Dying patients should have better access to general anaesthesia – experts

Ella Pickover, PA Health Correspondent
·2-min read

More must be done to offer patients at the end of their lives the option of general anaesthesia, experts have argued.

Offering medically induced unconsciousness is a process that can be used in end-of-life care but is largely reserved for surgery.

But anaesthesia experts and academics from the University of Oxford working in the field of ethics said general anaesthesia in end-of-life care has been “largely overlooked”.

Their paper stresses that offering general anaesthesia at the end of life is “not a form of assisted dying or euthanasia”, which are illegal in the UK.

The remarks come as a new survey of the public, published in the journal Plos One, suggest that people are largely in favour of patients being offered general anaesthesia in their final days.

The poll of 500 UK adults found that 88% wished to have the option of terminal anaesthesia available to them during their end-of-life care.

Meanwhile the separate article, published in the journal Anaesthesia, points out that pain medication is commonly given to patients in their final days, with some people sedated through drugs to alleviate agitation or distress.

But the authors argue that this “may not be enough”.

“For some patients these common interventions are not enough. Other patients may express a clear desire to be completely unconscious as they die,” said co-author Professor Julian Savulescu, Uehiro chair of practical ethics at the University of Oxford.

“Some dying patients just want to sleep.

“Patients have a right to be unconscious if they are dying. We have the medical means to provide this and we should.”

The paper suggests that if this were to be considered as an option for more people at the end of their lives there would need to be clear guidelines in place.

And informed consent would be crucial in helping patients understand implications of general anaesthesia for end-of-life care.

Co-author Jaideep Pandit, professor of anaesthesia at Oxford University Hospitals NHS Foundation Trust, added: “The desire to be unconscious as a means of eliminating the experience of physical or mental suffering is understandable.

“Unconsciousness through general anaesthesia offers the highest chance of making sure that the patient is unaware of going through an adverse process.”

He added: “Although general anaesthesia in end-of-life care has been used and described in the UK since 1995, modern multidisciplinary guidelines will be needed before this can be offered more widely.

“Raising this issue now is important, especially in view of international trends showing increased use of general anaesthesia for dying patients.”

The paper states that the use of general anaesthesia in end of life is an “impending development for which the specialty should prepare”.