1
40
8
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
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URL Address
<a href="http://doi.org/10.1056/NEJMsa071143" target="_blank" rel="noreferrer">http://doi.org/10.1056/NEJMsa071143</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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End-of-life practices in the Netherlands under the Euthanasia Act
Publisher
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The New England Journal Of Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2007
Subject
The topic of the resource
Female; Humans; Male; Analgesics; Questionnaires; Follow-Up Studies; Aged; Middle Aged; Netherlands; Suicide; 80 and over; cause of death; Opioid/administration & dosage; Hypnotics and Sedatives/administration & dosage; Assisted/legislation & jurisprudence/statistics & numerical data/trends; Euthanasia/legislation & jurisprudence/statistics & numerical data/trends; Withholding Treatment/statistics & numerical data/trends
Creator
An entity primarily responsible for making the resource
van der Heide A; Onwuteaka-Philipsen BD; Rurup ML; Buiting HM; van Delden JJ; Hanssen-de Wolf JE; Janssen AG; Pasman HR; Rietjens JA; Prins CJ; Deerenberg IM; Gevers JK; van der Maas PJ; van der Wal G
Description
An account of the resource
BACKGROUND: In 2002, an act regulating the ending of life by a physician at the request of a patient with unbearable suffering came into effect in the Netherlands. In 2005, we performed a follow-up study of euthanasia, physician-assisted suicide, and other end-of-life practices. METHODS: We mailed questionnaires to physicians attending 6860 deaths that were identified from death certificates. The response rate was 77.8%. RESULTS: In 2005, of all deaths in the Netherlands, 1.7% were the result of euthanasia and 0.1% were the result of physician-assisted suicide. These percentages were significantly lower than those in 2001, when 2.6% of all deaths resulted from euthanasia and 0.2% from assisted suicide. Of all deaths, 0.4% were the result of the ending of life without an explicit request by the patient. Continuous deep sedation was used in conjunction with possible hastening of death in 7.1% of all deaths in 2005, significantly increased from 5.6% in 2001. In 73.9% of all cases of euthanasia or assisted suicide in 2005, life was ended with the use of neuromuscular relaxants or barbiturates; opioids were used in 16.2% of cases. In 2005, 80.2% of all cases of euthanasia or assisted suicide were reported. Physicians were most likely to report their end-of-life practices if they considered them to be an act of euthanasia or assisted suicide, which was rarely true when opioids were used. CONCLUSIONS: The Dutch Euthanasia Act was followed by a modest decrease in the rates of euthanasia and physician-assisted suicide. The decrease may have resulted from the increased application of other end-of-life care interventions, such as palliative sedation.
2007
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1056/NEJMsa071143" target="_blank" rel="noreferrer">10.1056/NEJMsa071143</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2007
80 And Over
Aged
Analgesics
Assisted/legislation & jurisprudence/statistics & numerical data/trends
Backlog
Buiting HM
Cause Of Death
Deerenberg IM
Euthanasia/legislation & jurisprudence/statistics & numerical data/trends
Female
Follow-up Studies
Gevers JK
Hanssen-de Wolf JE
Humans
Hypnotics and Sedatives/administration & dosage
Janssen AG
Journal Article
Male
Middle Aged
Netherlands
Onwuteaka-Philipsen BD
Opioid/administration & dosage
Pasman HR
Prins CJ
Questionnaires
Rietjens JA
Rurup ML
Suicide
The New England Journal Of Medicine
van Delden JJ
van der Heide A
van der Maas PJ
van der Wal G
Withholding Treatment/statistics & numerical data/trends
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1089/jpm.2005.8.699" target="_blank" rel="noreferrer">http://doi.org/10.1089/jpm.2005.8.699</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Palliative sedation definition, practice, outcomes, and ethics
Publisher
An entity responsible for making the resource available
Journal Of Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Humans; United States; Palliative Care; Physician's Practice Patterns; Treatment Outcome; Ethics; Medical; Hypnotics and Sedatives/administration & dosage
Creator
An entity primarily responsible for making the resource
Davis MP; Ford PA
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1089/jpm.2005.8.699" target="_blank" rel="noreferrer">10.1089/jpm.2005.8.699</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2005
2005
Backlog
Davis MP
Ethics
Ford PA
Humans
Hypnotics and Sedatives/administration & dosage
Journal Article
Journal of Palliative Medicine
Medical
Palliative Care
Physician's Practice Patterns
Treatment Outcome
United States
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1089/jpm.2005.8.702" target="_blank" rel="noreferrer">http://doi.org/10.1089/jpm.2005.8.702</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Palliative sedation: The author's response
Publisher
An entity responsible for making the resource available
Journal Of Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Humans; United States; Palliative Care; Physician's Practice Patterns; Treatment Outcome; Ethics; Medical; Hypnotics and Sedatives/administration & dosage
Creator
An entity primarily responsible for making the resource
Rousseau P
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1089/jpm.2005.8.702" target="_blank" rel="noreferrer">10.1089/jpm.2005.8.702</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2005
2005
Backlog
Ethics
Humans
Hypnotics and Sedatives/administration & dosage
Journal Article
Journal Of Palliative Care
Medical
Palliative Care
Physician's Practice Patterns
Rousseau P
Treatment Outcome
United States
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/01.pcc.0000123547.28099.44" target="_blank" rel="noreferrer">http://doi.org/10.1097/01.pcc.0000123547.28099.44</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
A descriptive study of children dying in the pediatric intensive care unit after withdrawal of life-sustaining treatment
Publisher
An entity responsible for making the resource available
Pediatric Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Child; Female; Humans; Male; Intensive Care Units; Palliative Care; Euthanasia; Patient Participation; Time Factors; Pediatric; adolescent; Preschool; infant; retrospective studies; ICU Decision Making; Parents/psychology; Analgesics/administration & dosage; Hypnotics and Sedatives/administration & dosage; Passive; Neuromuscular Blockade
Creator
An entity primarily responsible for making the resource
Zawistowski CA; DeVita MA
Description
An account of the resource
OBJECTIVE: To examine physiologic and therapeutic changes following withdrawal of life-sustaining treatment in children. DESIGN: Retrospective chart review. SETTING: University-affiliated tertiary care pediatric hospital. PATIENTS: All patients who had life-sustaining treatment withdrawn over a 5-yr period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 125 charts were examined to obtain 50 in which the terminal event preceding death was withdrawal of life-sustaining treatment. Data are expressed as median (1st, 3rd quartiles). Median hospital stay before death was 20 days (1st and 3rd quartiles, 8 and 30). Median time from decision to withdraw life-sustaining treatment to actual withdrawal was 30 mins (1st and 3rd quartiles, 10 and 180). All interventions were simultaneously discontinued in 80% of patients with mechanical ventilation followed by vasopressors being most common. No patients had stepwise reduction in ventilator rate before discontinuing the mechanical ventilation. Devices were rarely removed from patients including endotracheal tubes. Time from withdrawal of life-sustaining treatment to death was 15 mins (5, 30); only seven patients took >60 mins to die. Multivariable analysis (Kruskal-Wallis test) of various factors revealed simultaneous withdrawal of life-sustaining treatment, female gender, and not having received renal therapy as hastening death. CONCLUSIONS: Forgoing life-sustaining treatment in a small cohort of children at a single institution follows a pattern: Most cases occur after prolonged intensive care unit stays, withdrawal of treatment occurs almost immediately after the decision to withdraw, most treatments are withdrawn simultaneously rather than sequentially, and most patients die within minutes of life-sustaining treatment cessation. This is the first pediatric study to report the time to death after withdrawal of life-sustaining treatment and factors associated with shorter time to death in children.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/01.pcc.0000123547.28099.44" target="_blank" rel="noreferrer">10.1097/01.pcc.0000123547.28099.44</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2004
Adolescent
Analgesics/administration & dosage
Backlog
Child
DeVita MA
Euthanasia
Female
Humans
Hypnotics and Sedatives/administration & dosage
ICU Decision Making
Infant
Intensive Care Units
Journal Article
Male
Neuromuscular Blockade
Palliative Care
Parents/psychology
Passive
Patient Participation
Pediatric
Pediatric Critical Care Medicine
Preschool
Retrospective Studies
Time Factors
Zawistowski CA
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/00003246-200008000-00064" target="_blank" rel="noreferrer">http://doi.org/10.1097/00003246-200008000-00064</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
End-of-life care in the pediatric intensive care unit after the forgoing of life-sustaining treatment
Publisher
An entity responsible for making the resource available
Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Humans; Intensive Care Units; Attitude of Health Personnel; Prospective Studies; Life Support Care; Job Satisfaction; Pediatric; infant; ICU Decision Making; Analgesics/administration & dosage; Hypnotics and Sedatives/administration & dosage; Terminal Care/methods; Ventilator Weaning
Creator
An entity primarily responsible for making the resource
Burns JP; Mitchell C; Outwater KM; Geller M; Griffith JL; Todres ID; Truog RD
Description
An account of the resource
OBJECTIVE: To describe the attitudes and practice of clinicians in providing sedation and analgesia to dying patients as life-sustaining treatment is withdrawn. STUDY DESIGN: Prospective case series of 53 consecutive patients who died after the withdrawal of life-sustaining treatment in the pediatric intensive care unit at three teaching hospitals in Boston. Data on the reasons why medications were given were obtained from a self-administered anonymous questionnaire completed by the critical care physician and nurse for each case. Data on what medications were given were obtained from a review of the medical record. RESULTS: Sedatives and/or analgesics were administered to 47 (89%) patients who died after the withdrawal of life-sustaining treatment. Patients who were comatose were less likely to receive these medications. Physicians and nurses cited treatment of pain, anxiety, and air hunger as the most common reasons, and hastening death as the least common reason, for administration of these medications. Hastening death was viewed as an "acceptable, unintended side effect" of terminal care by 91% of physician-nurse matched pairs. The mean dose of sedatives and analgesics administered nearly doubled as life-support was withdrawn, and the degree of escalation in dose did not correlate with clinician's views on hastening death. CONCLUSION: Clinicians frequently escalate the dose of sedatives or analgesics to dying patients as life-sustaining treatment is withdrawn, citing patient-centered reasons as their principle justification. Hastening death is seen as an unintended consequence of appropriate care. A large majority of physicians and nurses agreed with patient management and were satisfied with the care provided. Care of the dying patient after the forgoing of life-sustaining treatment remains underanalyzed and needs more rigorous examination by the critical care community.
2000
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00003246-200008000-00064" target="_blank" rel="noreferrer">10.1097/00003246-200008000-00064</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2000
Analgesics/administration & dosage
Attitude Of Health Personnel
Backlog
Burns JP
Critical Care Medicine
Geller M
Griffith JL
Humans
Hypnotics and Sedatives/administration & dosage
ICU Decision Making
Infant
Intensive Care Units
Job Satisfaction
Journal Article
Life Support Care
Mitchell C
Outwater KM
Pediatric
Prospective Studies
Terminal Care/methods
Todres ID
Truog RD
Ventilator Weaning
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.7326/0003-4819-132-5-200003070-00012" target="_blank" rel="noreferrer">http://doi.org/10.7326/0003-4819-132-5-200003070-00012</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids.
Publisher
An entity responsible for making the resource available
Annals Of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Humans; Male; United States; Consensus; Treatment Refusal; Aged; Intention; Fluid Therapy; Morals; Food; Suicide; Non-U.S. Gov't; Professional Patient Relationship; Research Support; patient care team; Death and Euthanasia; Psychological; Stress; Ethics; Assisted; Hypnotics and Sedatives/administration & dosage; Double Effect; Palliative Care/legislation & jurisprudence/methods
Creator
An entity primarily responsible for making the resource
Quill TE; Byock IR; Panel ACP-ASIMEnd-of-Life Care Consensus
Description
An account of the resource
When provided by a skilled, multidisciplinary team, palliative care is highly effective at addressing the physical, psychological, social, and spiritual needs of dying patients and their families. However, some patients who have witnessed harsh death want reassurance that they can escape if their suffering becomes intolerable. In addition, a small percentage of terminally ill patients receiving comprehensive care reach a point at which their suffering becomes severe and unacceptable despite unrestrained palliative efforts; some of these patients request that death be hastened. This paper presents terminal sedation and voluntary refusal of hydration and nutrition as potential last resorts that can be used to address the needs of such patients. These two practices allow clinicians to address a much wider range of intractable end-of-life suffering than physician-assisted suicide (even if it were legal) and can also provide alternatives for patients, families, and clinicians who are morally opposed to physician-assisted suicide. This paper will define the two practices, distinguish them from more standard palliative care interventions and from physician-assisted suicide, illustrate them with a real clinical scenario, provide potential guidelines and practicalities, and explore their moral and legal status. Although medicine cannot sanitize dying or provide perfect answers for all challenging end-of-life clinical problems, terminal sedation and voluntary refusal of hydration and nutrition substantially increase patients' choices at this inherently challenging time.
2000
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.7326/0003-4819-132-5-200003070-00012" target="_blank" rel="noreferrer">10.7326/0003-4819-132-5-200003070-00012</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2000
Aged
Annals Of Internal Medicine
Assisted
Backlog
Byock IR
Consensus
Death and Euthanasia
Double Effect
Ethics
Fluid Therapy
Food
Humans
Hypnotics and Sedatives/administration & dosage
Intention
Journal Article
Male
Morals
Non-U.S. Gov't
Palliative Care/legislation & jurisprudence/methods
Panel ACP-ASIMEnd-of-Life Care Consensus
Patient Care Team
Professional Patient Relationship
Psychological
Quill TE
Research Support
Stress
Suicide
Treatment Refusal
United States
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10349097" target="_blank" rel="noreferrer">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10349097</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Pain management and weaning from narcotics and sedatives
Publisher
An entity responsible for making the resource available
Current Opinion In Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
1999
Subject
The topic of the resource
Child; Attitude of Health Personnel; Drug Administration Schedule; Human; Analgesics/pharmacology/therapeutic use; Analgesia/trends; Hypnotics and Sedatives/administration & dosage; Narcotics/administration & dosage; Pain/psychology/therapy; Physician's Practice Patterns/standards/trends
Creator
An entity primarily responsible for making the resource
Ganea GR; Bogue CW
Description
An account of the resource
Over the last 10 years, there has been a fundamental change in physicians' attitudes toward analgesia and sedation in pediatrics. In this time, basic and clinical research have provided a wealth of information. In this paper we review important advances registered in the past year, including new molecular and physiological mechanisms of antinociception and sedation, behavioral and psychoemotional implications of pain, and advances in the clinical practice of pediatric analgesia and sedation. Fortunately, the attitude of physicians toward these matters has changed significantly and much more attention is now paid to the alleviation of pain and provision of adequate sedation. However, there remains, according to most estimates, incongruity between these advances and what is practiced clinically.
1999
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1999
Analgesia/trends
Analgesics/pharmacology/therapeutic use
Attitude Of Health Personnel
Backlog
Bogue CW
Child
Current Opinion In Pediatrics
Drug Administration Schedule
Ganea GR
Human
Hypnotics and Sedatives/administration & dosage
Journal Article
Narcotics/administration & dosage
Pain/psychology/therapy
Physician's Practice Patterns/standards/trends
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/j.jpeds.2011.01.022" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.jpeds.2011.01.022</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Whom are we comforting? An analysis of comfort medications delivered to dying neonates
Publisher
An entity responsible for making the resource available
The Journal Of Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2011
Subject
The topic of the resource
Humans; infant; Intensive Care Units; Attitude of Health Personnel; Medical Futility; Prognosis; Neonatal; Stress; Newborn; retrospective studies; ICU Decision Making; Palliative Care/methods; Pain/drug therapy; Physician Assisted Dying PAD; Analgesics/administration & dosage; Cardiopulmonary Resuscitation/methods; Decision Making/ethics; Hypnotics and Sedatives/administration & dosage; Neuromuscular Blocking Agents/administration & dosage; NICU; Psychological/drug therapy
Creator
An entity primarily responsible for making the resource
Janvier A; Meadow W; Leuthner SR; Andrews B; Lagatta J; Bos Arend; Lane L; Verhagen AAE
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jpeds.2011.01.022" target="_blank" rel="noreferrer">10.1016/j.jpeds.2011.01.022</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2011
Analgesics/administration & dosage
Andrews B
Attitude Of Health Personnel
Backlog
Bos Arend
Cardiopulmonary Resuscitation/methods
Decision Making/ethics
Humans
Hypnotics and Sedatives/administration & dosage
ICU Decision Making
Infant
Intensive Care Units
Janvier A
Journal Article
Lagatta J
Lane L
Leuthner SR
Meadow W
Medical Futility
Neonatal
Neuromuscular Blocking Agents/administration & dosage
Newborn
Nicu
Pain/drug Therapy
Palliative Care/methods
Physician Assisted Dying PAD
Prognosis
Psychological/drug therapy
Retrospective Studies
Stress
The Journal Of Pediatrics
Verhagen AAE