Pain at the end of life and its palliative care

ABSTRACT

Pain is a common problem at the end of life. Pain, no doubt, is a complex phenomenon that includes psychological, behavioral and social components. Mostly, the fear of pain is the common reason to support the idea of euthanasia. The experience of chronic pain is different from that of acute pain. Anxiety is replaced by despair. Hopelessness and frustration are felt and suffering is seen as endless. Treatments after treatment have fielded no relief. Despite comprehensive palliative care, some dying patients experience distressing symptoms that cannot be adequately relieved. The doctrine of double effect, the justification for palliative sedation, permits physicians to provide high doses sedatives to relieve suffering, provided that the intention is not to cause the patient's death. The role of the intention cannot be ignored in this doctrine. Physicians must understand and document which actions are consistent with an intention to relieve symptoms rather than to hasten death. Patient's consent is quite essential for palliative sedation