The ethical and legal aspects of palliative sedation in severely brain injured patients: a French perspective
Philosophy, Ethics, and Humanities in Medicine 6 (1):4- (2011)
|Abstract||To fulfill their crucial duty of relieving suffering in their patients, physicians may have to administer palliative sedation when they implement treatment-limitation decisions such as the withdrawal of life-supporting interventions in patients with poor prognosis chronic severe brain injury. The issue of palliative sedation deserves particular attention in adults with serious brain injuries and in neonates with severe and irreversible brain lesions, who are unable to express pain or to state their wishes. In France, treatment limitation decisions for these patients are left to the physicians. Treatment-limitation decisions are made collegially, based on the presence of irreversible brain lesions responsible for chronic severe disorders of consciousness. Before these decisions are implemented, they are communicated to the relatives. Because the presence and severity of pain cannot be assessed in these patients, palliative analgesia and/or sedation should be administered. However, palliative sedation is a complex strategy that requires safeguards to prevent a drift toward hastening death or performing covert euthanasia. In addition to the law on patients' rights at the end of life passed in France on April 22, 2005, a recent revision of Article 37 of the French code of medical ethics both acknowledges that treatment-limitation decisions and palliative sedation may be required in patients with severe brain injuries and provides legal and ethical safeguards against a shift towards euthanasia. This legislation may hold value as a model for other countries where euthanasia is illegal and for countries such as Belgium and Netherlands where euthanasia is legal but not allowed in patients incapable of asking for euthanasia but in whom a treatment limitation decision has been made|
|Keywords||No keywords specified (fix it)|
|Through your library||Configure|
Similar books and articles
Victor Cellarius (2011). 'Early Terminal Sedation' is a Distinct Entity. Bioethics 25 (1):46-54.
Laura Hawryluck, William Harvey, Louise Lemieux-Charles & Peter Singer (2002). Consensus Guidelines on Analgesia and Sedation in Dying Intensive Care Unit Patients. BMC Medical Ethics 3 (1):1-9.
H. ten Have & David Clark (eds.) (2002). The Ethics of Palliative Care: European Perspectives. Open University Press.
S. H. Lipuma (2013). Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis. Journal of Medicine and Philosophy 38 (2):190-204.
Timothy E. Quill (2012). Physicians Should “Assist in Suicide” When It Is Appropriate. Journal of Law, Medicine and Ethics 40 (1):57-65.
Blair Henry, Mervyn Dean, Victor Cellarius & Larry Librach (2011). To "Sleep Until Death"Jeffrey T. Berger Replies:Rights Vs. LibertyDavid Orentlicher Replies. Hastings Center Report 41 (1).
Jeroen G. J. Hasselaar (2008). Palliative Sedation Until Death: An Approach From Kant's Ethics of Virtue. Theoretical Medicine and Bioethics 29 (6):387-396.
R. Janssens, J. J. M. van Delden & G. A. M. Widdershoven (2012). Palliative Sedation: Not Just Normal Medical Practice. Ethical Reflections on the Royal Dutch Medical Association's Guideline on Palliative Sedation. Journal of Medical Ethics 38 (11):664-668.
Charles D. Douglas, Ian H. Kerridge & Rachel A. Ankeny (2013). Narratives of 'Terminal Sedation', and the Importance of the Intention-Foresight Distinction in Palliative Care Practice. Bioethics 27 (1):1-11.
Fiona Randall (1996). Palliative Care Ethics: A Good Companion. Oxford University Press.
Jos V. M. Welie (1992). The Medical Exception: Physicians, Euthanasia and the Dutch Criminal Law. Journal of Medicine and Philosophy 17 (4):419-437.
Joseph Boyle (2004). Medical Ethics and Double Effect: The Case of Terminal Sedation. Theoretical Medicine and Bioethics 25 (1):51-60.
Brian Pollard (2010). Fatal Licence: Commentary on the 'Consent to Medical Treatment and Palliative Care (Voluntary Euthanasia) Amendment Bill 2008'. [REVIEW] Bioethics Research Notes 22 (2):19.
Joachim Widder & Monika Glawischnig-Goschnik (2002). The Concept of Disease in Palliative Medicine. Medicine, Health Care and Philosophy 5 (2):191-197.
Marli Huijer & Guy Widdershoven (2001). Desires in Palliative Medicine. Five Models of the Physician‐Patient Interaction on Palliative Treatment Related to Hellenistic Therapies of Desire. Ethical Theory and Moral Practice 4 (2):143-159.
Added to index2011-02-09
Total downloads7 ( #133,587 of 549,571 )
Recent downloads (6 months)1 ( #63,397 of 549,571 )
How can I increase my downloads?