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Continuous Sedation at the End of Life: Ethical, Clinical and Legal Perspectives

New from Cambridge University Press: Continuous Sedation at the End of Life: Ethical, Clinical and Legal Perspectives

Continuous sedation until death (sometimes referred to as terminal sedation or palliative sedation) is an increasingly common practice in end-of-life care. However, it raises numerous medical, ethical, emotional and legal concerns.

These include: the reducing or removing of consciousness (and thus potentially causing ‘subjective death’), the withholding of artificial nutrition and hydration, the proportionality of the sedation to the symptoms, its adequacy in actually relieving symptoms rather than simply giving onlookers the impression that the patient is undergoing a painless ‘natural’ death, and the perception that it may be functionally equivalent to euthanasia. 

This book brings together contributions from clinicians, ethicists, lawyers and social scientists, and discusses guidelines as well as clinical, emotional and legal aspects of the practice. The chapters shine a critical spotlight on areas of concern and on the validity of the justifications given for the practice, including in particular the doctrine of double effect.

Introduction pp 1-28
By Sigrid Sterckx, Kasper Raus, Freddy Mortier

Continuous sedation until death: pp 29-46
By Sophie M. Bruinsma, Judith A.C. Rietjens, Agnes van der Heide

Death by equivocation: pp 47-64
By David Albert Jones

Palliative sedation: pp 65-85
By Josep Porta-Sales

Clinical aspects of palliative sedation pp 86-99
By Nigel P. Sykes

Understanding the role of nurses in the management of symptoms and distress in the last days of life pp 100-115
By Eleanor Wilson, Jane Seymour

Principle and practice for palliative sedation: pp 116-131
By David Orentlicher

The legal permissibility of continuous deep sedation at the end of life: pp 132-148
By Evelien Delbeke

The Dutch national guideline on palliative sedation pp 149-159
By Johan Legemaate

Continuous deep sedation at the end of life: pp 160-176
By Richard Huxtable, Ruth Horn

Can the doctrine of double effect justify continuous deep sedation at the end of life? pp 177-201
By Kasper Raus, Sigrid Sterckx, Freddy Mortier

Palliative sedation, consciousness and personhood pp 202-217
By Timothy Holahan, Thomas Carroll, Claudia Gonzalez, Timothy E. Quill

The ethical evaluation of continuous sedation at the end of life pp 218-227
By Johannes J.M. van Delden

Terminal sedation and euthanasia: pp 228-239
By Søren Holm

Terminal sedation: pp 240-249
By Margaret P. Battin

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