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I have serious misgivings about the whole concept of terminal
sedation. As an anaesthetist, I am very familiar with the induction of
coma to prevent suffering, albeit in a different context, namely, that of
allowing needed surgery to proceed. What is the context of terminal
sedation?
Coma seems a particularly inappropriate sledgehammer to crack the nut
of palliative symptom relief. Sure, a comatose patient does not suffer;
reductio ad absurdum, neither does a dead one. I cannot see any way in
which arguments for terminal sedation do not pave the way for euthanasia,
and indeed I would wish someone to explain to me very clearly the
difference between the two, given that I really have no problems with
inducing coma to prevent suffering. After all, that's anaesthesia,
precisely what I do every day.
Here in Hong Kong, relatives watch over a dying patient to catch
their last words. As a doctor working in ICU, I have heard enquiries when
intubated dying patients may speak their last to this world. I cannot
remember if there had been any requests for extubation to enable the dying
patient to utter his last, but any which might have come my way would be
met with a patient explanation why such requests are in inappropriate.
Terminal sedation would probably not find ready acceptance here.
A different understanding of coma induced to avoid suffering
I have serious misgivings about the whole concept of terminal
sedation. As an anaesthetist, I am very familiar with the induction of
coma to prevent suffering, albeit in a different context, namely, that of
allowing needed surgery to proceed. What is the context of terminal
sedation?
Coma seems a particularly inappropriate sledgehammer to crack the nut
of palliative symptom relief. Sure, a comatose patient does not suffer;
reductio ad absurdum, neither does a dead one. I cannot see any way in
which arguments for terminal sedation do not pave the way for euthanasia,
and indeed I would wish someone to explain to me very clearly the
difference between the two, given that I really have no problems with
inducing coma to prevent suffering. After all, that's anaesthesia,
precisely what I do every day.
Here in Hong Kong, relatives watch over a dying patient to catch
their last words. As a doctor working in ICU, I have heard enquiries when
intubated dying patients may speak their last to this world. I cannot
remember if there had been any requests for extubation to enable the dying
patient to utter his last, but any which might have come my way would be
met with a patient explanation why such requests are in inappropriate.
Terminal sedation would probably not find ready acceptance here.
Competing interests:
None declared
Competing interests: No competing interests