Forum.
Terminology
edation in palliative care is described in various ways, such as “sedation” (Stione P, 1997), “terminal sedation”(Quill T, 2000; Chater S, 1998), “sedation for intractable distress in the imminently dying” (Krakauer EL, 2000), “end-of-life sedation” (Furst CJ, 2002), “total sedation” (Peruselli C, 1999; Goldstein-Shirley J 2001), “sedation in the final phase”(Muller-Busch HC, 2001), “sedation in the terminal or final stages of life”(Muller-Busch HC, 2003), “palliative sedation” (Braun T, 2003), and “palliative sedation therapy” (Morita T, 2002; Beel A, 2002).
Although “terminal sedation” is often used in USA literature (Quill T, 2000), this term does not convey the important nature of the treatment (symptom palliation) and may be interpreted as an intention to terminate the patient’s life. Our interpretation is that sedation is an option for symptom control and is not euthanasia. The intention of sedation is to relieve intolerable suffering; the procedure is to use a sedating drug for symptom control; and the successful outcome is the alleviation of distress (EAPC Ethics task force on palliative care and euthanasia, 2003). In euthanasia the intention is to kill the patient; the procedure is to administer a lethal drug; and the successful outcome is immediate death.
We propose using either “palliative sedation therapy” or “sedation in end of life care” for the discussion by this task force, and possibly to become the standard term.
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