I think it’s extremely important to separate the author’s opinions from fact. I am deeply troubled by her claim that “the general population does not seem to realize that palliative care often means palliative sedation.”
On the contrary, palliative sedation has and will always be the exception rather than the norm to palliative practice. As a palliative care nurse with many years’ experience, I am surprised to read that this articulate and intelligent woman was led to believe that her mother was receiving palliative sedation.
In the overwhelming majority of palliative care units in Canada, palliative sedation is not given via regular injections, but rather by continuous infusion. What she described was the medical attempt at managing her mother’s symptoms — pain and shortness of breath. As you can see, it is not always successful. It is rare that palliative care specialists are unable to diminish symptoms to a tolerable degree for patients.
Palliative sedation — the use of powerful sedatives used to induce artificial sleep — does not cause one’s death. Death is not intentional, but rather the result of advancing disease.
In addition, Ms. Laheurte viewed her mother as “starving to death” once she was sedated. We know that people who are very close to death do not experience hunger and dehydration the way healthy people do. Dehydration experienced at the end of one’s life is not painful, according to a number of studies. Not wanting or needing to eat is an absolutely natural part of the dying process; I hardly consider this starving to death. Providing artificial fluids as a patient’s organs are failing can be detrimental, so we only consider this practice on a case by case basis.
Finally I would like to say that palliative sedation does work and it works well. However it must be done properly and only after the patient and family are fully informed and have consented to the process. This is by far the best way to make a terrible situation bearable, especially when the alternative is euthanasia.
No one I know who works in a palliative care unit is in favour of killing selected patients.
I am sorry that Ms. Laheurte’s experience was not as it should have been. Many of my colleagues fight on a daily basis for better education for all health care professionals to have access to the necessary knowledge to best understand how to gently and compassionately decrease a patient’s suffering.
We still haven’t figured out how to end the family’s suffering, but we can certainly provide support and compassion in a dignified way to those left behind.
Ms. Laheurte, please accept my deepest sympathy on the loss of your beautiful mother.
To view to original article via The Montreal Gazette, please click here.
To read the letter Rose De Angelis is referring to, please click here.
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