| Terminal Sedation |
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There is no evidence that titrated sedation causes the death of the patient and sedation does not equate with Euthanasia . At the end of life sedation is only used if the patient perceives their distress to be unbearable, and there are no other means of relieving that distress. In Palliative Care the doses of sedatives are titrated to keep the patient comfortable without compromising respiration or hastening death. Patients (or their legal representatives) do have the right to refuse life-sustaining treatment (such as with a Living Will ), which is legally considered neither euthanasia nor Suicide . However, once unconsciousness begins, the patient is no longer able to decide to stop the sedation or to request food or water and the clinical team needs to act in the patient's best interests. As sedation is titrated to avoid harm (including death), there is no legal or ethical uncertainty in a treatment which is purely for comfort. Consequently, terminal sedation is generally considered legal and acceptable, as belonging to normal medical practice, even in jurisdictions where euthanasia and physician-assisted suicide are not. Sedation at the end of life should be a treatment response to the symptom distress of terminal restlessness and agitation. There is a problem for the nurse or doctor in deciding ''who'' is distressed: the patient themself, the family, or the professional. Sedation is ''not'' routine in palliative and most patients die comfortably without the need for sedation. SEE ALSO EXTERNAL LINKS
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