Responding to Intractable Terminal Suffering
Authors: Eric L. Krakauer
Journal: Annals of Internal Medicine (2000)

Letters3 October 2000Responding to Intractable Terminal SufferingEric L. Krakauer, MD, PhDEric L. Krakauer, MD, PhDMassachusetts General Hospital; Boston, MA 02114 (Krakauer)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-7-200010030-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I applaud Quill and Byock's thoughtful discussion of options for responding to intractable terminal suffering (1). However, the term terminal sedation is confusion, misleading, and potentially harmful. First, the term is contradicted by the authors' own discussion of it. They write that terminal sedation, defined as "the use of high doses of sedatives to relieve extremes of physical distress," "is not restricted to end-of-life care." If the patient has a prospect of recovery, then the sedation may be used for intractable distress but is not necessarily "terminal." Second, the term terminal sedation inevitably connotes sedation intended to ...References1. Quill TE, Byock IR. Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids. ACP–ASIM End-of-Life Care Consensus Panel. Ann Intern Med. 2000;132:408-14. LinkGoogle Scholar2. Krakauer EL, Penson RT, Truog RD, King LA, Chabner BA, Lynch TJ. Sedation for intractable distress of a dying patient: acute palliative care and the principle of double effect. Oncologist. 2000;5:53-62. CrossrefMedlineGoogle Scholar3. Quill TE, Dresser R, Brock DW. The rule of double effect—a critique of its role in end-of-life decision making. N Engl J Med. 1997;337:1768-71. CrossrefMedlineGoogle Scholar4. Sulmasy DP, Pellegrino ED. The rule of double effect: clearing up the double talk. Arch Intern Med. 1999;159:545-50. CrossrefMedlineGoogle Scholar5. Chater S, Viola R, Paterson J, Jarvis V. Sedation for intractable distress in the dying—a survey of experts. Palliat Med. 1998;12:255-69. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital; Boston, MA 02114 (Krakauer) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoResponding to Intractable Terminal Suffering: The Role of Terminal Sedation and Voluntary Refusal of Food and Fluids Timothy E. Quill , Ira R. Byock , and Responding to Intractable Terminal Suffering Daniel P. Sulmasy , Wayne A. Ury , Judith C. Ahronheim , Mark Siegler , Leon Kass , John Lantos , Robert A. Burt , Kathleen Foley , Richard Payne , Carlos Gomez , Thomas J. Krizek , Edmund D. Pellegrino , and Russell K. Portenoy Responding to Intractable Terminal Suffering Timothy E. Quill and Ira R. Byock Palliative Treatment of Last Resort and Assisted Suicide Daniel P. Sulmasy , Wayne A. Ury , Judith C. Ahronheim , Mark Siegler , Leon Kass , John Lantos , Robert A. Burt , Kathleen Foley , Richard Payne , Carlos Gomez , Thomas J. Krizek , Edmund D. Pellegrino , and Russell K. Portenoy Palliative Treatment of Last Resort and Assisted Suicide Timothy E. Quill , Barbara Coombs Lee , and Sally Nunn Publication of Papers on Assisted Suicide and Terminal Sedation Daniel P. Sulmasy , Wayne A. Ury , Judith C. Ahronheim , Mark Siegler , Leon Kass , John Lantos , Robert A. Burt , Kathleen Foley , Richard Payne , Carlos Gomez , Thomas J. Krizek , Edmund D. Pellegrino , and Russell K. Portenoy Publication of Papers on Assisted Suicide and Terminal Sedation Lois Snyder Publication of Papers on Assisted Suicide and Terminal Sedation Frank Davidoff Responding to Intractable Terminal Suffering Morton Leonard Yanow Metrics Cited ByEuthanasia and palliative sedation in BelgiumPalliative Sedation Versus Euthanasia: An Ethical AssessmentCare of a Child Dying of CancerPalliative sedation vs. terminal sedation: What's in a name? 3 October 2000Volume 133, Issue 7Page: 560KeywordsEuthanasiaPalliative carePatientsSedationSedativesTreatment guidelines ePublished: 3 October 2000 Issue Published: 3 October 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...