Journal of Intensive and Critical Care Nursing

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Mini Review - Journal of Intensive and Critical Care Nursing (2024) Volume 7, Issue 1

Palliative sedation: Ethical considerations and nursing practice implications

Maharaj Johnson *

School of Nursing, Georgetown University, Washington, USA

*Corresponding Author:
Maharaj Johnson
School of Nursing, Georgetown University, Washington, USA
E-mail: maharajohnson@med.co.in

Received: 01-Feb-2024, Manuscript No. AAICCN-24-129297; Editor assigned: 06-Feb-2024, PreQC No. AAICCN-24-129297(PQ); Reviewed:20-Feb-2024, QC No. AAICCN-24-129297; Revised:22-Feb-2024, Manuscript No. AAICCN-24-129297(R); Published: 29-Feb-2024, DOI:10.35841/aaiccn-7.1.191

Citation: Singh NL. Palliative sedation: Ethical considerations and nursing practice implications. J Intensive Crit Care Nurs. 2024; 7(1):191

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Introduction

Palliative sedation, also known as terminal sedation or continuous deep sedation is a medical intervention used in end-of-life care to relieve severe refractory symptoms in patients with advanced illness. While palliative sedation can provide comfort and relief for patients nearing the end of life, it also raises complex ethical considerations and challenges for healthcare providers, including nurses. This article explores the ethical principles underlying palliative sedation and its implications for nursing practice in end-of-life care. Palliative sedation involves the administration of sedative medications to induce a state of decreased consciousness in patients experiencing intolerable suffering from symptoms such as pain, dyspnea, delirium, or existential distress. Unlike euthanasia or physician-assisted suicide, palliative sedation aims to alleviate suffering rather than hasten death and is considered ethically permissible when provided within the framework of palliative care principles and guidelines [1,2].

The ethical justification for palliative sedation is grounded in principles of beneficence, autonomy, nonmaleficence, and justice. The primary goal of palliative sedation is to relieve suffering and improve quality of life for patients who are in distress and nearing the end of life. By alleviating refractory symptoms, palliative sedation respects patients' autonomy and dignity, allowing them to die peacefully and with comfort. However, ethical considerations arise regarding the proportionality of sedation, informed consent, and the potential impact on patients' consciousness and communication with loved ones. Nurses play a pivotal role in the delivery of palliative sedation and must navigate complex ethical dilemmas while providing compassionate and ethical care to patients and their families [3, 4].

Nurses are responsible for ensuring that patients and their families fully understand the goals, risks, benefits, and alternatives to palliative sedation. This includes facilitating discussions about treatment options, goals of care, and end-of-life preferences to ensure informed decision-making and respect for patients' autonomy. Nurses must conduct thorough assessments of patients' symptoms, including pain, dyspnea, agitation, and psychological distress, to determine the appropriateness of palliative sedation. Nurses collaborate with interdisciplinary teams to develop individualized care plans and implement evidence-based interventions to address patients' symptoms and alleviate suffering [5, 6].

Nurses adhere to palliative care principles, including the principle of proportionality, which emphasizes the importance of using the least invasive interventions necessary to achieve symptom relief. Nurses advocate for the judicious use of palliative sedation as a last resort when other interventions have been ineffective in relieving refractory symptoms. Nurses closely monitor patients receiving palliative sedation to assess the effectiveness of symptom management, evaluate the level of sedation, and ensure patients' comfort and safety [7,8].

Nurses collaborate with healthcare providers to titrate sedative medications based on patients' responses and adjust treatment plans as needed to optimize symptom control. Nurses provide compassionate presence and emotional support to patients and their families throughout the process of palliative sedation. Nurses offer reassurance, comfort, and therapeutic communication to alleviate anxiety, promote dignity, and facilitate meaningful connections between patients and their loved ones [9, 10].

Conclusion

Palliative sedation presents complex ethical considerations for nurses involved in end-of-life care, requiring careful deliberation, communication, and compassionate decision-making. While palliative sedation can offer relief for patients experiencing intolerable suffering at the end of life, nurses must adhere to ethical principles, including respect for patient autonomy, beneficence, and proportionality. By maintaining a patient-centered approach and collaborating with interdisciplinary teams, nurses can ensure that palliative sedation is provided ethically and compassionately, honouring patients' wishes and preserving their dignity as they approach the end of life.

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