While more research is needed to explore the role of sedation in palliative care for diseases other than cancer, the results should offer reassurance to families wrestling with the best way to care for a terminally ill loved one, Caraceni told Reuters Health by email. Augusto Caraceni, a palliative care researcher at the Norwegian University of Science and Technology in Trondheim, in an accompanying editorial. Still, the findings should help put to rest ethical questions about whether continuous deep sedation at the end of life amounts to a form of euthanasia, because this type of care wasn’t linked to more rapid death, writes Dr.
It’s also unlikely that the findings would be the same for terminal patients who didn’t have cancer or who weren’t treated by palliative care specialists.
One limitation of the study, the authors acknowledge in Lancet Oncology, is that researchers lacked data on sedation practices used on individual patients. Hydration was administered less often at home than in the hospital or palliative care unit. The amount of artificial hydration provided didn’t appear to alter the connection between use of sedation and survival, the study found. Roughly 60 percent of patients received artificial hydration near the end of life, regardless of whether they got continuous deep sedation. With sedation, patients lived around 22 days, compared to about 26 days without sedation, a difference that was too small after adjusting for individual characteristics to rule out the possibility that it was due to chance. Our study indicated that continuous deep sedation did not shorten patient life or change patient’s dying process.” For the current study, Maeda and colleagues analyzed data on 1,827 patients with terminal cancer, including 269 who received continuous deep sedation, to see how long they survived after being enrolled in a palliative care program. “If they believed sedation shortened survival, their guilty feeling may become deeper. “Bereaved families often feel guilty and wonder if they could do more for the patient,” Maeda said by email. Isseki Maeda, a researcher at Osaka University Graduate School of Medicine in Japan. This possibility makes the decision all the more agonizing for families who must weigh making their loved ones comfortable against the potential to make matters worse, said lead study author Dr.
Even though continuous deep sedation has been used for decades to relieve suffering for the terminally ill, previous research has yielded mixed results on whether it shortens patient survival - especially if the powerful narcotics are provided without artificial hydration to prevent patients from dying of thirst. By Lisa Rapaport (Reuters Health) - Terminal cancer patients who receive continuous deep sedation to ease pain at the end of life might not die any sooner than people who don’t get this type of palliative care, a Japanese study suggests.
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