Document Detail


'Early terminal sedation' is a distinct entity.
MedLine Citation:
PMID:  19659853     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
There has been much discussion regarding the acceptable use of sedation for palliation. A particularly contentious practice concerns deep, continuous sedation given to patients who are not imminently dying and given without provision of hydration or nutrition, with the end result that death is hastened. This has been called 'early terminal sedation'. Early terminal sedation is a practice composed of two legally and ethically accepted treatment options. Under certain conditions, patients have the right to reject hydration and nutrition, even if these are life-sustaining. Patients are also entitled to sedation as palliation for intolerable, intractable suffering. Though early terminal sedation is thought to be rare at present, the changing nature of palliative medicine suggests its use will increase. Arguments regarding early terminal sedation have failed to recognize early terminal sedation as a distinct legal and ethical entity. It can be seen as both the simple sum of treatment refusal and sedation for palliation, analogous to terminal sedation. It can also be seen as an indivisible palliative treatment, more analogous to assisted suicide or euthanasia. But ultimately, it is wholly analogous neither to terminal sedation given when death is imminent, nor to assisted suicide or euthanasia. This paper contends that early terminal sedation should be considered as a distinct entity. Such a reconception promises to provide a way forward in the debate, practice and policy regarding this contentious area of palliative medicine.
Authors:
Victor Cellarius
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Bioethics     Volume:  25     ISSN:  1467-8519     ISO Abbreviation:  Bioethics     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704792     Medline TA:  Bioethics     Country:  England    
Other Details:
Languages:  eng     Pagination:  46-54     Citation Subset:  E; IM    
Copyright Information:
© 2009 Blackwell Publishing Ltd.
Affiliation:
Department of Family and Community Medicine, University of Toronto, Canada. victor.cellarius@utoronto.ca
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