Opponents and Proponents Views Regarding Palliative Sedation at End of Life Majd Abdelmajeed Awadi 1* and Majd T. Mrayyan 2 1 Arab Medical Center, Hashemite University, Amman, Jordan 2 Consultant of Nursing, The Hashemite University, Jordan * Corresponding author: Majd abdelmajeed awadi, MSN, RN, Clinical Nurse Specialist, Arab Medical Center, Hashemite University, Amman, Jordan, Tel: 00962789468095; E-mail: maawadi09@yahoo.com Received date: Jan 04, 2016, Accepted date: Jan 06, 2016, Published date: Jan 11, 2016 Copyright: © 2016 Awadi MA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Palliative sedation is sedating a patient to the point of unconsciousness to relieve one or more symptoms, when all other possible measurements have failure. Palliative sedation is charged with controversy since developed. The purpose of this position statement paper is to support and discussing opponents and proponents' views comprehensively around palliative sedation in terminally ill patients. The most important dispute was if palliative sedation hastens death or not, if it can be used as physician-assisted suicide, if it legalized euthanasia and (or) if it violate patient's autonomy. The current authors are supporting palliative sedation with advanced incurable patients in order to alleviate patients suffering, palliative sedation offer to terminally ill patients' comfortable experience at end of life and allow them to die in peace. Palliative sedation should be encouraged to get health care facilities and legal support. Keywords: Palliative sedation; Terminal sedation; Continuous deep sedation; Terminally ill patients; Proponents; Opponents; Position statement Introduction Palliative care is an approach focuses on improving quality of life for patient by managing current symptoms and preventing developing new symptoms [1]. About (50-84) percent of advanced oncology patients will sufer from (1 to 27) of unmanageable refractory symptoms [2]. In such these cases a high-quality aggressive palliative care fails to provide relief and comfort [3]. So, palliative sedation came as a therapy for refractory symptoms using pharmacological agent to induce deep sleep [4]. Te literature describes palliative sedation - also called terminal sedation, continuous deep sedation, or primary deep continuous sedation - as sedating a patient to the point of unconsciousness to relieve one or more symptoms when all other possible measurements have failed, or to relieve profound anguish that is not amenable to spiritual, psychological, or other interventions [4,5]. A symptom is considered "refractory" when it cannot adequately be controlled by therapies that do not seriously compromise consciousness [6]. Mostly the diagnostic criteria for "refractoriness" are based on the clinician’s determination [7]. Position statement paper as the term implies, a comprehensive discussion on a particular topic or topics in order to provide a more complete understanding of the issues involved and to clarify the rationale behind the position (American Academy of Family Physicians, 2015). Terefore, the purpose of this position statement paper is to discuss opponents and proponents’ views regarding palliative sedation at end of life and provide suggested recommendations in order to solve the problems facing palliative sedation. Te current author is supporting palliative sedation with advanced incurable patients in order to alleviate refractory severe symptoms that are not responded to other forms of treatment with the intent to relieve sufering only. Background Te palliative sedation in terminally ill patient is charged with controversy opinions since developed by Enck in the 1990s. Te purpose of this literature review is to pinpoint diferent opponents and proponents’ positions regarding palliative sedation for terminally ill patient. Opponents of palliative sedation for terminally ill patients Palliative sedation may be used by clinicians as a means of hastening death, and this is the most common abuse of palliative sedation, it may occur by the planned use of deep sedation in patients who have no refractory symptoms, this has been called ‘slow euthanasia [8,9]. Or it may be used as a means of death by planned use of overdose much more than what is enough to provide adequate comfort, this has been called physician-assisted Suicide; excess doses can compromise physiological functions such as spontaneous respiration and hemodynamic stability [8,10]. Palliative sedation may be used to inappropriate patients due to inadequate patient assessment that may have overlooked a potentially reversible cause of distress without consultation with palliative care experts or a multidisciplinary team [10,11]. Higgins and Altilio argued that the sedation may be given as family’s - or others - wishes and not as a response to the patient him or herself [12], and this may mean violate patients autonomy. Other researchers argued that at times palliative sedation is tantamount to euthanasia. Te issue whether the combination of Awadi and Mrayyan, J Palliat Care Med 2016, 6:1 DOI: 10.4172/2165-7386.1000242 Opinion Open Access J Palliat Care Med ISSN:2165-7386 JPCM, an open access journal Volume 6 • Issue 1 • 1000242 Journal of Palliative Care & Medicine J o u r n a l o f P a IIi a t i v e C a r e & M e d i c i n e ISSN: 2165-7386