Citation

Raho JA, Miccinesi G. J. Med. Philos. 2015; 40(5): 529-553.

Affiliation

University of California, Los Angeles, Los Angeles, California, USA Cancer Prevention and Research Institute (ISPO), Florence, Italy.

Copyright

(Copyright © 2015, Society for Health and Human Values, Publisher University of Chicago Press)

DOI

10.1093/jmp/jhv018

PMID

26242447

Abstract

Patients who are imminently dying sometimes experience symptoms refractory to traditional palliative interventions, and in rare cases, continuous sedation is offered. Samuel H. LiPuma, in a recent article in this Journal, argues that continuous sedation until death is equivalent to physician-assisted suicide/euthanasia based on a higher brain neocortical definition of death. We contest his position that continuous sedation involves killing and offer four objections to the equivalency thesis. First, sedation practices are proportional in a way that physician-assisted suicide/euthanasia is not. Second, continuous sedation may not entirely abolish consciousness. Third, LiPuma's particular version of higher brain neocortical death relies on an implausibly weak construal of irreversibility-a position that is especially problematic in the case of continuous sedation. Finally, we explain why continuous sedation until death is not functionally equivalent to neocortical death and, hence, physician-assisted suicide/euthanasia. Concluding remarks review the differences between these two end-of-life practices.

Language: en