ABSTRACT
Critical illness, many interventions used in intensive care, and the intensive care environment itself can all cause distress and psychoses (see Chapter 3). Traditionally, sedation was usually used to facilitate invasive ventilation, with the arguable benefit that many sedative drugs induce amnesia. But sedation also deprives the individual of their autonomy, and to some extent their current awareness of being alive. Improved ventilator technology makes invasive ventilation more tolerable for conscious patients. Increasingly, sedative drugs have been viewed as ‘chemical restraints’ (Bray et al., 2004), an intervention only justified when there is a specific indication, and within the limits of that indication.
