FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 342:508-511 February 17, 2000 Number 7 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

The right of a patient or surrogate to refuse life-sustaining treatment, including mechanical ventilation, is firmly established in American law and bioethics.¹ Moreover, practice standards now encourage clinicians to administer sedatives and analgesics in doses that fully relieve the pain and suffering of terminally ill patients, including patients from whom life support is being withdrawn.² In addition to receiving these medications, however, some patients from whom mechanical ventilation is being withdrawn have been receiving or are given neuromuscular blocking agents at the time of death. By blocking neuromuscular transmission, these agents cause paralysis until they are metabolized or their action . . . [Full Text of this Article]

References

Related Letters:

Neuromuscular Blockade at the End of Life
Riker R. R., Fraser G. L., Rohr W. B., Truog R. D., Burns J. P., Mitchell C., Johnson J., Robinson W.
Extract | Full Text  
N Engl J Med 2000; 342:1921-1922, Jun 22, 2000. Correspondence

This article has been cited by other articles:

• Verhagen, A A E, Dorscheidt, J H H M, Engels, B, Hubben, J H, Sauer, P J (2009). Analgesics, sedatives and neuromuscular blockers as part of end-of-life decisions in Dutch NICUs. Arch. Dis. Child. Fetal Neonatal Ed. 94: F434-F438 [Abstract] [Full Text]  
• Verhagen, A. A. E., van der Hoeven, M. A. H., van Meerveld, R. C., Sauer, P. J. J. (2007). Physician Medical Decision-making at the End of Life in Newborns: Insight Into Implementation at 2 Dutch Centers. Pediatrics 120: e20-e28 [Abstract] [Full Text]  
• Lo, B., Rubenfeld, G. (2005). Palliative Sedation in Dying Patients: "We Turn to It When Everything Else Hasn't Worked". JAMA 294: 1810-1816 [Abstract] [Full Text]  
• Solomon, M. Z., Sellers, D. E., Heller, K. S., Dokken, D. L., Levetown, M., Rushton, C., Truog, R. D., Fleischman, A. R. (2005). New and Lingering Controversies in Pediatric End-of-Life Care. Pediatrics 116: 872-883 [Abstract] [Full Text]  
• Burns, J. P., Mitchell, C. (2005). Is There Any Consensus About End-of-Life Care in Pediatrics?. Arch Pediatr Adolesc Med 159: 889-891 [Full Text]  
• Garros, D., Rosychuk, R. J., Cox, P. N. (2003). Circumstances Surrounding End of Life in a Pediatric Intensive Care Unit. Pediatrics 112: e371-371 [Abstract] [Full Text]  
• Perkin, R M, Resnik, D B (2002). The agony of agonal respiration: is the last gasp necessary?. J. Med. Ethics 28: 164-169 [Abstract] [Full Text]  
• Pierucci, R. L., Kirby, R. S., Leuthner, S. R. (2001). End-of-Life Care for Neonates and Infants: The Experience and Effects of a Palliative Care Consultation Service. Pediatrics 108: 653-660 [Abstract] [Full Text]  
• Street, K, Henderson, J, Inwald, D., Vandyck, W., Greig-Midlane, H., Edwards, S. J L (2001). Ethical debate: The distinction between withdrawing life sustaining treatment under the influence of paralysing agents and euthanasia Are we treading a fine line? Paralysing agents may be given up to but not at or beyond the point of extubation The parents' perspective on withdrawing treatment The doctrine of double effect is difficult but not impossible to apply. BMJ 323: 388-391 [Full Text]  
• LUCE, J. M., ALPERS, A. (2000). Legal Aspects of Withholding and Withdrawing Life Support from Critically Ill Patients in the United States and Providing Palliative Care to Them. Am. J. Respir. Crit. Care Med. 162: 2029-2032 [Full Text]  
• Riker, R. R., Fraser, G. L., Rohr, W. B., Truog, R. D., Burns, J. P., Mitchell, C., Johnson, J., Robinson, W. (2000). Neuromuscular Blockade at the End of Life. NEJM 342: 1921-1922 [Full Text]  
• Suter, Peter. M. (2000). Intensive Care Medicine 2000: First Signs of Maturity?. Anesth. Analg. 90: 1236-1237 [Full Text]