Ethical analysis of the practice of sedation for end of life suffering

Abstract

The last resort, active and intentional act of sedating a patient at end of life to relieve suffering is not a novel practice. However, this palliative care measure is muddled with a multitude of ethical concerns that loom over the practice and hinder its application. This dissertation undertakes an in-depth analysis of this palliative care measure. Initially the analysis highlights the compulsion for it, that is end of life suffering, intractable and intolerable which refractory to other palliation attempts. Moreover, the analysis seeks to sieve through the myriad of terms and definitions, as well as conflicting interpretations of the practice of sedation at end of life. The conditions for the intervention are highlighted and an ethical appraisal is undertaken using the principle of proportionality, the rule of double effect as well as the principles of biomedical ethics. Finally, the analysis undertakes an examination of the common contemporary questions and clinical dilemmas that often challenge the practice including, its association with aid-in-dying, euthanasia and physician-assisted suicide practices, the impact of the practice on palliative care as well as the notion of existential suffering and sedation at end of life.