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The National Hospice and Palliative Care Organization's criteria, as well as national and international standards, are followed while using palliative sedation treatment (PST). The recommendations [1] cover terminology, rationale, methodology, medications, dangers, and judgement procedures. The critical modifications of principles that are being compared in terms of important aspects of PST: prevalence, type of sedation (mild or deep), survival, medication, food intake, fluid intake, judgement, physician attitudes, family experience, efficacy, safety, and important ethical issues related to refractoriness of symptoms, existential suffering, patient data, and family consent [2]. In the realm of stroke, new treatments, endovascular procedures, neuroimaging, public awareness, and risk factor control have all gotten a lot of attention. Because over 800,000 people have a stroke each year, more attention to stroke prevention and treatment is required. Despite breakthroughs in stroke treatment, death and severe disability are still common outcomes, and these numbers are expected to quadruple when the baby boomers reach the peak age for stroke. [3]. I'm particularly curious to examine how our clinical practice has changed over time, as well as how patients' autonomy and family engagement have been seen [4]. The willingness of physicians to tolerate emotional strain at the intrapsychic and interpretative levels in order to balance ethical stress among the various individual autonomies in the field, that is, the effort to change the cultural aspect of society and dominant opinions, is dependent on the extent to which the patient is able to or wants to assume responsibility for his or her own options [5, 6].

Conclusion

The researchers concluded that attitudes of responsibility among physicians and their families are essential determinants in advance directives because they determine the role that family members will accept in end-of-life decisions. More research is almost certainly required to completely comprehend this complex phenomenon. The physician's and care team's responsibility is to use a moderate traditionalism strategy to customize therapeutic decision-making communication to the degree of autonomy available in each family's situation, as well as the patient's and family's coping habits, if necessary. Despite the importance of family members or surrogates making decisions based on the patient's presumed will, the palliative care team faces the challenge of balancing the ideal degree of patient autonomy with realistic awareness of dealing with patients and family members with whom they are unfamiliar. In this way, palliative care organisations can help to change society's cultural level and prevalent ideas.

1. Abbey J, Piller N, Bellis A, Esterman A, Parker D, et al. (2004) Int J Palliat Nurs 10:6-13.

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2. Borreani C, Brunelli C, Bianchi E, Piva L, Moro C, et al. (2012) J Pain Symptom Manage 43:739-746.

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3. Elkins JS, Johnston SC (2003) Stroke 34:2109-2112.

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4. Borreani C, Brunelli C, Miccinesi G, Morino P, Piazza M, et al. (2008) J Pain Symptom Manage 36:335-350.

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5. Morita T, Akeki T, Sugawara Y, Chihara S, Uchitomi Y (2002) J Clin Oncol 20:758-764.

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6. Núñez Olarte JM, Guillén G (2001) Cancer Control 8:46-54.

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