The moral difference or equivalence between continuous sedation until death and physician-assisted death: word games or war games?: a qualitative content analysis of opinion pieces in the indexed medical and nursing literature

J Bioeth Inq. 2012 Jun;9(2):171-83. doi: 10.1007/s11673-012-9369-8. Epub 2012 Mar 21.

Abstract

Continuous sedation until death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, often provokes medical-ethical discussions in the opinion sections of medical and nursing journals. Some argue that CSD is morally equivalent to physician-assisted death (PAD), that it is a form of "slow euthanasia." A qualitative thematic content analysis of opinion pieces was conducted to describe and classify arguments that support or reject a moral difference between CSD and PAD. Arguments pro and contra a moral difference refer basically to the same ambiguous themes, namely intention, proportionality, withholding artificial nutrition and hydration, and removing consciousness. This demonstrates that the debate is first and foremost a semantic rather than a factual dispute, focusing on the normative framework of CSD. Given the prevalent ambiguity, the debate on CSD appears to be a classical symbolic struggle for moral authority.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Deep Sedation / ethics*
  • Humans
  • Morals
  • Palliative Care / ethics*
  • Qualitative Research
  • Semantics
  • Suicide, Assisted / ethics*
  • Symbolism
  • Terminal Care / ethics*