Sedation, not euthanasia

In his opinion piece last Wednesday, Matt Vickers referred to palliative sedation being a “legal grey area” and “a form of legal euthanasia . . . regarded as ethical by the New Zealand Medical Association”. This is incorrect. There is a clear distinction between providing symptom relief and causing death.

The intent of palliative sedation is to relieve distress by sedating a dying patient in their last hours or days, using a continuous intravenous or subcutaneous infusion of a sedative drug. It is only considered when all other symptom-relieving measures have failed.

The level of sedation is set to remove distress, and doctors and carers work with the patient and carer and/or family members to determine this. While the effect may be to slightly increase the risk of hastening death, it does not usually alter the timing or mechanism of a patient’s death, as the symptoms being addressed are most often associated with very advanced terminal illness.

Sedatives are administered only when symptoms have become intractable and when the patient is terminal, so that the expected loss of life duration is nil or minimal. This is not a “grey area”, nor euthanasia. Dr Stephen Child, chairman, New Zealand Medical Association.