AMA Supports Palliative Sedation—As it Should

The AMA has officially supported palliative sedation. This should be able to go without saying. But due to assisted suicide advocates trying to turn palliative sedation into “terminal” sedation, confusion has arisen. In any event, from the story in the American Medical News:

When all else fails to control patients’ pain at the end of life, it is appropriate for physicians to sedate such patients to unconsciousness, according to new ethical policy adopted at the AMA Annual Meeting in June.

The rarely employed practice of palliative or terminal sedation is sometimes perceived as speeding the dying process, leading critics to dub it a form of physician-assisted suicide. But evidence of such a hastening effect is lacking, according to a Council on Ethical and Judicial Affairs report adopted by the House of Delegates. “These are unusual circumstances that require us to urgently relieve these symptoms by sedating patients to unconsciousness,” said CEJA member H. Rex Greene, MD, a Lima, Ohio, oncologist and palliative medicine specialist. “This is not intended to end life.”

Key words: “When all else fails,” and “rarely employed process,” and, “this is not intended to end life.”

I know Rex Greene and he is a powerful voice against assisted suicide and euthanasia. And his quote is absolutely true. But the article should have added that any confusion that may exist about palliative sedation was not caused by opponents of assisted suicide. Rather proponents intentionally sowed confusion by—as in California’s AB 2747 before it was gutted in committee—seeking to pass legislation that would transform it from a rarely used but legitimate palliative measure into a “treatment” available to all terminally ill patients on demand—whether their symptoms warranted it or not.

Palliative sedation, as described in the article, is proper and ethical. But if euthanasia advocates get their way, it would become a form of back-door assisted suicide/euthanasia—as now appears to be the case in the killer country the Netherlands where doctors increasingly use sedation so they don’t have to be at the bedside when they euthanize the patient. They should cease and desist their redefinition attempts now for the benefit of all of us.