To clarify the prevalence and the characteristics of patients who received palliative sedation therapy for psycho-existential suffering, a questionnaire was sent to 105 responsible physicians at all certified palliative care units in Japan. The participants were requested to report the number of patients who received continuous deep sedation for refractory psycho-existential suffering during the past year, and to provide details of the 2 most recent patients. A total of 81 physicians returned questionnaires (response rate, 80%). Twenty-nine physicians (36%) reported clinical experience in continuous deep sedation for psycho-existential suffering. The overall prevalence of continuous deep sedation was calculated as 1.0% (90 cases/8,661 total patient deaths), and a total of 46 patient histories were collected. Performance status just before sedation was 3 or 4 in 96%, and predicted survival was 3 weeks or less in 94%. The suffering requiring sedation was feeling of meaninglessness/worthlessness (61%), burden on others/dependency/inability to take care of oneself (48%), death anxiety/fear/panic (33%), wish to control the time of death by oneself (24%), and isolation/lack of social support (22%). Before sedation, intermittent sedation and specialized psychiatric, psychological, and/or religious care had been performed in 94% and 59%, respectively; 89% of 26 depressed patients had received antidepressant medications. All competent patients (n=37) expressed explicit requests for sedation, and family consent was obtained in all cases where family members were available (n=45). Palliative sedation for psycho-existential suffering was performed in exceptional cases in specialized palliative care units in Japan. The patient condition was generally very poor, and the suffering was refractory to intermittent sedation and specialized psychiatric, psychological, and/or religious care. Sedation was performed on the basis of patient and family consent. These findings suggest that palliative sedation for psycho-existential suffering could be ethically permissible in exceptional cases if the proportionality and autonomy principle is applied. More discussion about the role of palliative sedation therapy for refractory psycho-existential suffering in end-of-life care is urgently necessary.
Support Care Cancer, Vol. 10, No. 8. (November 2002), pp. 637-646.
The findings presented in this discussion seek to make a contribution to fostering an appreciation of the importance of research on spirituality, a previously neglected dimension of health care. Qualitative research methodology based on open-ended interviews with 12 survivors of haematological malignancies was used. The interviews were transcribed verbatim and thematically analysed using the NUD*IST computer package. The preliminary findings from the study indicate a need for the development of a new language for articulating spirituality. The present discussion is an introductory attempt to begin to explore the notion of, and language for, the idea of ’spiritual pain’. The findings indicate that individuals need a strong sense of meaning-making and connection with life to be able to deal with the demands of aggressive, invasive treatments. Such a connection can be threatened by a break with the normal or expected relationships and satisfaction with life through physical, identity, relational and existential challenges and losses. When the disconnection is acutely painful (a subjective phenomenon depending on the individual) it then is experienced as spiritual pain, creating a void that challenges the individual’s ability to derive any meaning from their existence. This study is seen as preliminary work, the first step in a series of articles aimed at beginning to develop, through research, a language of spiritual care.
Older adults comprise one of the fastest growing demographic groups in the United States today, and are also described as the most spiritual and religious of all the age groups. Although older adults have historically underutilized counseling services, this may soon change as a result of the increase of older adults seeking services and changing attitudes toward therapy. The spiritual life review is a modification of the life review—an efficacious and commonly used counseling technique with older adults, and is suggested as one way to increase service utilization and promote healthy development among spiritual older adults. A description of the spiritual life review is given, along with a case study to provide preliminary evidence for this technique’s utility. The limitations and ethical concerns associated with the spiritual life review are also discussed.
“There are many tests by which a gentleman may be known. But there is one test which is above all; the test of authority – how he exercises power over those subordinate to him. Many people mismanage the power that God has given us, including Lucifer, …” Posted by BlessedOne to success living healing word spiritual financial on Thu May 01 2008
There are many tests by which a gentleman may be known. But there is one test which is above all; the test of authority – how he exercises power over those subordinate to him. Many people mismanage the power that God has given us, including Lucifer, …
“Should you tell your partner, your friends and your co-workers about your spiritual beliefs?
When I first learned of the Law of Attraction, I kept insanely quiet about it and did not let on to any of my friends or family about it. I studied in silence …” Posted by goodtofeelgood to lawofattraction manifestation manifest Hicks abraham Creation spiritual on Fri Mar 28 2008
Should you tell your partner, your friends and your co-workers about your spiritual beliefs?
When I first learned of the Law of Attraction, I kept insanely quiet about it and did not let on to any of my friends or family about it. I studied in silence …
“Exploring and Experiencing Our Spiritual Nature, a Journey to Wholeness, will provide and opportunity to expand your awareness as it invites you to go within to explore and experience Spirit.” Posted by PeacockAndPaisley to energy-based reiki healing spiritual on Thu Mar 06 2008
Exploring and Experiencing Our Spiritual Nature, a Journey to Wholeness, will provide and opportunity to expand your awareness as it invites you to go within to explore and experience Spirit.
“This women had a serious problem. She wanted to donate $800 towards her favourite charity. Her husband was reluctant. He did not find it worthwhile. There was a tiff in the house. This women was not working and she was taking care of her children at home.” Posted by Meditation1080 to lies spirituality spiritual new age information on Mon Mar 03 2008
This women had a serious problem. She wanted to donate $800 towards her favourite charity. Her husband was reluctant. He did not find it worthwhile. There was a tiff in the house. This women was not working and she was taking care of her children at home.
“This is an e-mail I received earlier this week John, I came across your blog and was hoping you could give me your thoughts on the topic of spiritual titles.” Posted by jonclayton (who is an author) with 1 comment to jesus titles another one spiritual on Fri Feb 29 2008
This is an e-mail I received earlier this week John, I came across your blog and was hoping you could give me your thoughts on the topic of spiritual titles.
“We’ve all felt the frustration of dropped calls, as well as unanswered prayers. We’ve noticed that the secret to answered prayers is similar to the marketing messages used to sell cell phones!” Posted by richardisr to spirituality prayer spiritual growth on Wed Jan 30 2008
We’ve all felt the frustration of dropped calls, as well as unanswered prayers. We’ve noticed that the secret to answered prayers is similar to the marketing messages used to sell cell phones!
