Bioethics 27 (1):1-11 (2013)

Authors
Rachel Allyson Ankeny
University of Adelaide
Abstract
The moral importance of the ‘intention–foresight’ distinction has long been a matter of philosophical controversy, particularly in the context of end-of-life care. Previous empirical research in Australia has suggested that general physicians and surgeons may use analgesic or sedative infusions with ambiguous intentions, their actions sometimes approximating ‘slow euthanasia’. In this paper, we report findings from a qualitative study of 18 Australian palliative care medical specialists, using in-depth interviews to address the use of sedation at the end of life. The majority of subjects were agnostic or atheistic. In contrast to their colleagues in acute medical practice, these Australian palliative care specialists were almost unanimously committed to distinguishing their actions from euthanasia. This commitment appeared to arise principally from the need to maintain a clear professional role, and not obviously from an ideological opposition to euthanasia. While some respondents acknowledged that there are difficult cases that require considered reflection upon one's intention, and where there may be some ‘mental gymnastics,’ the nearly unanimous view was that it is important, even in these difficult cases, to cultivate an intention that focuses exclusively on the relief of symptoms. We present four narratives of ‘terminal’ sedation – cases where sedation was administered in significant doses just before death, and may well have hastened death. Considerable ambiguities of intention were evident in some instances, but the discussion around these clearly exceptional cases illustrates the importance of intention to palliative care specialists in maintaining their professional roles
Keywords double effect  euthanasia  qualitative research  end‐of‐life  intention  hypnotics and sedatives  terminal care
Categories (categorize this paper)
DOI 10.1111/j.1467-8519.2011.01895.x
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy


Upload a copy of this paper     Check publisher's policy     Papers currently archived: 71,436
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

Intention, Plans, and Practical Reason.J. David Velleman - 1991 - Philosophical Review 100 (2):277-284.

Add more references

Citations of this work BETA

Considering Intentions in Decision Making: What Is So Odd About It?Anton Markoč - 2017 - Journal of Social Philosophy 48 (4):481-498.

View all 6 citations / Add more citations

Similar books and articles

Medical Ethics and Double Effect: The Case of Terminal Sedation.Joseph Boyle - 2004 - Theoretical Medicine and Bioethics 25 (1):51-60.
The Double Life of Double Effect.Allison McIntyre - 2004 - Theoretical Medicine and Bioethics 25 (1):61-74.
Terminal Sedation as Palliative Care: Revalidating a Right to a Good Death.George P. Smith - 1998 - Cambridge Quarterly of Healthcare Ethics 7 (4):382-387.
Intention, Foresight, and Mutilation: A Response to Giebel.Christopher Kaczor - 2007 - International Philosophical Quarterly 47 (4):477-482.

Analytics

Added to PP index
2011-07-05

Total views
82 ( #143,292 of 2,520,397 )

Recent downloads (6 months)
1 ( #405,718 of 2,520,397 )

How can I increase my downloads?

Downloads

My notes