Medicine, Health Care and Philosophy

, Volume 16, Issue 3, pp 533–542 | Cite as

Continuous sedation until death: moral justifications of physicians and nurses—a content analysis of opinion pieces

  • Sam Rys
  • Freddy Mortier
  • Luc Deliens
  • Reginald Deschepper
  • Margaret Pabst Battin
  • Johan Bilsen
Scientific Contribution

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. A content analysis of opinion pieces in medical and nursing literature was conducted to examine how clinicians define and describe CSD, and how they justify this practice morally. Most publications were written by physicians and published in palliative or general medicine journals. Terminal Sedation and Palliative Sedation are the most frequently used terms to describe CSD. Seventeen definitions with varying content were identified. CSD was found to be morally justified in 73 % of the publications using justifications such as Last Resort, Doctrine of Double Effect, Sanctity of Life, Autonomy, and Proportionality. The debate over CSD in the opinion sections of medical and nursing journals lacks uniform terms and definitions, and is profoundly marked by ‘charged language’, aiming at realizing agreement in attitude towards CSD. Not all of the moral justifications found are equally straightforward. To enable a more effective debate, the terms, definitions and justifications for CSD need to be further clarified.

Keywords

Terminal Sedation Palliative Sedation Deep Sedation Content analysis Opinions Palliative care Terminal care 

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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Sam Rys
    • 1
    • 2
  • Freddy Mortier
    • 2
    • 3
  • Luc Deliens
    • 2
    • 4
  • Reginald Deschepper
    • 1
    • 2
  • Margaret Pabst Battin
    • 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.Department of PhilosophyUniversity of UtahSalt Lake CityUSA

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