Document Detail


Sedation, alimentation, hydration, and equivocation: careful conversation about care at the end of life.
MedLine Citation:
PMID:  12044133     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the recent medical ethics literature, several authors have recommended terminal sedation and refusal of hydration and nutrition as important, morally acceptable, and relatively uncontroversial treatment options for end-of-life suffering. However, not all authors use these terms to refer to the same practices. This paper examines the various ways that the terms terminal sedation and refusal of hydration and nutrition have been used in the medical literature. Although some of these practices are ethically appropriate responses to end-of-life suffering, others (at least as they are currently described in the medical ethics literature) are not. This paper identifies and discusses the principles that morally distinguish these practices from one another and specifically describes different features of medical practices and moral principles that affect the moral acceptability of various medical treatments. These distinctions reveal the complexity of the issues surrounding terminal sedation and refusal of hydration and nutrition, a complexity that has not been adequately addressed in recent discussions.
Authors:
Lynn A Jansen; Daniel P Sulmasy
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of internal medicine     Volume:  136     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-04     Completed Date:  2002-06-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  845-9     Citation Subset:  AIM; E; IM    
Affiliation:
The John J. Conley Department of Ethics, Saint Vincent's Hospital and Medical Center, 153 West 11th Street (NR 815), New York, NY 10011, USA. ljansen@saintvincentsnyc.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Double Effect Principle*
Female
Fluid Therapy*
Humans
Hypnotics and Sedatives / administration & dosage*
Male
Middle Aged
Physician's Role
Physician-Patient Relations
Terminal Care* / psychology
Terminology as Topic*
Treatment Refusal
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives
Comments/Corrections
Comment In:
Ann Intern Med. 2002 Dec 17;137(12):1008-10; author reply 1008-10   [PMID:  12484724 ]
Ann Intern Med. 2002 Dec 17;137(12):1010-1; reply 1010-1   [PMID:  12484730 ]
Ann Intern Med. 2002 Dec 17;137(12):W2; author reply W2   [PMID:  12484745 ]
Ann Intern Med. 2002 Dec 17;137(12):1008-10; author reply 1008-10   [PMID:  12484728 ]
Ann Intern Med. 2002 Dec 17;137(12):1008-10; author reply 1008-10   [PMID:  12484729 ]
Ann Intern Med. 2002 Dec 17;137(12):W1; author reply W1   [PMID:  12484744 ]

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