Medical College of Wisconsin
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Palliative sedation therapy for terminal movement disorders. BMJ Support Palliat Care 2020 Aug 31

Date

09/02/2020

Pubmed ID

32868285

DOI

10.1136/bmjspcare-2020-002577

Abstract

Palliative sedation therapy (PST) can be a challenging area of palliative medicine because of the complex ethical considerations involved. PST is a medical therapy used for refractory symptoms in terminally ill patients and is often considered ethically justified due to the principle of double effect. Even in cases where PST is clearly indicated such as refractory cancer pain, there is potential for moral distress among clinicians. Here, we present a unique case in which multiple therapeutic options were limited in a patient with overlapping diagnoses of catatonia, medication-induced extrapyramidal symptoms, and dementia with Lewy bodies. We review how existing frameworks can be applied to similar situations and offer practical strategies to support medical decision-making regarding PST and reduce the risk of moral distress among clinicians.

Author List

Partain DK, Zehm A

Author

April Zehm MD Associate Professor in the Medicine department at Medical College of Wisconsin