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Widen use of general anaesthesia for dying patients?

Wednesday April 21st 2021

General anaesthesia should be widely available as part of end of life care, according to a group of British specialists.

The ethics and anaesthesia specialists are calling for a debate on widening the availability of general anaesthesia at the end of life.

Currently, dying patients are often given painkillers, and later If needed, continuous deep sedation, or palliative/terminal sedation. But general anaesthesia is increasingly being used in Western Europe and Scandinavia.

Professor Julian Savulescu of the University of Oxford, UK, and colleagues published a paper in Anaesthesia yesterday (20 April).

Professor Savulescu said: "For some patients these common interventions are not enough. Other patients may express a clear desire to be completely unconscious as they die. Some dying patients just want to sleep. Patients have a right to be unconscious if they are dying. We have the medical means to provide this and we should."

Co-author Professor Jaideep Pandit, added: "Unconsciousness through general anaesthesia offers the highest chance of making sure that the patient is unaware of going through an adverse process."

New multidisciplinary guidelines are needed before this can be offered more widely, the professor says.

Fears have been raised that this move would hasten death, but the authors point out there is no reduction in survival time for patients given continuous deep sedation. In some cases, the general anaesthesia can be continued for up to 14 days.

A recent survey carried out by members of this research team found that 88% of respondents in the general public support the option of deep sedation for dying patients. In the survey, 64% said they would choose this option for themselves.

Takla, A. et al. General anaesthesia in end-of-life care: extending the indications for anaesthesia beyond surgery. Anaesthesia 20 April 2021 doi: 10.1111/anae.15459

[abstract]

Tags: Elderly Health | NHS | Pain Relief | Pharmaceuticals | UK News

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