Palliative sedation a ‘peaceful way to die’

Christchurch Press 17 Sep 2012
Within 10 minutes of having her first dose of sedative, Col Pieper’s terminally-ill mother drifts to sleep. A medication pump is set up to continuously give her the sedative midazolam to ensure she stays asleep until she dies. Three and a half days later, she dies peacefully, as she had chosen. Pieper, a West Coast-based registered nurse, says her mother had originally wanted to be euthanised, but switched her thinking only weeks from death once she learned about palliative sedation. She could choose because she lived in the Netherlands, one of a few countries in the world to legalise euthanasia. The euthanasia debate has reignited in New Zealand with Labour MP Maryan Street’s End of Life Choice private member’s bill, which she lodged in the ballot box in July. It must be selected before it can be considered by Parliament. Late last month, Prime Minister John Key faced strong criticism from the medical profession after claiming euthanasia was happening in our hospitals and that he would consider it if terminally ill. Hospice New Zealand’s clinical director, Associate Professor Sandy Macleod, says Key was incorrectly informed but agrees the public has little knowledge of other end-of-life options, such as palliative sedation. “In euthanasia, you are trying to kill the person. In palliative sedation, you are trying to kill the intractable symptoms,” Macleod says. “There are plenty of options other than killing people that we have at our disposal.” Palliative sedation is quite common practice in New Zealand hospices when someone is within days of death and suffering distressing, uncontrollable symptoms, such as delirium or extreme breathlessness, he says. A Christchurch study found a quarter of people dying at the city’s hospice had palliative sedation, he says. In the Netherlands, medical guidelines state a terminally-ill person must be within two weeks of death and suffering unbearable symptoms that are unrelieved by treatment to qualify for palliative sedation. While no such formal guidelines exist in New Zealand, it is discussed in the Palliative Care Handbook.
http://www.stuff.co.nz/the-press/news/7687633/Palliative-sedation-a-peaceful-way-to-die