This article is rated C-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: | |||||||||||||||||||||
|
This article was the subject of a Wiki Education Foundation-supported course assignment, between 29 June 2020 and 21 August 2020. Further details are available on the course page. Student editor(s): Mau.Shin1, VTONGUCSF, Atrinh22, Ssofeso.
Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT ( talk) 06:03, 17 January 2022 (UTC)
I'm putting this first only as time-line.
Is this sentence clear? To me it seems ... fractured:
"Patients (or their legal representatives) only have the right to refuse treatments in living wills; they cannot demand life saving treatments, or any treatments at all."
"Have the right to refuse" makes sense. But then "cannot demand life saving treatments or any treatments at all"? It's as though some conditional is missing.
==
BenTrem (
talk) 05:20, 5 November 2016 (UTC)
I was wondering if anyone knew the official law concerning terminal sedation. If anyone has any idea it would be greatly appreciated. —Preceding unsigned comment added by 141.233.8.152 ( talk • contribs) 00:09, 8 April 2005
In most nhs hospitals in the UK , they put all elderly patients on codeine anyway, enter non existent 'pain' on their nursing records, then finish them off with midazolam and alfentanil to alleviate non existent agitation - no one checks their controlled drugs registers, although all uk police forces have a dedicated officer who is supposed to - most of them are married to nurses, so they dont have to give anyone they consider 'elderly' any of the treatments that a 30 year old would be entitled to - its licenced murder, the way the NHS practice it in this area - quite why you are even dressing this subject up with an 'ethical discussion' I can't fathom - its murder done with smoke and mirrors, the intention is murder - it avoids blocking up nhs beds with 'lives unworthy of life' - small matter of 'consent ' is conveniently circumvented by filling them up with morphine first, and saying the loss of conciousness is due to something like a stroke to their relatives - they rely on visitors knowing absolutely nothing about doseages and respiratory side effects of 'palliative care' drugs. Its rife - but as the 'attending doctor' is the one who writes the cause of death on the death certificate, no one questions it at all . —Preceding unsigned comment added by Thomaswilliamlofthouse ( talk • contribs) 01:00, 13 April 2008 (UTC)
--> OMG, Do you have any reference for this? —Preceding unsigned comment added by 93.97.29.181 ( talk) 18:35, 26 March 2009 (UTC)
With regards to the "License For Murder" link title: If there is a controversy regarding Terminal Sedation, a more appropriate tack would be to create a separate section with the controversy detailed in neutral POV terms, then cite the website.
Dr. Scarabus (
talk) 19:26, 16 April 2008 (UTC)
"Sedation is not routine in palliative and most patients die comfortably without the need for sedation."
Do you have any data to back this claim? I don't get how death is "comfortable". The outward signs may resemble sleep or comfort, but death is nothing like that as the body is violently shutting down. What if the patient is feeling extreme pain and distress, but cannot outwardly show this during their last moment due to paralysis or some other factor (ie the brain cells that receive pain input still work but those that send effector signals died off first)?
It might also be extremely distressing
if the normal reflexes aren't working and the patient may feel like they are drowning (since they can't breath due to the loss of medullary function) but there may be no convulsions to indicate this due to the same reasons as above (loss of effector signals). Then again, it might not. We can't know for sure without data. —Preceding unsigned comment added by 64.12.116.5 ( talk • contribs) 03:37, 20 April 2006
Hey guys, LOVE that "repeatedly ordered to give lethal morphine injection (to an opiate-tolerant person!), injected it into pillow" stuff, but last time I checked, that sounds more like some nurse getting caught red-handed for vast amounts of NHS morphine "disappearing" on their shift (and going into their pockets to sell or their veins to relax)... then coming up with a valid excuse AND trying to shift the blame over to her boss, probably the guy who caught her for the morphine. 208.127.80.59 ( talk) 07:10, 8 September 2011 (UTC)
I feel this article should be changed from terminal sedation to palliative sedation. The goal of sedation is the palliation of symptoms, not the ending of life (terminal). Calling it terminal sedation implies the goal is death. Palliative sedation can be stopped and reversed or used at different levels of sedation, therefore not always happening at the same time as death. I will await comments from others before changing. SpoticusKC 05:13, 30 June 2007 (UTC)
No the request is that it more closely reflects the common medical language regarding this procedure, which you note has some controversy. SpoticusKC ( talk) 11:26, 9 May 2008 (UTC)
While the whole article is a little NPOV, this section reads more like an advocate's position and not a neutral, disspassionate encylopedia. I think its needs to be cleaned up to a NPOV standard. I'm sadly not able to take a stab at editing it right now, but I hope someone can look at it. Caelarch ( talk) 23:22, 28 February 2009 (UTC)
I'm concerned by the use of quotes around 'best interests' in the risk assesment section. Partucularly their use in the following:
"busy NHS teams can decide it is in their 'best interests' to withold all treatments, and this is common, particularly with elderly or disabled patients."
It seems to imply that under the NHS clinical staff will withhold treatment on cost grounds, or because docs/nurses are too lazy to care for their patients. It clearly has no place on wikipedia. Especially as no citations is given.
Worse still:
"Sensible patients can therefore, under UK law, give a directive that they refuse 'Palliative Care' or 'Terminal Sedation', or 'any drug likely to supress my respiration' in a 'living will' or 'Advance Directive', and avoid being involuntarily euthenased, but it is imperative that these phrases are explicitly included in the advance directive."
--This is hardly encyclopaedic prose. I'm cleaning up this section post haste. —Preceding unsigned comment added by 93.97.29.181 ( talk) 18:24, 26 March 2009 (UTC)
Our proposed edits include: - — Preceding unsigned comment added by Atrinh22 ( talk • contribs) 21:57, 27 July 2020 (UTC)
- More statistics for US in the opening section (MS)
- Types of patients eligible for palliative care (such as disease states)(MS)
- Alternative care methods used prior to palliative sedation (TS)
- Find citations for sections on : "General practice", "Drugs used", "Sedation vs. euthanasia"(AT)
- Find alternative guidelines for statistics on palliative sedation outside of the UK (VT)
- Add more information to the "Policies" section (look up US guidelines)(VT)
- Add more information on the "hospice care movement" and expand on history of the movement, as well as the history of how palliative sedation came to be (TS)
- Organize into first line and second line drugs used and more details on the "Drugs Used" section (AT) Mau.Shin1 ( talk) 20:57, 28 July 2020 (UTC)
Do the group’s edits substantially improve the article as described in the Wikipedia peer review “Guiding framework”?
Has the group achieved its overall goals for improvement?
Does the draft submission reflect a neutral point of view? If not, specify…
Is there any evidence of plagiarism or copyright violation?
Are the edits formatted consistent with Wikipedia’s manual of style? If not, specify…
-The group's edits to the article do substantially add to the article by adding more information about palliative sedation itself but also some of the history relating to it and its prevalence in other countries. I also think it was very important that there was distinction between palliative sedation and euthanasia. Overall the structure of the article is very balanced and doesn't just focus on one area such as the drugs used for palliative sedation. I'm not sure if this group is done editing or not, but I would like to see a little bit more on the policies regarding this subject that have been approved and what about these policies makes it considered ethical.
-It looks like this group has achieved its overall goals for improving this page.
-The points on this page are cited and verifiable with the exception of like two sentences where there was a "citation" next to the information presented, although those particular edits were from someone outside of the group who had previously edited. I think this group has done a very good job at citing the sources they used to contribute to this article since there is a wide variety of sources that were used instead of only a couple articles per person. Dholston1 ( talk) 21:48, 3 August 2020 (UTC)
"Titrated sedation might speed up death, although death is considered a side effect and sedation does not equate with euthanasia. A survey of 663 physicians found half had an experience of their treatment being characterised as murder, euthanasia, or killing in the preceding five years with palliative sedation (along with stopping of hydration and nutrition) being the most common act in palliative care interpreted as killing."
To be clear, if death should happen as a mere "side effect" of sedation - it does not equated with and should not be interpreted as a killing?
So that's okay then? — Preceding unsigned comment added by 95.149.166.137 ( talk) 10:36, 21 July 2023 (UTC)
Then again, while the use of powerfull drugs to end pain or life might be open to question, is not the end result of stopping all hydration and nutrition very cut and dry? — Preceding unsigned comment added by 91.110.75.17 ( talk) 16:27, 21 July 2023 (UTC)
This article is rated C-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: | |||||||||||||||||||||
|
This article was the subject of a Wiki Education Foundation-supported course assignment, between 29 June 2020 and 21 August 2020. Further details are available on the course page. Student editor(s): Mau.Shin1, VTONGUCSF, Atrinh22, Ssofeso.
Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT ( talk) 06:03, 17 January 2022 (UTC)
I'm putting this first only as time-line.
Is this sentence clear? To me it seems ... fractured:
"Patients (or their legal representatives) only have the right to refuse treatments in living wills; they cannot demand life saving treatments, or any treatments at all."
"Have the right to refuse" makes sense. But then "cannot demand life saving treatments or any treatments at all"? It's as though some conditional is missing.
==
BenTrem (
talk) 05:20, 5 November 2016 (UTC)
I was wondering if anyone knew the official law concerning terminal sedation. If anyone has any idea it would be greatly appreciated. —Preceding unsigned comment added by 141.233.8.152 ( talk • contribs) 00:09, 8 April 2005
In most nhs hospitals in the UK , they put all elderly patients on codeine anyway, enter non existent 'pain' on their nursing records, then finish them off with midazolam and alfentanil to alleviate non existent agitation - no one checks their controlled drugs registers, although all uk police forces have a dedicated officer who is supposed to - most of them are married to nurses, so they dont have to give anyone they consider 'elderly' any of the treatments that a 30 year old would be entitled to - its licenced murder, the way the NHS practice it in this area - quite why you are even dressing this subject up with an 'ethical discussion' I can't fathom - its murder done with smoke and mirrors, the intention is murder - it avoids blocking up nhs beds with 'lives unworthy of life' - small matter of 'consent ' is conveniently circumvented by filling them up with morphine first, and saying the loss of conciousness is due to something like a stroke to their relatives - they rely on visitors knowing absolutely nothing about doseages and respiratory side effects of 'palliative care' drugs. Its rife - but as the 'attending doctor' is the one who writes the cause of death on the death certificate, no one questions it at all . —Preceding unsigned comment added by Thomaswilliamlofthouse ( talk • contribs) 01:00, 13 April 2008 (UTC)
--> OMG, Do you have any reference for this? —Preceding unsigned comment added by 93.97.29.181 ( talk) 18:35, 26 March 2009 (UTC)
With regards to the "License For Murder" link title: If there is a controversy regarding Terminal Sedation, a more appropriate tack would be to create a separate section with the controversy detailed in neutral POV terms, then cite the website.
Dr. Scarabus (
talk) 19:26, 16 April 2008 (UTC)
"Sedation is not routine in palliative and most patients die comfortably without the need for sedation."
Do you have any data to back this claim? I don't get how death is "comfortable". The outward signs may resemble sleep or comfort, but death is nothing like that as the body is violently shutting down. What if the patient is feeling extreme pain and distress, but cannot outwardly show this during their last moment due to paralysis or some other factor (ie the brain cells that receive pain input still work but those that send effector signals died off first)?
It might also be extremely distressing
if the normal reflexes aren't working and the patient may feel like they are drowning (since they can't breath due to the loss of medullary function) but there may be no convulsions to indicate this due to the same reasons as above (loss of effector signals). Then again, it might not. We can't know for sure without data. —Preceding unsigned comment added by 64.12.116.5 ( talk • contribs) 03:37, 20 April 2006
Hey guys, LOVE that "repeatedly ordered to give lethal morphine injection (to an opiate-tolerant person!), injected it into pillow" stuff, but last time I checked, that sounds more like some nurse getting caught red-handed for vast amounts of NHS morphine "disappearing" on their shift (and going into their pockets to sell or their veins to relax)... then coming up with a valid excuse AND trying to shift the blame over to her boss, probably the guy who caught her for the morphine. 208.127.80.59 ( talk) 07:10, 8 September 2011 (UTC)
I feel this article should be changed from terminal sedation to palliative sedation. The goal of sedation is the palliation of symptoms, not the ending of life (terminal). Calling it terminal sedation implies the goal is death. Palliative sedation can be stopped and reversed or used at different levels of sedation, therefore not always happening at the same time as death. I will await comments from others before changing. SpoticusKC 05:13, 30 June 2007 (UTC)
No the request is that it more closely reflects the common medical language regarding this procedure, which you note has some controversy. SpoticusKC ( talk) 11:26, 9 May 2008 (UTC)
While the whole article is a little NPOV, this section reads more like an advocate's position and not a neutral, disspassionate encylopedia. I think its needs to be cleaned up to a NPOV standard. I'm sadly not able to take a stab at editing it right now, but I hope someone can look at it. Caelarch ( talk) 23:22, 28 February 2009 (UTC)
I'm concerned by the use of quotes around 'best interests' in the risk assesment section. Partucularly their use in the following:
"busy NHS teams can decide it is in their 'best interests' to withold all treatments, and this is common, particularly with elderly or disabled patients."
It seems to imply that under the NHS clinical staff will withhold treatment on cost grounds, or because docs/nurses are too lazy to care for their patients. It clearly has no place on wikipedia. Especially as no citations is given.
Worse still:
"Sensible patients can therefore, under UK law, give a directive that they refuse 'Palliative Care' or 'Terminal Sedation', or 'any drug likely to supress my respiration' in a 'living will' or 'Advance Directive', and avoid being involuntarily euthenased, but it is imperative that these phrases are explicitly included in the advance directive."
--This is hardly encyclopaedic prose. I'm cleaning up this section post haste. —Preceding unsigned comment added by 93.97.29.181 ( talk) 18:24, 26 March 2009 (UTC)
Our proposed edits include: - — Preceding unsigned comment added by Atrinh22 ( talk • contribs) 21:57, 27 July 2020 (UTC)
- More statistics for US in the opening section (MS)
- Types of patients eligible for palliative care (such as disease states)(MS)
- Alternative care methods used prior to palliative sedation (TS)
- Find citations for sections on : "General practice", "Drugs used", "Sedation vs. euthanasia"(AT)
- Find alternative guidelines for statistics on palliative sedation outside of the UK (VT)
- Add more information to the "Policies" section (look up US guidelines)(VT)
- Add more information on the "hospice care movement" and expand on history of the movement, as well as the history of how palliative sedation came to be (TS)
- Organize into first line and second line drugs used and more details on the "Drugs Used" section (AT) Mau.Shin1 ( talk) 20:57, 28 July 2020 (UTC)
Do the group’s edits substantially improve the article as described in the Wikipedia peer review “Guiding framework”?
Has the group achieved its overall goals for improvement?
Does the draft submission reflect a neutral point of view? If not, specify…
Is there any evidence of plagiarism or copyright violation?
Are the edits formatted consistent with Wikipedia’s manual of style? If not, specify…
-The group's edits to the article do substantially add to the article by adding more information about palliative sedation itself but also some of the history relating to it and its prevalence in other countries. I also think it was very important that there was distinction between palliative sedation and euthanasia. Overall the structure of the article is very balanced and doesn't just focus on one area such as the drugs used for palliative sedation. I'm not sure if this group is done editing or not, but I would like to see a little bit more on the policies regarding this subject that have been approved and what about these policies makes it considered ethical.
-It looks like this group has achieved its overall goals for improving this page.
-The points on this page are cited and verifiable with the exception of like two sentences where there was a "citation" next to the information presented, although those particular edits were from someone outside of the group who had previously edited. I think this group has done a very good job at citing the sources they used to contribute to this article since there is a wide variety of sources that were used instead of only a couple articles per person. Dholston1 ( talk) 21:48, 3 August 2020 (UTC)
"Titrated sedation might speed up death, although death is considered a side effect and sedation does not equate with euthanasia. A survey of 663 physicians found half had an experience of their treatment being characterised as murder, euthanasia, or killing in the preceding five years with palliative sedation (along with stopping of hydration and nutrition) being the most common act in palliative care interpreted as killing."
To be clear, if death should happen as a mere "side effect" of sedation - it does not equated with and should not be interpreted as a killing?
So that's okay then? — Preceding unsigned comment added by 95.149.166.137 ( talk) 10:36, 21 July 2023 (UTC)
Then again, while the use of powerfull drugs to end pain or life might be open to question, is not the end result of stopping all hydration and nutrition very cut and dry? — Preceding unsigned comment added by 91.110.75.17 ( talk) 16:27, 21 July 2023 (UTC)