¿Es necesario precisar el concepto de sedación?

  1. Sanz Rubiales, Álvaro
  2. Barón Duarte, Francisco Javier
  3. Valle, María Luisa del
Cuadernos de bioética

ISSN: 1132-1989 2386-3773

Year of publication: 2015

Volume: 26

Issue: 86

Pages: 111-116

Type: Article

More publications in: Cuadernos de bioética


Palliative sedation in defined as the deliberate reduction in the level of consciousness of the patient by administering the appropriate drugs in order to avoid intense suffering caused by one or more refractory symptoms; sedation in the patient who is in his last days or hours of life is assumed to be continuous and as deep as needed. Clinical experience shows specific situations where it is likely that there is some confusion of terms. We could erroneously understand as palliative sedation the cases of symptomatic treatment of hyperactive delirium in a patient in its last days (a situation that sometimes is presented as the first cause of palliative sedation) or those in which it is carried out a progressive increase in the palliative treatment that often have a sedative effect, parallel to the increased severity of symptoms because of disease progression in severe ill patients. In both scenarios, sedating drugs are used to relieve end-of-life clinical complications and suffering but the circumstances of the patient, the goal of these treatments, and the way they are used do not match the definition of sedation.

Bibliographic References

  • Breitbart, W., Alici, Y. “Evidence-based treatment of delirium in patients with cancer”. Journal of Clinical Oncology 14, (2012), 1206-1214.
  • Bustamante, MA. “Limitación terapéutica y conflictos éticos. Proporcionalidad”. Revista Argentina de Medicina Respiratoria 3, (2006), 137-141.
  • Centeno, C., Sanz, A., Bruera, E. “Delirium in advanced cancer patients”. Palliative Medicine 18, (2004), 184-194.
  • Cherny, NI., Radbruch, L. “European Association for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care”. Palliative Medicine 23, (2009), 581-593.
  • Claessens, P., Menten, J., Schotsmans, P., Broeckaert, B. “Palliative sedation: a review of the research literature”. Journal of Pain & Symptom Management 36, (2008), 310-333.
  • Ellershaw, J., Ward, C. “Care of the dying patient: the last hours or days of life”. British Medical Journal 326, (2003), 30-34.
  • Fainsinger, RL., Waller, A., Bercovici, M., et al. “A multicentre international study of sedation for uncontrolled symptoms in terminally ill patients”. Palliative Medicine 14, (2000), 257-265.
  • Guía… Sedación paliativa. Consejo Oficial de Colegios Oficiales de Médicos, Pontevedra, 2012. https://www. cgcom.es/sites/default/files/guia_sedaccion_paliativa_0.pdf (accedido el 10 de febrero de 2014)
  • Kirk, TW., Mahon, MM. “National Hospice and Palliative Care Organization (NHPCO) position statement and commentary on the use of palliative sedation in imminently dying terminally ill patients”. Journal of Pain & Symptom Management 39, (2010), 914-923.
  • Morrison, RS., Meier, DE. “Palliative care”. New England Journal of Medicine 350, (2004), 2582-2590.
  • Sancho Zamora, MA. “Sedación paliativa”. Medicina Paliativa 20, (2013), 73-74.
  • Sanz Rubiales, A. “Sedación”. En: Nuevo Diccionario de Bioética, 2ª Edición. Simón Vázquez, C. Editorial Monte Carmelo, Burgos, 2012, 760-772.
  • Verkerk, M., van Wijlick, E., Legemaate, J., de Graeff, A. “A National Guideline for Palliative Sedation in The Netherlands”. Journal of Pain & Symptom Management 34, (2007), 666-670.