Pain Management in Children with Severe Neurological Impairment (421)

Abstract

of last resort. What is more controversial, however, is palliative sedation to unconsciousness for patients whose physical pain may be adequately managed, but whose existential suffering cannot be otherwise abated by aggressive multidisciplinary care. This session offers participants the opportunity to think about how work in existential psychology and philosophy can inform ethical decision-making and policy development related to palliative sedation. The debate over sedation for existential suffering rarely takes the time to articulate what is meant by the term existential suffering. Indeed, more often than not the meaning of the term is simply implied: suffering of or from a nonphysical etiology. In other words, suffering that is not equivalent to or arising from physical pain. While there are a handful of conceptual models of existential suffering in the psychology and palliative care literature, there is no commonly used definition or set of diagnostic criteria to identify suffering as existential. Yet, several professional societies including the American MedicalAssociationhave issuedpositionstatements opposing the use of palliative sedation for existential suffering. The diagnosis and treatment of existential suffering offers an opportunity for translational work between the humanities, social sciences, and palliative care. The literature and practice of psycho-oncology offers one example of such translation. Drawing on the work of Irvin Yolom in existential psychology, Breitbart and colleagues have developed interventions for suffering that translate Yalom’s four realms of existential concern into clinical interventions for advanced cancer patients. The panel will further investigate ways to translate conceptualizations of suffering in existential philosophy and psychology in ways that can more robustly inform the debate on the use of palliative sedation for existential suffering.