The assisted suicide movement is ever about blurring vital distinctions and deconstructing crucial definitions. One target has been the proper pain control technique known as palliative sedation, a rarely required procedure in which patients near death are sedated to control pain or other symptoms such as severe agitation or air hunger that cannot be alleviated in any other manner.
Confusion about this–some of it intentionally sown by assisted suicide advocates–induced the National Hospice and Palliative Care Organization to issue a statement clarifying the proper methods and purposes of sedation as a palliative technique. From the statement:
Availability
For the small number of imminently dying patients whose suffering is intolerable and refractory, NHPCO supports making the option of palliative sedation, delivered by highly trained healthcare professionals acting as an interdisciplinary team, available to patients.
Proportionality
Since the goal is symptom relief (and not unconsciousness per se), sedation should be titrated to reduce consciousness to the minimum level necessary to render symptoms tolerable. For most patients this will mean less than total unconsciousness, allowing the patient to rest comfortably, but to be aroused…
Relationship to Euthanasia and Assisted Suicide
Properly administered, palliative sedation of patients who are imminently dying is not the proximate cause of patient death, nor is death a means to achieve symptom relief in palliative sedation. As such, palliative sedation is categorically distinct from euthanasia and assisted suicide.
Contrast this with the intentional misdefinition of palliative sedation two pro assisted suicide legislators tried to foist on California (AB 2747), under the influence of Compassion and Choices, which would have mutated palliative sedation into terminal sedation via induced coma and dehydration:
442 (d) “Palliative sedation” means the use of sedative medications to relieve extreme suffering by making the patient unaware and unconscious, while artificial food and hydration are withheld, during the progression of the disease leading to the death of the patient.
That didn’t pass. But the crucial difference between palliative sedation–as described by the NHPCO–and terminal sedation–favored by the death with dignity crowd–is the difference between medically caring properly for patients and turning killing into both a means and an end.
May 11th, 2010 | 2:04 pm
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May 11th, 2010 | 2:10 pm
Wesley, thanks for pointing out this important distinction. Several of my father’s friends and acquaintances have died in hospice, some very soon after entering (i.e., within days or even hours), and Dad is convinced that hospice euthanized them.
I have tried to explain to him the important distinction between palliative care as hospice would give and euthanasia, but he remains convinced otherwise. And frankly, as you yourself have mentioned in the past, some in the assisted suicide crowd want to convert hospice to the euthanasia role, which would undermine its mission and community support.
My mother, who was bedridden after major strokes and under my care, passed away suddenly in the hospital last August pending surgery to reinstall a feeding tube. I had seen her just a short while that day before her death, and she was conscious and responsive. Dad has raised doubts that her death was entirely natural, because of his growing suspicions about the new bioethics; that is, as he put it, maybe she received some sort of injection to finish her off (and she was not under hospice care). Now he has me wondering a bit… And if hospice ever becomes identified with euthanasia, watch out.
May 11th, 2010 | 6:49 pm
K-man: I’m so sorry to hear about your mother. I think that perhaps your suspicions are warranted. Perhaps you should consider having an independent medical examiner do an autopsy.
The fact that your mother was conscious, and responsive, a short while prior to her death, should cause, at least some concern. What was the doctor’s explanation for her death?
May 12th, 2010 | 1:38 pm
Unfortunately, the NHPCO took a ‘neutral’ stance toward palliative sedation for “existential suffering” thereby leaving the door wide open to further blurring of distinctions.
May 12th, 2010 | 3:09 pm
Too late for an autopsy after all these months, but the listed cause of death was stroke-related heart failure. She did have frequent ministrokes, and one more might have done her in. Maybe. She had been considered stable and so was not on a vital signs monitor, and I suspect (if the hospital wasn’t up to any monkey business) that staff found her dead during routine checks. It still stuns me that she was dead less than two hours after I had visited her and brought her flowers.
May 13th, 2010 | 2:51 am
I admire your courage, through your terrible loss. Take care.
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