PARIS, August 26 (EDIZIONES) –
Just over a year ago, Spain passed a euthanasia law, making it the fifth country in the world to have such regulations. Many people confuse it with palliative sedation, although it is not the same thing.
That’s why Infosalus has interviewed Dr. Elia Martínez Moreno, medical oncologist at the University Hospital of Fuenlabrada (Community of Madrid), and communication member of the Spanish Society of Palliative Care (SECPAL), who answers the main questions that we ask ourselves what palliative sedation is.
According to this scientific society, Palliative sedation is the administration of drugs to reduce consciousness in a terminally ill patient.and if necessary to relieve suffering related to one or more refractory symptoms, requiring express, implied or delegated consent.
Dr. Martínez Moreno explains that a refractory symptom is a symptom that cannot be controlled by the usual pharmacological measures, that the specialists are not able to control with the measures that medicine offers for the control of said symptom; these may include, for example, dyspnoea or shortness of breath, intense psychomotor agitation (an epileptic state that occurs in brain tumours), or any other symptom, including emotional psychological distress, which is also included in the indications for palliative sedation.
« Palliative sedation is necessary when a patient with a short life prognosis reaches a certain clinical situation, in which it is difficult to control his symptoms.and requires a deliberate reduction in their level of consciousness so that they do not suffer. It does not lengthen or shorten the patient’s life, but it allows better control of symptoms, ”explains Dr. Martínez Moreno.
HOW IT IS MADE
Palliative sedation must have the express, implied or delegated consent of the patient.as he puts it: “We have to have the prior consent of the patients, with whom we share the time. If we see that things are going badly, we do so verbally or in writing with the patient, or where the patient does not have the capacity to make decisions, we agree the initiation of such a measure with the family” .
This decision, he acknowledges, is made by the doctor. “These are patients who need frequent care, delivered by care teams and other personnel. In addition, the doses initially used in palliative sedation must be increased several times and there are scales to assess patients’ level of sedation to ensure that the goal is achieved.. In such a situation, there can be no delay in obtaining patient comfort,” says Mr. Martínez Moreno.
The SECPAL member goes on to say that it is a pharmacological procedure, carried out using sedative drugs, and that it consists of The level of consciousness of the patient is lowered, which prevents him from noticing the symptom that causes him enormous discomfort at the end of his life.
Here, this doctor repeats that palliative sedation is necessary in all cases where the patient has poor control of his symptoms and where no psychological, pharmacological or social treatment can be offered. “In other words, if all resources have been used and the patient has not achieved adequate symptomatic control, palliative sedation is medically indicated,” he adds.
DOES NOT SHORTEN OR EXTEND LIFE
With all this, the SECPAL Communication member wants to clarify that in palliative sedation, doctors accompany the patient at the end of life and with this practice, “their life is neither shortened nor prolonged”, but rather accompanies the patient through the process of dying, “as naturally as birth, so that it is comfortable, pleasant, comfortable, or easy.”
“Palliative sedation will never prolong the patient’s life. The patient’s life is determined by age, by his organism, by the characteristics and functions of his organs, because there are many families who confuse euthanasia with euthanasia, or vice versa, they think that in being sedated they live longer than expected and may think that we are somehow prolonging their life”, warns this expert in palliative care.
She also emphasizes that death must be understood as part of life. “It is important to be clear about this and to understand that we are able to support the dying person. It is important to be clear about this and to understand that we are able to accompany patients in the dying process, so that they can go through it without any suffering”, Dr. Martínez underlines.
She believes that the most important thing is to discern this idea because today, patients, in their last days, even their last hours, ask for euthanasia, “a very long process which requires many controls on the part of different actors. , and which would even be deleterious for the patient”.
He asserts in this sense that, if they have to euthanize a patient who suffers a lot from dyspnea, pain or any other refractory symptom, they are doing their job badly”. Euthanasia does not happen overnight, palliative sedation can happen at any moment if the patient needs it,” says Dr. Elia Martínez Moreno, medical oncologist at Fuenlabrada University Hospital and member of SECPAL.