A conscious choice
Is it ethical to aim for unconsciousness at the end of life
Bibliographic Data
| ID | 21504237 |
|---|---|
| Authors | Antony Takla (0000-0001-6138-5184, Faculty of Medicine, Nursing and Health Sciences, Monash University Clayton Victoria Australia, corresponding author), Julian Savulescu (0000-0003-1691-6403, Oxford Uehiro Centre for Practical Ethics Faculty of Philosophy University of Oxford Oxford United Kingdom of Great Britain and Northern Ireland), Dominic Wilkinson (0000-0003-3958-8633, Oxford Uehiro Centre for Practical Ethics Faculty of Philosophy University of Oxford Oxford United Kingdom of Great Britain and Northern Ireland) |
| Year | 2021 |
| Volume | 35 |
| Issue | 3 |
| Pages | 284-291 |
| Publication date | 2021-03-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Bioethics (JOURNAL) |
| Journal identifiers | ISSN: 0269-9702 • E-ISSN: 1467-8519 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/bioe.12838 |
| PMID | 33332623 |
| OpenAlex | W3096232650 |
| Language | EN |
| Citations received | 6 |
| References cited | 1 |
One of the most commonly referenced ethical principles when it comes to the management of dying patients is the doctrine of double effect (DDE). The DDE affirms that it is acceptable to cause side effects (e.g. respiratory depression) as a consequence of symptom‐focused treatment. Much discussion of the ethics of end of life care focuses on the question of whether actions (or omissions) would hasten (or cause) death, and whether that is permissible. However, there is a separate question about the permissibility of hastening or causing unconsciousness in dying patients. Some authors have argued that the DDE would not permit end of life care that directly aims to render the patient unconscious. The claim is that consciousness is an objective human good and therefore doctors should not intentionally (and permanently) suppress it. Three types of end of life care (EOLC) practices will be explored in this article. The first is symptom‐based management (e.g. analgesia); the second is proportional terminal sedation as a means of relieving suffering (also referred to as palliative sedation or continuous deep sedation); and finally, deliberate and rapid sedation to unconsciousness until death (a practice we call terminal anaesthesia in this paper). After examining the common arguments for the various types of symptom‐based management and sedation, we apply the DDE to the latter two types of EOLC practices. We argue that aiming at unconsciousness, contrary to some claims, can be morally good or at least morally neutral in some dying patients
Anesthesia · Consciousness · End-of-life care · Medical law · Palliative care · Political science · Principle of double effect · Psychiatry · Psychoanalysis · Sedation · Unconscious mind · Unconsciousness · Anesthesia and Sedative Agents · Ethics in medical practice · Law · Medicine · Nursing · Palliative Care and End-of-Life Issues · Psychology
Is Unconsciousness the Intention? Physicians’ Perspectives on Palliative Sedation Outside Specialized Palliative Care
A conscious choice
The last low whispers revisited
Double-effect sedation
Expanded terminal sedation in end-of-life care
Should Terminal Sedation Be Expanded to Individuals Who Choose to Die Via the Voluntary Stopping of Eating and Drinking
| Unique citing works | 6 |
|---|---|
| Citations per year | 1.2 |
| Citation span | 2021 - 2026 (6) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 6 |