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.

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