The agony of agonal respiration: is the last gasp necessary?
Perkin, R. M.; Resnik, D. B.
Gasping respiration in the dying patient is the last respiratory pattern prior to terminal apnoea. The duration of the gasping respiration phase varies; it may be as brief as one or two breaths to a prolonged period of gasping lasting minutes or even hours. Gasping respiration is very abnormal, easy to recognise and distinguish from other respiratory patterns and, in the dying patient who has elected to not be resuscitated, will always result in terminal apnoea. Gasping respiration is also referred to as agonal respiration and the name is appropriate because the gasping breaths appear uncomfortable and raise concern that the patient is suffering and in agony. Enough uncertainty exists about the influence of gasping respiration on patient wellbeing, that it is appropriate to assume that the gasping breaths are burdensome to patients. Therefore, gasping respiration at the end of life should be treated. We propose that there is an ethical basis, in rare circumstances, for the use of neuromuscular blockade to suppress prolonged episodes of agonal respiration in the well-sedated patient in order to allow a peaceful and comfortable death. Originally published Journal of Medical Ethics, Vol. 28, No. 3, June 2002
Perkin, R. M., & Resnik, D. B.. (June 2002). The agony of agonal respiration: is the last gasp necessary?. Journal of Medical Ethics, (28:3), p.164-169. Retrieved from http://hdl.handle.net/10342/3067
Perkin, R. M., and Resnik, D. B.. "The agony of agonal respiration: is the last gasp necessary?". Journal of Medical Ethics. 28:3. (164-169.), June 2002. October 26, 2020. http://hdl.handle.net/10342/3067.
Perkin, R. M. and Resnik, D. B., "The agony of agonal respiration: is the last gasp necessary?," Journal of Medical Ethics 28, no. 3 (June 2002), http://hdl.handle.net/10342/3067 (accessed October 26, 2020).
Perkin, R. M., Resnik, D. B.. The agony of agonal respiration: is the last gasp necessary?. Journal of Medical Ethics. June 2002; 28(3) 164-169. http://hdl.handle.net/10342/3067. Accessed October 26, 2020.
East Carolina University