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Palliative sedation therapy for terminal movement disorders
  1. Daniel Kent Partain1 and
  2. April Zehm2
  1. 1Center for Palliative Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA
  2. 2Division of Hematology and Oncology, Palliative Care Program, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  1. Correspondence to Dr Daniel Kent Partain, Center for Palliative Medicine, Mayo Clinic Rochester, Rochester, MN 55905-0002, USA; partain.daniel{at}mayo.edu

Abstract

Palliative sedation therapy (PST) can be a challenging area of palliative medicine because of the complex ethical considerations involved. PST is a medical therapy used for refractory symptoms in terminally ill patients and is often considered ethically justified due to the principle of double effect. Even in cases where PST is clearly indicated such as refractory cancer pain, there is potential for moral distress among clinicians. Here, we present a unique case in which multiple therapeutic options were limited in a patient with overlapping diagnoses of catatonia, medication-induced extrapyramidal symptoms, and dementia with Lewy bodies. We review how existing frameworks can be applied to similar situations and offer practical strategies to support medical decision-making regarding PST and reduce the risk of moral distress among clinicians.

  • end of life care
  • delirium
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Footnotes

  • Twitter @danielpartainmd

  • Contributors DKP drafted the manuscript, revised it critically and is responsible for the overall content as the guarantor. AZ revised the manuscript critically and collaborated with the patient’s healthcare surrogate to obtain consent for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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