Consensus guidelines on analgesia and sedation in dying intensive care unit patients

BMC Medical Ethics

Peter A Singer²  Louise Lemieux-Charles⁴  William RC Harvey³  Laura A Hawryluck¹ 

[1] University of Health Network, University of Toronto, Toronto, Canada;Department of Medicine, University of Toronto;University of Toronto Joint Centre for Bioethics, Toronto;Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

关键词: Intensive Care;    Consensus guidelines;    Assisted suicide;    Euthanasia;    Terminal sedation;    Double effect;    Analgesia;    Sedation;    Death;    Palliation;   

Others  :  1092216
DOI  :  10.1186/1472-6939-3-3

 received in 2002-04-15, accepted in 2002-08-12,  发布年份 2002

【 摘 要 】

Background

Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia.

Methods

Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12).

Results

After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU.

Conclusion

Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia.

【 授权许可】

   
2002 Hawryluck et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

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