Abstract
By ‘terminal sedation’ I denote, in the present chapter, a procedure where through heavy sedation a terminally ill patient is put into a state of coma, where the intention of the doctor is that the patient should stay comatose until he or she is dead. No extraordinary monitoring of the medical state of the patient is undertaken. Normal hydration is ignored. All this means that in some cases where patients are being terminally sedated, death is hastened; if the disease does not kill the patient, some complication in relation to the sedation, or the withdrawal of treatment and hydration, or the combination of these, does.
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Notes
The example is presented in, and is followed by, a discussion in several issues of the journal. See also the selective bibliography of the literature since 1990.
Gillian M. Craig, ‘On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far?’, Journal of medical ethics, Vol. 20, 1994: 139–143.
R.J. Dunlop, J.E. Ellershaw, M.J. Baines, N. Sykes, and C.M. Saunders, ‘On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far? A reply’, Journal of Medical Ethics, Vol. 21. 1995: 141–143.
Lawrence J. Schneiderman, ‘Is it morally justifiable not to sedate this patient before ventilator withdrawal’ The Journal of Clinical Ethics Vol 2 1991: 129–130
Many philosophers have attempted to make this kind of distinction, most ingenious among them all, Jonathan Bennett. But in my opinion even Bennett fails. Those who want to check this assessment of mine should read his most recent treatment of the subject, which can be found in his book, The Act Itself (Oxford: Oxford UP, 1995), chapters 4 through 8.
An authoritative statement of the principle of double effect can be found in New Catholic Encyclopedia, McGraw-Hill, New York, 1967.
Airedale NHS Trust v. Bland (1993).
‘The Additive Fallacy’, Ethics, 1988:5–31
American Association for Hospice and Palliative Medicine, Position statement on the end-of-life, Appendix of this volume, p. 128.
‘Palliative Options of Last Resort’, JAMA, Vol. 278, 1997. In this book reprinted as Chapter 1. p. 6.
Ibid., p. 7.
Ibid., pp. 7–8.
‘Is Sedation Without Hydration or Nourishment in Terminal Care Lawful?’, Medico-Legal Journal, Vol. 62, 1994:200.
Ibid.
At a meeting held at The National Board of Health and Welfare on Oct. 29. 1997.
Håkan Samuelsson and Eva Thornberg, ‘Symptomlindring inte dödshjälp’ (Symptom control is not euthanasia), Göteborgs-Posten. January 1. 1998.
This description it taken from M. O’Connor, D.W. Kissane, and O. Spruyt, ‘Sedation of the terminally ill — a clinical perspective’ Monash Bioethics Review. Vol 18 1999 n 22
Dag Lundberg, Psykologiska och etiska aspekter’ (Psychological and Ethical Aspects), in Matts Halldin and Sten G. Lindahl (eds.), Anestesi (Anaesthesia) (Stockholm: Liber, 1999), p 190. My own translation.
‘Sedation Before Ventilator Withdrawal: Medical and Ethical Considerations’, The Journal of Clinical Ethics, Vol. 2, 1991:127.
Guidelines on palliative sedation adopted by the Norwegian Medical Association, Appendix of this volume, p. 132–133.
‘Morphine Drips, Terminal Sedation, and Slow Euthanasia: Definitions and Facts, Not Anecdotes’, Journal of Palliative rare Vnl 1 1996.3d
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Tännsjö, T. (2004). Terminal Sedation: A Substitute for Euthanasia?. In: Tännsjö, T. (eds) Terminal Sedation: Euthanasia in Disguise?. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-2124-4_2
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DOI: https://doi.org/10.1007/978-1-4020-2124-4_2
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