Etički aspekti palijativne sedacije

Abstract

In contemporary society, despite technological advance, death and dying remain inevitable high technology and frightening reality. In response, post-modern society returns to the traditional approach of 'good death' that emphasizes managing with symptoms, treatment in accordance with the wishes, welfare and social support. Palliative care is a re-discover old practice of relief of suffering and the achievement of the highest possible quality of life. It helps to patient to live active and creative as far as possible through the struggle with the 'total pain' (physical, psychological, spiritual and social pain). Despite the efforts of palliative care, there are refractory symptoms whose intensity increases with the approaching of death, which adversely affect the well being of patients. These symptoms can't be treated without compromising patient awareness. Palliative sedation represents the intravenous administration of sedatives which the consciousness of patients lowers deep sufficiently that would provide comfort to the moment of death. Palliative sedation is not 'indirect euthanasia'. It is different from euthanasia by intent. In palliative sedation is intended relief of suffering, not death as in euthanasia, because death is not necessary for the relief of suffering. Predictable effect of shortening the life with palliative sedation is justified by the principle of double effect. One of the possible answers to the question of human dignity in suffering and dying is the one who is, in accordance with the human right to dignity in dying, present in palliative care.