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      "titulo" => "La vacuna recombinante contra el herpes z&#243;ster&#44; en creciente expansi&#243;n y con m&#225;s evidencia"
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    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Continuous deep sedation and euthanasia"
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    "saludo" => "Dear Editor&#44;"
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        "autoresLista" => "Yesid Jos&#233; Ortega Pacheco"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">During my master&#39;s internship in the Social Psychology of Health at the Oncology and Palliative Care Department at La Timome Hospital in France&#44; I had the opportunity to attend an interdisciplinary medical board in order to assess the request of a terminally ill patient for continuous deep sedation&#44; motivated by the patient&#39;s wish to die and to relieve the pain caused by his disease&#46; This request led me to question why continuous deep sedation instead of euthanasia&#63; Given that in my native Colombia&#44; euthanasia has been a decriminalised medical procedure since 1997&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> I was surprised to discover that this medical practice is prohibited in France&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In such cases&#44; the role of the psychologist is not oriented towards decision-making&#44; on the contrary&#44; the psychologist highlights the psychological process the patient is undergoing and the motivation to make such a request&#46; But what is the difference between continuous deep sedation and euthanasia&#44; which many people perceive to be the same&#44; but with different procedures&#63;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Euthanasia is a process that accelerates the death of a patient with a terminal illness that causes incurable pain&#46; This process must be carried out under the supervision of a specialised medical team responsible for administering the medication that brings out the patient&#39;s death&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> Euthanasia represents the end of chronic pain&#44; it helps the patient to end their agony and suffering so that the patient can die in peace and without any pain&#44; with full awareness of their decision&#46; Another advantage of euthanasia is that it is a completely voluntary decision&#44; a process in which the patient and all those involved agree to proceed&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> On a social level&#44; it could be said that euthanasia is socially known as mercy killing&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Continuous deep sedation involves the administration of a series of medications that reduce the patient&#39;s consciousness until the end of their life&#46; The aim is to reduce the pain experienced by the patient in their final moments in order to make death as comfortable as possible&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> However&#44; continuous deep sedation is not intended to cause death&#46; This procedure aims to deliberately decrease the patient&#39;s consciousness under a certain medication to avoid suffering caused by symptoms that cannot be alleviated by medical treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> In the case of euthanasia&#44; a single action is required to bring about the patient&#39;s death&#59; in the case of continuous deep sedation&#44; medication is administered to patients for hours or even days until the patient&#39;s death&#46; Similar to euthanasia&#44; it requires the patient&#39;s consent&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Generally&#44; people tend to oppose euthanasia because of religious or political views&#44; simply because it is an anti-life practice&#46; In contrast&#44; very few people tend to oppose continuous deep sedation as it is considered an end to suffering not only for the patient but also for their own family&#44; as patients are not aware of the physical and psychological discomfort they experience due to the medication&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">But what happens in cases where the analgesics provided by doctors are insufficient to relieve the patient&#39;s pain&#63; It is clear that over-medication can lead to death&#44; so is sedation still insufficient in its objective&#44; and should the patient be allowed to continue to agonise until the imminent arrival of death&#63; These questions seem to be difficult to answer in the French context as it leads to an ethical&#44; political and moral dilemma for many health care professionals in the country&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Although both procedures are intended to alleviate the suffering of the patient&#44; continuous deep sedation only ends conscious life but not biological life&#44; and we even see patients lying in bed&#44; asleep&#44; with no signs of physical or psychological discomfort&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">But why prolong the pain and suffering of terminally ill patients who also know they are going to die&#63; Why judge personal decisions of patients who choose to end their pain&#63; Why put our way of understanding and comprehending the world before that of others&#63; Or should governments around the world simply prioritise the development of treatments to eliminate patient suffering rather than eliminating the patient who suffers&#63;</p><p id="par0045" class="elsevierStylePara elsevierViewall">There are questions that seem difficult to answer which not only raise controversy but also allow for the development of proposals that can improve the care of terminally ill patients&#44; as in this case&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial disclosure</span><p id="par0050" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors report no financial or other relationship relevant to the subject of this article&#46;</p></span></span>"
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