@article{ref1,
title="Distancing sedation in end-of-life care from physician-assisted suicide and euthanasia",
journal="Singapore medical journal",
year="2016",
author="Tze-Ling-Gwendoline-Beatrice SOH,  and Lalit-Kumar-Radha KRISHNA,  and Sim, Shin-Wei and Alethea-Chung-Peng YEE, ",
volume="",
number="",
pages="220-227",
abstract="Lipuma equates continuous sedation until death (CSD) to physician-assisted suicide/euthanasia (PAS/E) based on the premise that iatrogenic unconsciousness negates social function and, thus, personhood, leaving a patient effectively 'dead'. Others have extrapolated upon this position further, to suggest that any use of sedation and/or opioids at the end of life would be analogous to CSD and thus tantamount to PAS/E. These posits sit diametrically opposite to standard end-of-life care practices. This paper will refute Lipuma's position and the posits borne from it. We first show that prevailing end-of-life care guidelines require proportional and monitored use of sedatives and/or opioids to attenuate fears that the use of such treatment could hasten death. These guidelines also classify CSD as a last resort treatment, employed only when symptoms prove intractable, and not amenable to all standard treatment options. Furthermore, CSD is applied only when deemed appropriate by a multidisciplinary palliative medicine team. We also show that empirical data based on local views of personhood will discount concerns that iatrogenic unconsciousness is tantamount to a loss of personhood and death.<p /><p>Language: en</p>",
language="en",
issn="0037-5675",
doi="10.11622/smedj.2016086",
url="http://dx.doi.org/10.11622/smedj.2016086"
}