BIOETYKA / ETYKA MEDYCZNA

BIOETYKA / ETYKA MEDYCZNA - Przeglądy aktów prawnych

Framework for Continuous Palliative Sedation Therapy in Canada –  Canadian Society for Palliative Care Physicians (CSPCP) 2012

Indicatons

1. CPST (continuous palliative sedation therapy) is indicated only for refractory and intolerable suffering, usually in the last 2 weeks of life.
2. The care team should have or seek expertise to determine that the symptoms are refractory and intolerable.
3. CPST for purely existential symptoms should be initiated only in rare cases of severe existential distress and after careful consultation with experts in the area.

Decision making 

1. Decisions regarding CPST should conform to the accepted national, provincial, and institutional policies for decision making and informed consent in law and medical ethics.
2. Decisions regarding CPST and concurrent treatments should be considered separately as well as together.
3. Decisions regarding CPST should involve all relevant members of a health care team, one of whom should, preferably, be a clinician experienced in CPST.
4. Decisions regarding CPST should be revisited periodically with the family, health care providers, and, where possible, the patient.
5. CPST related decision making should incorporatespecific cultural and religious/spiritual values and practices into the plan of care for patients and families, and should involve language interpreters if needed.

Monitoring and outcomes s. 4

1. A patient receiving CPST should be monitored for:

   1. Relief of suffering 

   2. Level of consciousness (depth of sedation)

   3. Potential adverse effects of sedation

2. Family and healthcare professionals should be moni-tored for:

   1. Psychological distress

   2. Spiritual distress