Pharmacologic paralysis and withdrawal of mechanical ventilation at the end of life

Article Abstract:

Doctors should not give a patient on a ventilator neuromuscular blocking agents before removing the patient from the ventilator. Neuromuscular blocking agents are used to paralyze muscles while the patient is being placed on the ventilator and are sometimes continued during artificial ventilation. This is done to make patients comfortable while they are on the ventilator. However, these drugs should be stopped before the patient is removed from the ventilator. Dying patients should receive painkillers and sedatives but neuromuscular drugs would be unethical.

Usage, Artificial respiration, Mechanical ventilation, Neuromuscular blocking agents

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Barbiturates in the care of the terminally ill

Article Abstract:

Giving barbiturates to terminally ill patients could be seen as both kind and cruel. Barbiturates effectively reduce pain through deep sedation or unconsciousness, but at the same time, they often bring on early death because they slow respiration. Barbiturates are also used to intentionally kill prisoners through lethal injection and are a form of euthanasia, or mercy killing, for patients in countries like the Netherlands. Medically, giving barbiturates can be ethically justified in the following cases: to ease physical suffering when other options have not worked, to produce unconsciousness before a patient is removed from a ventilator and to relieve psychological suffering. When the distinction between reducing pain and hastening death becomes blurred, treatment decisions become more complex.

Health aspects, Barbiturates

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Is informed consent always necessary for randomized, controlled trials?

Article Abstract:

A group of doctors argues against using informed consent in clinical trials. The use of informed consent when carrying out medical research on humans arose after the Nuremberg trials. However, studies have shown that many patients do not understand the consent forms. A good institutional review board can ensure that patients are not being exposed to questionable treatments. In 1996, the FDA and the Department of Health and Human Services said doctors did not need to get informed consent when treating emergency conditions. Most doctors can use experimental treatments on individual patients without getting informed consent.

Methods, Clinical trials, Informed consent (Medical law), Informed consent

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