title: Palliative sedation: ethical perspectives from Latin America in comparison with European recommendations.
abstract: OBJECTIVE
  Palliative sedation is a standard procedure used in palliative care especially for patients at the very end of their lives, who are enduring otherwise intractable suffering. It consists of the administration of sedatives and, when necessary, other drugs, usually by infusion, either subcutaneously or intravenously, at the necessary rate to achieve the patient's relief, by means of reducing the consciousness of the patient. If this administration is not discontinued, the usual outcome is the patient's death. So, the most frequent criticisms regarding the procedure are those that consider it as a form of euthanasia. The intention of the review is analyzing the status questionis in Europe and Latin America.
  
  
  RESULTS
  Current thinking and research about this issue refers especially to the terminology, the boundaries between palliative sedation and slow euthanasia, especially in pediatric settings, the lacking of precise definition for concepts such as refractory symptoms and unbearable suffering, and the place for existential suffering in this context; the ethical positioning of Latin-American normative and authors is similar to that of Europe.
  
  
  CONCLUSIONS
  It does not seem that solution to the conflicting points will come from better guidelines or more experts' meetings. Instead, efforts should be directed to reinforce moral, professional integrity, within the framework of an ethics of virtue, as inherent to palliative care. Such ethics can effectively be taught and infused, and then required to all healthcare professionals.
authors: Hospital Privado de Comunidad, Mar del Plata, National Academy of Medicine, Buenos Aires, Argentina. urska.lunder@klinika-golnik.si
authors: Jorge L
authors: JL
authors: Manzini
mesh_terms: D016292:Procedural Sedation / Q000379:methods*; D003243:Consciousness; D004992:Ethics, Medical; D005060:Europe; D005066:Euthanasia, Passive / Q000941:ethics; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007843:Latin America; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000941:ethics / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*
chemical_list: D006993:Hypnotics and Sedatives