The principles of revised clinical guidelines about palliative sedation therapy of the Japanese society for palliative medicine

Article indépendant

IMAI, Kengo | MORITA, Tatsuya | AKECHI, Tatsuo | BABA, Mika | YAMAGUCHI, Takashi | SUMI, Hiroko | TASHIRO, Shimon | AITA, Kaoruko | SHIMIZU, Tetsuro | HAMANO, Jun | SEKIMOTO, Go | MAEDA, Isseki | SHINJO, Takuya | NAGAYAMA, Jun | HAYASHI, Eriko | HISAYAMA, Yukie | INABA, Kazuto | ABO, Hirofumi | SUGA, Akihiko | IKENAGA, Masayuki

Background: When the suffering of a terminally ill patient is intolerable and refractory, sedatives are sometimes used for symptom relief. Objective: To describe the main principles of revised Japanese clinical guidelines about palliative sedation therapy. Design: Consensus methods using the Delphi technique were used. Results: The main principles of the guidelines that were newly defined or developed are as follows: (1) palliative sedation was defined as "administration of sedatives for the purpose of alleviating refractory suffering" (excluding the aim of reducing patient consciousness); (2) palliative sedation was classified according to the method of administration of sedatives: respite sedation versus continuous sedation (including (continuous) proportional sedation and continuous deep sedation); (3) a description of state-of-the-art recommended treatments for difficult symptoms such as delirium, dyspnea, and pain before the symptom was determined as refractory was included; (4) the principle of proportionality was newly defined from an ethical point of view; and (5) families' consent was regarded as being desirable (mandatory in the previous version). Conclusions: We described the main principles of revised Japanese clinical guidelines about palliative sedation therapy. Further consensus building is necessary.

http://dx.doi.org/10.1089/jpm.2019.0626

Voir la revue «JOURNAL OF PALLIATIVE MEDICINE, 23»

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