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Continuous deep sedation and homicide: an unsolved problem in law and professional morality

When a severely suffering dying patient is deeply sedated, and this sedated condition is meant to continue until his death, the doctor involved often decides to abstain from artificially administering fluids. For this dual procedure almost all guidelines require that the patient should not have a li...

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Detalles Bibliográficos
Autor principal: den Hartogh, Govert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880626/
https://www.ncbi.nlm.nih.gov/pubmed/26715284
http://dx.doi.org/10.1007/s11019-015-9680-3
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description When a severely suffering dying patient is deeply sedated, and this sedated condition is meant to continue until his death, the doctor involved often decides to abstain from artificially administering fluids. For this dual procedure almost all guidelines require that the patient should not have a life expectancy beyond a stipulated maximum of days (4–14). The reason obviously is that in case of a longer life-expectancy the patient may die from dehydration rather than from his lethal illness. But no guideline tells us how we should describe the dual procedure in case of a longer life-expectancy. Many arguments have been advanced why we should not consider it to be a form of homicide, that is, ending the life of the patient (with or without his request). I argue that none of these arguments, taken separately or jointly, is persuasive. When a commission, even one that is not itself life-shortening, foreseeably renders a person unable to undo the life-shortening effects of another, simultaneous omission, the commission and the omission together should be acknowledged to kill her. I discuss the legal and ethical implications of this conclusion.
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spelling pubmed-48806262016-06-21 Continuous deep sedation and homicide: an unsolved problem in law and professional morality den Hartogh, Govert Med Health Care Philos Scientific Contribution When a severely suffering dying patient is deeply sedated, and this sedated condition is meant to continue until his death, the doctor involved often decides to abstain from artificially administering fluids. For this dual procedure almost all guidelines require that the patient should not have a life expectancy beyond a stipulated maximum of days (4–14). The reason obviously is that in case of a longer life-expectancy the patient may die from dehydration rather than from his lethal illness. But no guideline tells us how we should describe the dual procedure in case of a longer life-expectancy. Many arguments have been advanced why we should not consider it to be a form of homicide, that is, ending the life of the patient (with or without his request). I argue that none of these arguments, taken separately or jointly, is persuasive. When a commission, even one that is not itself life-shortening, foreseeably renders a person unable to undo the life-shortening effects of another, simultaneous omission, the commission and the omission together should be acknowledged to kill her. I discuss the legal and ethical implications of this conclusion. Springer Netherlands 2015-12-29 2016 /pmc/articles/PMC4880626/ /pubmed/26715284 http://dx.doi.org/10.1007/s11019-015-9680-3 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Scientific Contribution
den Hartogh, Govert
Continuous deep sedation and homicide: an unsolved problem in law and professional morality
title Continuous deep sedation and homicide: an unsolved problem in law and professional morality
title_full Continuous deep sedation and homicide: an unsolved problem in law and professional morality
title_fullStr Continuous deep sedation and homicide: an unsolved problem in law and professional morality
title_full_unstemmed Continuous deep sedation and homicide: an unsolved problem in law and professional morality
title_short Continuous deep sedation and homicide: an unsolved problem in law and professional morality
title_sort continuous deep sedation and homicide: an unsolved problem in law and professional morality
topic Scientific Contribution
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880626/
https://www.ncbi.nlm.nih.gov/pubmed/26715284
http://dx.doi.org/10.1007/s11019-015-9680-3
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