title: Addressing the Concerns Surrounding Continuous Deep Sedation in Singapore and Southeast Asia: A Palliative Care Approach.
abstract: The application of continuous deep sedation (CDS) in the treatment of intractable suffering at the end of life continues to be tied to a number of concerns that have negated its use in palliative care. Part of the resistance towards use of this treatment option of last resort has been the continued association of CDS with physician-associated suicide and/or euthanasia (PAS/E), which is compounded by a lack clinical guidelines and a failure to cite this treatment under the aegis of a palliative care approach. I argue that reinstituting a palliative care-inspired approach that includes a holistic review of the patient's situation and the engagement of a multidisciplinary team (MDT) guided by clearly defined practice requirements that have been lacking amongst many prevailing guidelines will overcome prevailing objections to this practice and allow for the legitimization of this process.
authors.affiliation: Department of Palliative Medicine, National Cancer Center Singapore, 11 Hospital Drive, Singapore, 169610, Singapore. lalit.krishna@nccs.com.sg.
authors.forename: Lalit Kumar Radha
authors.initials: LK
authors.lastname: Krishna
mesh_terms: D001210:Asia, Southeastern; D001291:Attitude of Health Personnel; D054810:Deep Sedation; D005065:Euthanasia; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D010348:Patient Care Team; D010820:Physicians; D017410:Practice Guidelines as Topic; D012846:Singapore; D017236:Suicide, Assisted; D013727:Terminal Care / Q000379:methods*
keywords: Continuous deep sedation; End of life; Palliative care; Palliative sedation; Ring Theory of Personhood; Terminal sedation