Talk:Terminal sedation

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[edit] I

I was wondering if anyone knew the official law concerning terminal sedation. If anyone has any idea it would be greatly appreciated.

Terminal sedation, when used as a treatment response to terminal restlessness and agitation, should present no medico-legal problem. Using sedation inappropriately may lead to problems of professional misconduct. It would only be a problem if someone was over sedated with the intention of shortening life.

Rossodio - I note you comments re: subjectivity. However, "slow euthanasia" is unacceptable because it is not co-terminous with terminal sedation. It is itself a term that is subjective and misleading in this context. Terminal sedation is a legitimate clinical goal in all jurisprudences; euthanasia is the active shortening of life and is nothing to do with terminal sedation. Ravenswater 19:36, 30 January 2006 (UTC)

In most nhs hospitals in the UK , they put all elderly patients on codeine anyway, enter non existent 'pain' on their nursing records, then finish them off with midazolam and alfentanil to alleviate non existent agitation - no one checks their controlled drugs registers, although all uk police forces have a dedicated officer who is supposed to - most of them are married to nurses, so they dont have to give anyone they consider 'elderly' any of the treatments that a 30 year old would be entitled to - its licenced murder, the way the NHS practice it in this area - quite why you are even dressing this subject up with an 'ethical discussion' I can't fathom - its murder done with smoke and mirrors, the intention is murder - it avoids blocking up nhs beds with 'lives unworthy of life' - small matter of 'consent ' is conveniently circumvented by filling them up with morphine first, and saying the loss of conciousness is due to something like a stroke to their relatives - they rely on visitors knowing absolutely nothing about doseages and respiratory side effects of 'palliative care' drugs. Its rife - but as the 'attending doctor' is the one who writes the cause of death on the death certificate, no one questions it at all . —Preceding unsigned comment added by Thomaswilliamlofthouse (talk • contribs) 01:00, 13 April 2008 (UTC)

With regards to the "License For Murder" link title: If there is a controversy regarding Terminal Sedation, a more appropriate tack would be to create a separate section with the controversy detailed in neutral POV terms, then cite the website.Dr. Scarabus (talk) 19:26, 16 April 2008 (UTC)

[edit] "Most patients die comfortably"

"Sedation is not routine in palliative and most patients die comfortably without the need for sedation."

Do you have any data to back this claim? I don't get how death is "comfortable". The outward signs may resemble sleep or comfort, but death is nothing like that as the body is violently shutting down. What if the patient is feeling extreme pain and distress, but cannot outwardly show this during their last moment due to paralysis or some other factor (ie the brain cells that receive pain input still work but those that send effector signals died off first)?

It might also be extremely distressing 9who for ? the nurses injecting the stuff mainly?) if the normal reflexes aren't working and the patient may feel like they are drowning (since they can't breath due to the loss of medullary function) but there may be no convulsions to indicate this due to the same reasons as above (loss of effector signals). Then again, it might not. We can't know for sure without data.

With midazolam and alfentanil iv, the synergistic effects knock out the ability to sense CO2 levels in the blood - so all voluntary respiration stops - its used in Intensive Care for people on mechanical ventilators to stop them fighting the machine, but is adminsitered in the NHS on side wards mainly - CO2 just builds up in the blood, but the midazolam and morphine levels are so high, they dont twitch and upset the bitches of nurses who know exactly what they are doing when they inject this stuff, and dont really give a toss one way or the other.

[edit] "Change of title of article to Palliative Sedation?"

I feel this article should be changed from terminal sedation to palliative sedation. The goal of sedation is the palliation of symptoms, not the ending of life (terminal). Calling it terminal sedation implies the goal is death. Palliative sedation can be stopped and reversed or used at different levels of sedation, therefore not always happening at the same time as death. I will await comments from others before changing.SpoticusKC 05:13, 30 June 2007 (UTC)

Is the above request for revision to 'palliate' your own concience? Lets call a spade a spade - its manslaughter by the back door - it was used to 'palliate' 70 elderly bed blockers in a Portsmouth hospital in the Uk, none of whom were in any pain at all, there were just insufficient funds for them to be supported by social services at home - all the district sherriff could say at the inquest was that it was the strangest form of 'pain relief' he had ever seen - if he'd expressed it any harder, the doctors threatened to sue him for defamation - its murder...do you do it as part of your job, Guber? —Preceding unsigned comment added by Thomaswilliamlofthouse (talk • contribs) 01:08, 13 April 2008 (UTC)

No the request is that it more closely reflects the common medical language regarding this procedure, which you note has some controversy.SpoticusKC (talk) 11:26, 9 May 2008 (UTC)