Talk:Palliative sedation

message: I'm putting this first only as time-line.
Is this sentence clear? To me it seems ... fractured:
"Patients (or their legal representatives) only have the right to refuse treatments in living wills; they cannot demand life saving treatments, or any treatments at all."
"Have the right to refuse" makes sense. But then "cannot demand life saving treatments or any treatments at all"? It's as though some conditional is missing.
==BenTrem (talk) 05:20, 5 November 2016 (UTC)
thread_title: Clarity?

message: I was wondering if anyone knew the official law concerning terminal sedation.  If anyone has any idea it would be greatly appreciated.  —Preceding unsigned comment added by 141.233.8.152 (talk • contribs) 00:09, 8 April 2005
:Terminal sedation, when used as a treatment response to terminal restlessness and agitation, should present no medico-legal problem. Using sedation inappropriately may lead to problems of professional misconduct. It would only be a problem if someone was over sedated with the intention of shortening life.
:Rossodio - I note you comments re: subjectivity. However, "slow euthanasia" is unacceptable because it is not co-terminous with terminal sedation. It is itself a term that is subjective and misleading in this context. Terminal sedation is a legitimate clinical goal in all jurisprudences; euthanasia is the active shortening of life and is nothing to do with terminal sedation. Ravenswater 19:36, 30 January 2006 (UTC)
thread_title: Law?

message: While the whole article is a little NPOV, this section reads more like an advocate's position and not a neutral, disspassionate encylopedia. I think its needs to be cleaned up to a NPOV standard. I'm sadly not able to take a stab at editing it right now, but I hope someone can look at it. Caelarch (talk) 23:22, 28 February 2009 (UTC)
replies: text: It may read like an advocate, but isn't legally correct.  Law's vary form country to country.  A "living will" is of doubtful legality in America, and of no effect elsewhere. Patients do have right to refuse treatment - this isn't limited to living wills.  Patients can demand life saving treatments. Whether they get it is another matter. Once a patient is no longer conscious, the clinical team cannot simply act in the patient's best interests. They must follow the directions of the legal next of kin, or any person with power of attorney for personal care.JohnC (talk) 03:18, 20 February 2011 (UTC)
replies: text: What? So a person comes in with some minor injury, but noticeable bloodloss, with his heir&next of kin in tow, gets prepped for surgery and goes out... NOW the heir can fast-track himself to an inheritance and bullshit about the patient not believing in blood transfers for religious reasons or some crap like that? Or better yet just tell them to let the patient die, no need to give a reason?  — Preceding unsigned comment added by 208.127.80.59 (talk) 07:15, 8 September 2011 (UTC)
replies: text:  Re: JohnC actually wrong in a large number of countries using UK medical models. Patients do have a right to refuse treatment, absolutely. There is however no medicolegal obligation to follow the directions of the next of kin nor power of attorney if it is not in the clinical interests of the patient outside, to my knowledge, of the US. This is best reflected in NFR/not for code status - in the USA doctors are often limited to continuing futile resuscitation events and cannot change a patient's resuscitation status without consent. In many other countries, there are protections in law (UK, AU, NZ etc) for a not-for-resuscitation order due to the senior clinician's judgment that a patient would not survive the attempt - IE, not in the patient's best interest; such as in the case of disseminated malignancy. You can trust me on the truth of this matter if you like - I sign these forms. --115.70.65.7 (talk) 02:26, 29 August 2015 (UTC)
thread_title:  Legal position 

message: I'm concerned by the use of quotes around 'best interests' in the risk assesment section. Partucularly their use in the following:
"busy NHS teams can decide it is in their 'best interests' to withold all treatments, and this is common, particularly with elderly or disabled patients."
It seems to imply that under the NHS clinical staff will withhold treatment on cost grounds, or because docs/nurses are too lazy to care for their patients. It clearly has no place on wikipedia. Especially as no citations is given.  
Worse still:
"Sensible patients can therefore, under UK law, give a directive that they refuse 'Palliative Care' or 'Terminal Sedation', or 'any drug likely to supress my respiration' in a 'living will' or 'Advance Directive', and avoid being involuntarily euthenased, but it is imperative that these phrases are explicitly included in the advance directive."
--This is hardly encyclopaedic prose. I'm cleaning up this section post haste.  —Preceding unsigned comment added by 93.97.29.181 (talk) 18:24, 26 March 2009 (UTC)
thread_title: NHS Bashing?!

message: Our proposed edits include:
-  — Preceding unsigned comment added by Atrinh22 (talk • contribs) 21:57, 27 July 2020 (UTC)
thread_title:  Foundations II 2020 Group 19 proposed edits 

message: Do the group’s edits substantially improve the article as described in the Wikipedia peer review “Guiding framework”?
* Yes, the edits have expanded the lead which makes it easy to understand and includes points of discussion that act as subsequent headings within the article. For example, the paragraph describing what palliative sedation provides acts a brief overview of the section on "General Practice". However, I believe the use of the word "patients" is not recommended as it makes it sound like one is writing to health professionals.  T.Tsai,UCSF (talk) 21:46, 3 August 2020 (UTC)
replies: text: Well I have never been so stunned in all my Wikipedia life as I have been by this group of students.  I doubt you guys know that you are unique and rare.  In all my years of seeing (and deleting a lot of) student work which was a big time waste better spent on improving articles, out of the blue this happens.  Who are you guys, anyway?  Congrats on such fine work.    Gandydancer (talk) 00:58, 5 August 2020 (UTC)
thread_title:  Group 20 Peer Review 

message: "Titrated sedation might speed up death, although death is considered a side effect and sedation does not equate with euthanasia. A survey of 663 physicians found half had an experience of their treatment being characterised as murder, euthanasia, or killing in the preceding five years with palliative sedation (along with stopping of hydration and nutrition) being the most common act in palliative care interpreted as killing."
To be clear, if death should happen as a mere "side effect" of sedation - it does not equated with and should not be interpreted as a killing? 
So that's okay then?  — Preceding unsigned comment added by 95.149.166.137 (talk) 10:36, 21 July 2023 (UTC)
replies: text: Wikipedia's job is mostly to talk about what people say in other sources (which can be aided by an understanding of the topic). This will probably show up in ethics. Lots of issues that are normally cut-and-dry become more murky in life and death situations. An ethics text might well explore this at length, but some analogies would be to, say, a risky operation that might kill someone but also could improve their life greatly. For me the really murky issues here are more around consent - particularly when you sedate people so they can't consent - potentially in a procedural fashion. Talpedia 12:31, 21 July 2023 (UTC)

text: They tend to have an excuse for these things. The argument is that people are less able to digest food etc. But yeah, four hours is quite different from 3 days in this regard. My mother had a friend who deliberately starved herself to death as a form of euthanasia... so perhaps there can be some agency there. Talpedia 16:54, 21 July 2023 (UTC)

text: I guess my question is what do you want wikipedia to do about it. Wikipedia summarizes the best literature in a nuanced and balanced way. This is a controversial issue - we can ensure that the coverage of the material is good. Most people don't know about palliative sedation, some people who do consider practices involuntary euthanasia, people who work in palliative care - perhaps understandably have excuses. I can say, yes, people agree with you. But to do anything on wikipedia you get to do is add reliable material in a balanced and complete fashion or encourage others to do so. Talpedia 17:13, 21 July 2023 (UTC)
thread_title:  Side effects