Distancing sedation in end-of-life care from physician-assisted suicide and euthanasia
Singapore medical journal
;
: 220-227, 2016.
Article
in English
| WPRIM
| ID: wpr-296427
ABSTRACT
Lipuma equates continuous sedation until death (CSD) to physician-assisted suicide/euthanasia (PAS/E) based on the premise that iatrogenic unconsciousness negates social function and, thus, personhood, leaving a patient effectively 'dead'. Others have extrapolated upon this position further, to suggest that any use of sedation and/or opioids at the end of life would be analogous to CSD and thus tantamount to PAS/E. These posits sit diametrically opposite to standard end-of-life care practices. This paper will refute Lipuma's position and the posits borne from it. We first show that prevailing end-of-life care guidelines require proportional and monitored use of sedatives and/or opioids to attenuate fears that the use of such treatment could hasten death. These guidelines also classify CSD as a last resort treatment, employed only when symptoms prove intractable, and not amenable to all standard treatment options. Furthermore, CSD is applied only when deemed appropriate by a multidisciplinary palliative medicine team. We also show that empirical data based on local views of personhood will discount concerns that iatrogenic unconsciousness is tantamount to a loss of personhood and death.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Palliative Care
/
Philosophy, Medical
/
Terminal Care
/
Unconsciousness
/
Attitude of Health Personnel
/
Euthanasia
/
Suicide, Assisted
/
Practice Guidelines as Topic
/
Personhood
/
Death
Type of study:
Practice guideline
Limits:
Humans
Language:
English
Journal:
Singapore medical journal
Year:
2016
Type:
Article
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