Journal of Bioethical Inquiry

, Volume 9, Issue 2, pp 171–183

The Moral Difference or Equivalence Between Continuous Sedation Until Death and Physician-Assisted Death: Word Games or War Games?

A Qualitative Content Analysis of Opinion Pieces in the Indexed Medical and Nursing Literature
  • Sam Rys
  • Reginald Deschepper
  • Freddy Mortier
  • Luc Deliens
  • Douglas Atkinson
  • Johan Bilsen
Original Research

DOI: 10.1007/s11673-012-9369-8

Cite this article as:
Rys, S., Deschepper, R., Mortier, F. et al. Bioethical Inquiry (2012) 9: 171. doi:10.1007/s11673-012-9369-8

Abstract

Continuous sedation until death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, often provokes medical–ethical discussions in the opinion sections of medical and nursing journals. Some argue that CSD is morally equivalent to physician-assisted death (PAD), that it is a form of “slow euthanasia.” A qualitative thematic content analysis of opinion pieces was conducted to describe and classify arguments that support or reject a moral difference between CSD and PAD. Arguments pro and contra a moral difference refer basically to the same ambiguous themes, namely intention, proportionality, withholding artificial nutrition and hydration, and removing consciousness. This demonstrates that the debate is first and foremost a semantic rather than a factual dispute, focusing on the normative framework of CSD. Given the prevalent ambiguity, the debate on CSD appears to be a classical symbolic struggle for moral authority.

Keywords

Deep sedationEuthanasiaPalliative careTerminal care

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Sam Rys
    • 1
    • 2
  • Reginald Deschepper
    • 1
    • 2
  • Freddy Mortier
    • 2
    • 3
  • Luc Deliens
    • 2
    • 4
  • Douglas Atkinson
    • 5
  • Johan Bilsen
    • 1
    • 2
  1. 1.Department of Public Health, Faculty of Medicine and PharmacyVrije Universiteit BrusselBrusselBelgium
  2. 2.End-of-Life Care Research GroupGhent University and Vrije Universiteit BrusselBrusselsBelgium
  3. 3.Bioethics Institute GhentGhent UniversityGhentBelgium
  4. 4.Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Expertise Centre for Palliative CareVU University Medical CenterAmsterdamthe Netherlands
  5. 5.Interfacultair Departement voor Taalonderwijs (ITO)Vrije Universiteit BrusselBrusselsBelgium