore, CSD is applied only when deemed appropriate by a multidisciplinary palliative medicine team. We also show that empirical data based on local views of personhood will discount concerns that iatrogenic unconsciousness is tantamount to a loss of personhood and death.


Assuntos
Humanos , Analgésicos Opioides , Usos Terapêuticos , Atitude do Pessoal de Saúde , Morte , Sedação Profunda , Ética , Ética Médica , Eutanásia , Ética , Hipnóticos e Sedativos , Usos Terapêuticos , Cuidados Paliativos , Ética , Pessoalidade , Filosofia Médica , Guias de Prática Clínica como Assunto , Suicídio Assistido , Ética , Assistência Terminal , Ética , Inconsciência
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