Open AccessIntractable End‐of‐Life Suffering and the Ethics of Palliative Sedation
Author(s) -
Cassell Eric J.,
Rich Ben A.
Publication year - 2010
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2009.00786.x
Subject(s) - palliative sedation , medicine , sedation , palliative care , pain medicine , intensive care medicine , anesthesia , anesthesiology , nursing
Palliative sedation (sedation to unconsciousness) as an option of last resort for intractable end‐of‐life distress has been the subject of ongoing discussion and debate as well as policy formulation. A particularly contentious issue has been whether some dying patients experience a form of intractable suffering not marked by physical symptoms that can reasonably be characterized as “existential” in nature and therefore not an acceptable indication for palliative sedation. Such is the position recently taken by the American Medical Association. In this essay we argue that such a stance reflects a fundamental misunderstanding of the nature of human suffering, particularly at the end of life, and may deprive some dying patients of an effective means of relieving their intractable terminal distress.