![]() Also, one of the guiding principles of palliative sedation is that it is applied when the anticipated life span of a terminally ill patient is in the range of hours to days. For clarity, the goal of palliative sedation is truly aimed at sedation, not a cessation of life, and studies have shown that palliative sedation overall is not associated with a shortened life span. Additionally, ethical and legal issues surrounding this topic, as it appears, at least superficially similar to the process of physician-assisted suicide or euthanasia, discourage physicians from initiating conversations or planning for palliative sedation in patients. Some controversy arises over a lack of consistency in defining "refractory symptoms" and a lack of adequate knowledge among patients, family members, and healthcare workers alike regarding the issue of palliative sedation. However, there is still open controversy and ethical debate about the use of palliative sedation for the relief of existential or psychological distress in terminally ill patients. There is a well-established practice and relative acceptance of the use of palliative sedation to relieve these symptoms. The most common refractory symptoms in terminally ill patients are delirium, intractable pain, and shortness of breath. Palliative sedation involves therapy to resolve or alleviate refractory symptoms at the end of life. All rights reserved.Palliative sedation encompasses a broad range of activities aimed at relieving distress in terminally ill patients. Clinicians may minimize this regret by facilitating a shared understanding of the disease and prognosis, advising families explicitly when to talk based on terminal awareness, providing continuous emotional support, and validating their decision on talking about death.Įnd-of-life discussion bereaved family cancer regret.Ĭopyright © 2017 American Academy of Hospice and Palliative Medicine. ![]() Three process factors ("prognostic disclosure to patient", "upsetting of patient and family", and "family's sense of uncertainty about when to act based on terminal awareness" ) and an outcome factor ("having achieved a good death" ) contributed to the regret of talking insufficiently.Ī third of bereaved families of adult cancer patients regretted not having talked about death sufficiently. Exploratory analyses identified the underlying structures of process, option, and outcome subscales of factors contributing to regret.Īmong 678 bereaved families (response rate 68%), 224 (33%) regretted not having talked about death sufficiently, whereas 40 (5.9%) conversely regretted having talked about death. ![]() We conducted a nationwide survey of 999 bereaved families of cancer patients admitted to 133 inpatient hospices in Japan and surveyed families' regret on talking about death. To explore the prevalence of a regret of not having talked about death with a deceased loved one among bereaved family members of adult cancer patients, and to systematically explore factors contributing to their regret. Little is known about how often and which bereaved families regret not having talked about death with their deceased loved one. Talking about death is an important issue for terminally-ill cancer patients and their families. ![]()
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