Palliative Sedation
In specific circumstances palliative sedation (PS)
may be implemented to alleviate uncontrollable
pain, seizures, respiratory distress and existential
suffering despite rigorous treatment of refractory
symptoms at EOL. There is a paucity of published
reports to determine incidence and prevalence
of palliative sedation instituted in children
with brain tumors. The initiation of PS occurs
once the medical team and parents determine that
the child has true refractory symptoms causing
unbearable suffering. It is imperative that the
intent of PS be addressed well before initiation so
that parents understand that PS is not intended to
hasten death but to support the child through this
diffi cult stage of their dying process. Engaging
the parents and the multidisciplinary team early
in the process minimizes moral distress and
unites the parents and team in shared EOL goals.
Such cases require written guidelines and expertise
to direct the administration of continuous
high-dose opioids and sedation