Department of Neurology, Lahey Clinic, Burlington, MA 01805, USA.
Neurology. 2010 Apr 20;74(16):1303-9. doi: 10.1212/WNL.0b013e3181d9edcb. Epub 2010 Mar 17.
Sedation for the imminently dying (SFTID) is a controversial practice that involves the provision of sedation to imminently dying patients with the intent of relieving their suffering when symptoms are refractory to other interventions. The goal of this research was to ascertain the opinions regarding SFTID that are held by neurologists who are interested in ethics and end-of-life care.
Members of the American Academy of Neurology Ethics Section were surveyed regarding their familiarity and experience with SFTID and their opinions pertaining to it. To determine whether their opinions varied in relationship to clinical context, a single stem question for 5 different case scenarios was used.
A total of 96% of respondents agreed or strongly agreed that the primary purpose of SFTID was to relieve suffering, 83% disagreed or strongly disagreed that SFTID was morally equivalent to euthanasia, and 85% disagreed or strongly disagreed that SFTID was legally equivalent to euthanasia. For the case scenarios, 92% agreed or strongly agreed that SFTID was acceptable for imminently dying patients with metastatic cancer, while 50% agreed or strongly agreed that SFTID was acceptable for patients with end-stage amyotrophic lateral sclerosis, and only 7% agreed or strongly agreed that SFTID was acceptable for posttraumatic quadriplegic patients not at risk for imminent death.
The overwhelming majority of neurologists surveyed endorse the concept that sedation for the imminently dying differs morally and legally from euthanasia and that it is an acceptable therapeutic option for some but not all patients who are imminently dying of a terminal illness.
临终镇静（SFTID）是一种有争议的做法，它涉及对即将死亡的患者提供镇静，以缓解其他干预措施无法缓解的症状。本研究的目的是了解对临终关怀和伦理学感兴趣的神经科医生对 SFTID 的看法。
对美国神经病学伦理分会的成员进行了调查，了解他们对 SFTID 的熟悉程度和经验，以及他们对此的看法。为了确定他们的意见是否与临床情况有关，我们使用了 5 种不同案例的单一问题。
96%的受访者同意或强烈同意 SFTID 的主要目的是缓解痛苦，83%的受访者不同意或强烈不同意 SFTID 在道德上等同于安乐死，85%的受访者不同意或强烈不同意 SFTID 在法律上等同于安乐死。对于案例情况，92%的受访者同意或强烈同意 SFTID 适用于患有转移性癌症的即将死亡的患者，而 50%的受访者同意或强烈同意 SFTID 适用于患有终末期肌萎缩侧索硬化症的患者，只有 7%的受访者同意或强烈同意 SFTID 适用于没有即将死亡风险的创伤后四肢瘫痪患者。
绝大多数接受调查的神经科医生都认为，临终镇静在道德和法律上与安乐死不同，并且对于某些但不是所有患有绝症的即将死亡的患者来说，这是一种可接受的治疗选择。
