Deep and continuous palliative sedation (terminal sedation): clinical-ethical and philosophical aspects

Lancet Oncol. 2009 Jun;10(6):622-7. doi: 10.1016/S1470-2045(09)70032-4.


Terminal sedation continues to fuel debate. When confronted with a patient for whom terminal sedation is considered a possible treatment option, decision making can be difficult. In this paper we focus on the clinical-ethical issues, with an aim to provide clinicians with ways of framing the issue from an ethical point of view. In addition to the clinical-ethical issues, terminal sedation touches upon interesting and complex questions of an essentially philosophical nature. What it means to be a "person" is one such question, and is a topic that is relevant to clinical, daily practice. Accordingly, in the latter part of this paper we draw briefly on selected philosophical positions to elucidate this question. A doctor's belief of what it means to be a "person" might well affect their actions. For example, if a doctor believes terminal sedation involves the destruction of the person, they might not be willing to proceed with it.

MeSH terms

  • Deep Sedation* / ethics
  • Humans
  • Palliative Care / ethics*
  • Terminal Care / ethics*