This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Morita, T. Articles by Chihara, S. Search for Related Content PubMed PubMed Citation Articles by Morita, T. Articles by Chihara, S. Social Bookmarking                         What's this?

Terminal sedation for existential distress

Seirei Hospice, Seirei Mikatabara Hospital, Hamamatsu, Shizuoka, Japan

Junichi Tsunoda, MD

Seirei Hospice, Seirei Mikatabara Hospital, Hamamatsu, Shizuoka, Japan

Satoshi Inoue, MD

Seirei Hospice, Seirei Mikatabara Hospital, Hamamatsu, Shizuoka, Japan

Satoshi Chihara, MD

Seirei Hospice, Seirei Mikatabara Hospital, Hamamatsu, Shizuoka, Japan

Although sedation for existential distress has been actively discussed in the palliative care literature, empirical reports are limited. A retrospective cohort study was performed to clarify the physical conditions of terminally ill cancer patients who expressed existential distress and received sedation.

Of 248 consecutive hospice inpatients, 20 patients expressed a belief that their lives were meaningless and received sedation.

The target symptoms for sedation were dyspnea (n = 10), agitated delirium (n = 8), and pain (n = 1). Only one patient received sedation for psychological distress alone, although physical symptoms were acceptably relieved.

The Palliative Performance Scale just before sedation was 10 (n = 7), 20 (n = 11), 30 (n = 1), and 40 (n = 1). All but one patient could take nourishment orally of only mouthfuls or less. Edema, dyspnea at rest, and delirium were observed in 10, 13, and 14 cases, respectively. The Palliative Prognostic Index was greater than 6.0 in all but one case with a mean of 12 ± 3.3.

In conclusion, in our practice, sedation was principally performed for physical symptoms of cancer patients in very late stages. Further research is encouraged to establish standard therapy for existential distress of the terminally ill.

American Journal of Hospice and Palliative Medicine®, Vol. 17, No. 3, 189-195 (2000)
DOI: 10.1177/104990910001700313


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				N. I Cherny, L. Radbruch, and The Board of the European Association for Palliati European Association for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care Palliative Medicine, October 1, 2009; 23(7): 581 - 593. [Abstract] [PDF]

				J. Rietjens, H. Buiting, H. Pasman, P. van der Maas, J. van Delden, and A van der Heide Deciding about continuous deep sedation: physicians' perspectives: A focus group study Palliative Medicine, July 1, 2009; 23(5): 410 - 417. [Abstract] [PDF]

				V Cellarius Terminal sedation and the "imminence condition" J. Med. Ethics, February 1, 2008; 34(2): 69 - 72. [Abstract] [Full Text] [PDF]

				National Ethics Committee, Veterans Health Adminis The Ethics of Palliative Sedation as a Therapy of Last Resort American Journal of Hospice and Palliative Medicine, January 1, 2007; 23(6): 483 - 491. [Abstract] [PDF]

				P. G. Fine The Evolving and Important Role of Anesthesiology in Palliative Care Anesth. Analg., January 1, 2005; 100(1): 183 - 188. [Abstract] [Full Text] [PDF]