Palliative Sedation – What the Family Physician Should Knowgerman translation / full article
Background: Patients with advanced incurable diseases hope for a dying process without „suffering“. Modern medicine offers many options for symptom control, but does not always achieve a satisfactory relief of unbearable physical and psychological suffering. If palliation does not achieve sufficient effects within an acceptable time frame or should unreasonable side effects occur, palliative sedation might help. Palliative sedation is the temporary or permanent use of awareness dampening drugs to achieve sufficient relief from refractory symptoms and to make the dying process more bearable. Search Method: Pragmatic search in medical data banks under the medical subject heading „palliative sedation“ and „terminal sedation“.Main Messages: The decision-making process for the implementation of palliative sedation should be well thought over and discussed in an interdisciplinary context with a multi-professional team. A helpful orientation can bei found in the guideline of the European Association for Palliative Care (EAPC). An experience-based professional exchange between the family physician and a palliative care physician or SAPV team, is a valuable tool in the decision-making process. It is important to look after the family members in this strenuous and exhausting situation.Conclusions: Family physicians should feel encouraged to consult a palliative care physician for advice in this difficult decision-making process. In particular for the smooth implementation and monitoring of palliative sedation, the cooperation with an experienced outpatient palliative care team (SAPV) with its personal and technical resources is absolutely advisable. In addition admission to a palliative ward or hospice should be considered for an adequate and safe implementation.