Christian Worldview Concepts

The Ethics of Terminal Sedation as a Treatment for End-of-Life Pain and Suffering

Is Terminal Sedation a Form of Killing?

If it isn't, why does it look so much like killing? The clear intention is to hasten the patient's death when sedation is accompanied by the standard practice of withdrawing or withholding food, fluids and other supportive care. Only one conclusion to be drawn from such an act — the death of the patient is intended.

Some argue that the only motive is to relieve pain and suffering for someone whose symptoms cannot be managed in any other way. This is akin to Jack Kevorkian's claim that when he administered carbon monoxide to his "patients" his only intention was to relieve their pain. Likewise, when sedation is accompanied by removal or withholding of all supportive care, the clear outcome will be death.

Some proponents claim that terminal sedation accompanied by withholding/withdrawal of supportive care is simply the principle of double effect at work — achieving a desired effect (i.e., relief of pain) while experiencing an undesired effect (i.e., hastened death). While appeals to the principle of double effect may carry weight in situations where pain management requires administering increased dosages of medications at the risk of hastening the patient's death through the suppression of respiration, such claims in relation to terminal sedation with hydration/nutrition withdrawal are bogus.

Administering drugs to control pain may increase the risk of a hastened death, albeit an unintended result, however, inducing deep sleep accompanied by ceasing all supportive care does not leave the outcome in doubt. If death is the intended result, then the means by which it is achieved makes no moral difference, regardless of whether the killing is done under medical auspices or not.