New palliative care ethical guideline released

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Palliative care workers are allowed to sedate some patients with intractable pain at the end of life--but only as a last-resort measure, according to a new ethical guideline approved by the American Medical Association at its most recent annual meeting.

Critics of palliative or terminal sedation argue that the practice is a thinly veiled form of physician-assisted suicide, though a report by the Council on Ethical and Judicial Affairs finds the sedation does not necessarily hasten death. Between 5% and 30% of end-of-life patients experience a form of intractable pain, according to the Annals of Internal Medicine.

The new ethical guideline does not permit physicians to use the sedation treatment to allay a patient's emotional stress, instead calling for social and spiritual guidance in those instances. The guideline also does not permit doctors to use palliative sedation as a means by which to end a life. Rather, the goal is to give guidance to hospitals and care facilities that may be reluctant to allow the practice, and to provide protection for the palliative team involved.

More information is available at www.ama-assn.org.