Sedation at the End-of-life: An Interdisciplinary Approach

1. Front Matter

   Pages i-xviii

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2. Sedation at the End of Life. Clinical Realities, Trends and Current Debate

   • Paulina Taboada

   Pages 1-14

3. Palliative Sedation and the Goals of Care at the End of Life

   • William F. Sullivan

   Pages 15-26

4. Clinical Aspects of Palliative Sedation for Refractory Symptoms

   • Paul W. Walker

   Pages 27-40

5. The Use of Palliative Sedation to Treat Existential Suffering: A Reconsideration

   • Aron Portnoy, Punam Rana, Camilla Zimmermann, Gary Rodin

   Pages 41-54

6. The Relevance of Double Effect to Decisions About Sedation at the End of Life

   • Joseph Boyle

   Pages 55-71

7. The Field of Application of the Principle of the Double Effect and the Problem of Palliative Sedation

   • Alejandro Miranda

   Pages 73-90

8. ‘Palliative Sedation’, Ethics and the Law: An Overview of the ‘Sanctity of Life’, ‘Best Interests’ and ‘Autonomy’

   • John Keown

   Pages 91-109

9. Palliative Sedation: Some Legal Precautions in the Case of Chile

   • Angela Vivanco

   Pages 111-120

10. Clinical Guidelines for the Use of Palliative Sedation: Moving from Contention to Consensus

    • Blair Henry

    Pages 121-141

11. The Case Against Clinical Guidelines for Palliative Sedation

    • John F. Scott

    Pages 143-159

12. Back Matter

    Pages 161-175

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The book’s main contribution is its interdisciplinary approach to the issue of sedation at the end-of-life. Because it occurs at the end of life, palliative sedation raises a number of important ethical and legal questions, including whether it is a covert form of euthanasia and for what purposes it may legally be used. Many of the book chapters address the first question and almost all deal with a specific form of the second: whether palliative sedation should be used for those experiencing “existential suffering”? This raises the question of what existential suffering is, a topic that is also discussed in the book. The different chapters address these issues from the perspectives of the relevant disciplines: Palliative Medicine, Bioethics, Law and Theology. Hence, helpful accounts of the clinical and historical background for this issue are provided and the importance of drawing accurate ethical and legal distinctions is stressed throughout the whole book. So the volume represents avaluable contribution to the emerging literature on this topic and should be helpful across a broad spectrum of readers: philosophers, theologians and physicians.

• Care at the End of Life
• Palliative Sedation
• Refractory Symptoms
• Sedation at the end of life
• agitated delirium and dyspnea
• end-of-life sedation

“This book is a very timely overview of PS that is increasingly being used in palliative care at the end of life. I would recommend it particularly to palliative care and hospice providers while all of us should become as familiar with this complex paradigm as possible.” (Thomas M. Pitre, The Linacre Quarterly, Vol. 85 (2), May, 2018)

“The purpose of this book is to analyze several clinical, ethical, and legal questions related to the use of sedation at the end of life, also termed palliative sedation (PS). ... If you work in palliative care and are interested in the ethics of end-of-life care and palliative sedation in particular, this book provides a lot of information and even more to think about.” (Roger Woodruf, IAHPCBook Reviews, hospicecare.com, Vol. 19 (1), January, 2018)

“The book is intended primarily for those working in palliative medicine and scholars interested in the topic. … This is a valuable contribution to the field of palliative medicine, addressing the difficult and poignant topic of end-of-life sedation. The editor has shown great care in gathering a diverse collection of essays addressing relevant ethical issues, thereby providing a much-needed, comprehensive analysis of end-of-life sedation.” (Kathrine Bendtsen, Doody's Book Reviews, April, 2015)

• Faculty of Medicine, Centre for Bioethics and Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

  Paulina Taboada

Policies and ethics