Humanities
Skip to main content Skip to main navigation menu Skip to site footer
  • Register
  • Login
  • Menu
  • Home
  • Current
  • Archives
  • Announcements
  • About
    • About the Journal
    • Submissions
    • Editorial Team
    • Privacy Statement
    • Contact
  • Register
  • Login

Journal of Education, Health and Sport

Comparative Analysis of Palliative Sedation and Euthanasia - a literature review
  • Home
  • /
  • Comparative Analysis of Palliative Sedation and Euthanasia - a literature review
  1. Home /
  2. Archives /
  3. Vol. 62 (2024) /
  4. Medical Sciences

Comparative Analysis of Palliative Sedation and Euthanasia - a literature review

Authors

  • Artur Bednarski University Teaching Hospital them F. Chopin in Rzeszów, Poland https://orcid.org/0000-0002-1505-9465
  • Aleksandra Krużel Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0002-5538-9220
  • Seweryn Ziajor Medical Center in Łańcut, Poland https://orcid.org/0000-0001-8430-1764
  • Piotr Sajdak Medical Center in Łańcut, Poland https://orcid.org/0009-0001-1771-8874
  • Justyna Tomasik Medical University of Lublin, Poland https://orcid.org/0000-0001-6114-6992
  • Marika Dębik Provincial Specialist Hospital in Wrocław, Poland https://orcid.org/0009-0006-7504-5184
  • Marcel Stodolak E.Szczeklik Specialist Hospital, Tarnów, Poland https://orcid.org/0009-0002-8315-3549
  • Łukasz Szydłowski Polish Red Cross Maritime Hospital, Gdynia, Poland https://orcid.org/0009-0001-1667-251X
  • Klaudia Żurowska Lower Silesian Specialist Hospital Emergency Medicine Center, Wrocław, Poland https://orcid.org/0009-0005-4431-767X
  • Mikołaj Turski E.Szczeklik Specialist Hospital, Tarnów, Poland https://orcid.org/0009-0003-7548-939X
  • Kamil Kłos Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0002-5308-0940

DOI:

https://doi.org/10.12775/JEHS.2024.62.012

Keywords

palliative sedation, euthanasia, terminal state

Abstract

Introduction and purpose: Palliative care is designed to ensure proper comfort in living and dying, primarily by alleviating suffering in patients for whom medical interventions have proved ineffective. In situations where suffering is unbearable, palliative care offers "last resort" treatment, namely palliative sedation. This involves the intentional administration of sedative drugs to the patient to reduce the level of consciousness, even inducing sleep, in order to control suffering caused by conditions that are resistant to other treatments. The aim of this article is to present various perspectives on palliative sedation.

Description of the state knowledge: Topics discussed include: cessation of hydration and nutrition, loss of patient control over decision-making in treatment progression after the induction of pharmacological coma, the principle of double effect, complications arising from the use of indiscriminate polypharmacy, and views on life shortening through palliative sedation or its comparison to euthanasia. The distinction between palliative sedation and euthanasia is explored, with arguments on both sides contributing to ongoing debates. The paper concludes by advocating for comprehensive guidelines and interdisciplinary assessments to ensure ethical and patient-centered decision-making in the application of palliative sedation in terminally ill patients.

Summary: A discussion is necessary on the creation of acceptable and appropriate procedures that would not arouse the controversies currently associated with the use of palliative sedation.

 

References

Recommendations of the Council of Europe (Re 2003) 24 of the Committee of Ministers to member states regarding the organization of palliative care (Council of Europe, Strasbourg, 2003)

Jansen LA. Disambiguating clinical intentions: the ethics of palliative sedation. J Med Philos. 2010;35(1):19-31. doi:10.1093/jmp/jhp056

Sykes, N. Zagadnienia związane ze schyłkowym okresem życia. Medycyna Praktyczna. Onkologia. 2009;(3):46–52.

Williams G. The principle of double effect and terminal sedation. Med Law Rev. 2001;9(1):41-53. doi:10.1093/medlaw/9.1.41

Quill TE, Lo B, Brock DW, Meisel A. Last-resort options for palliative sedation. Ann Intern Med. 2009;151(6):421-424. doi:10.7326/0003-4819-151-6-200909150-00007

Orentlicher, D. Sąd Najwyższy i terminalna sedacja. Możliwość etycznie gorsza od lekarskiej pomocy w samobójstwie. Tłum. J. Malczewski. W: J. Galewicz, (red.), Wokół śmierci i umierania. Kraków: Universitas. 2009:211-244

Raus, K.S., Sterckx, S., Mortimer, F. Continuous Deep Sedation at the End of Life the “Natural Death” Hypothesis. Bioethics, 2012;26(6):45–52.

Papavasiliou ES, Brearley SG, Seymour JE, Brown J, Payne SA; EURO IMPACT. From sedation to continuous sedation until death: how has the conceptual basis of sedation in end-of-life care changed over time?. J Pain Symptom Manage. 2013;46(5):691-706. doi:10.1016/j.jpainsymman.2012.11.008

Blanchet V, Viallard M-L, Aubry R. Sedation en medecine palliative: recommandations chez l’adulte et specificites au domicile et en geriatrie. Medecine palliative – Soins de support – Accompagnement – Ethique 2010;9:59-70. Doi : 10.1016/j.medpal.2010.01.006

Cherny NI, Radbruch L; Board of the European Association for Palliative Care. European Association for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care. Palliat Med. 2009;23(7):581-593. doi:10.1177/0269216309107024

Aszyk, P. Granice leczenia. Kraków: Rethos. 2006. 159-164

Hauser K, Walsh D. Palliative sedation: welcome guidance on a controversial issue. Palliat Med. 2009;23(7):577-579. doi:10.1177/0269216309107022

Rietjens JA, van Zuylen L, van Veluw H, van der Wijk L, van der Heide A, van der Rijt CC. Palliative sedation in a specialized unit for acute palliative care in a cancer hospital: comparing patients dying with and without palliative sedation. J Pain Symptom Manage. 2008;36(3):228-234. doi:10.1016/j.jpainsymman.2007.10.014

Sykes N, Thorns A. Sedative use in the last week of life and the implications for end-of-life decision making. Arch Intern Med. 2003;163(3):341-344. doi:10.1001/archinte.163.3.341

Fainsinger R, Miller MJ, Bruera E, Hanson J, Maceachern T. Symptom control during the last week of life on a palliative care unit. J Palliat Care. 1991;7(1):5-11.

Muller-Busch HC, Andres I, Jehser T. Sedation in palliative care - a critical analysis of 7 years experience. BMC Palliat Care. 2003;2(1):2. Published 2003 May 13. doi:10.1186/1472-684X-2-2

Leheup B, Piot E, Ducrocq X, Wary B. Théorie du double effet et sédation pour détresse en phase terminale : réflexion autour de la survie des patients sédatés. La Presse médicale. 2012 Oct;41(10):927-932. doi:10.1016/j.lpm.2011.12.010

Ślipko T. Zarys etyki ogólnej. WAM, Kraków 2004.

Leheup BF. Le principe du double effet: un outil aidant à la réflexion éthique dans le cadre de la sédation pour détresse en phase terminale. Medecine palliative – Soins de support – Accompagnement – Ethique 2006; 5: 82-86 doi:MP-04-2006-5-2-1636-6522-101019-200601528

Blanchet V, Viallard M-L, Aubry R. Sedation en medecine palliative: recommandations chez l’adulte et specificites au domicile et en geriatrie. Medecine palliative – Soins de support – Accompagnement – Ethique 2010; 9: 59-70 doi : 10.1016/j.medpal.2010.01.006

Morita T, Inoue S, Chihara S. Sedation for symptom control in Japan: the importance of intermittent use and communication with family members. J Pain Symptom Manage. 1996;12(1):32-38. doi:10.1016/0885-3924(96)00046-2

Fondras JC, Rameix S. Questions éthiques associées à la pratique de la sédation en phase terminale. Medecine palliative – Soins de support – Accompagnement – Ethique 2010; 9: 120-125. doi: 10.1016/j.medpal.2010.01.001.

Tomczyk M. Sedacja paliatywna to nie eutanazja. Służba Zdrowia, 17 października 2011; 50-53.

Gormally, L. (2004). Terminal Sedation and the Doctrine of the Sanctity of Life. In: Tännsjö, T. (eds) Terminal Sedation: Euthanasia in Disguise?. Springer, Dordrecht. doi:10.1007/978-1-4020-2124-4_8

Szewczyk, K. Bioetyka. Medycyna na granicach życia. T. 1. Warszawa: Wydawnictwo Naukowe PWN. 2009:210

Quill TE, Lo B, Brock DW. Palliative options of last resort: a comparison of voluntarily stopping eating and drinking, terminal sedation, physician-assisted suicide, and voluntary active euthanasia. JAMA. 1997;278(23):2099-2104. doi:10.1001/jama.278.23.2099

Tomczyk M., Sopata M.J., Viallard M-L., Beloucif S., Mamzer M-F., Herve C. 2014. Sedacja paliatywna u dorosłych – wybrane aspekty etyczne. Medycyna Paliatywna. 6(2): 76-80.

Woroń J., Leppert W., Tymiński R., Graczyk M., Kutaj–Wąsikowska H., Serednicki W., Wordliczek J. Niepożądane efekty polifarmakoterapii u pacjentów z bólem towarzyszącym chorobie nowotworowej leczonych w ramach świadczeń z zakresu opieki paliatywnej. Ból 2017: 18(4): 11-19

Cellarius V. 'Early terminal sedation' is a distinct entity. Bioethics. 2011;25(1):46-54. doi:10.1111/j.1467-8519.2009.01747

Orentlicher D. The Supreme Court and physician-assisted suicide--rejecting assisted suicide but embracing euthanasia. N Engl J Med. 1997;337(17):1236-1239. doi:10.1056/NEJM199710233371713

McStay R. Terminal sedation: palliative care for intractable pain, post Glucksberg and Quill. Am J Law Med. 2003;29(1):45-76.

Tännsjö, T. (2004). Terminal Sedation: A Substitute for Euthanasia?. In: Tännsjö, T. (eds) Terminal Sedation: Euthanasia in Disguise?. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-2124-4_2

Warnock, M., Macdonald, E. (2008). Easeful Death. Is There a Case for Assisted Dying? Oxford: Oxford University Press. s. 106-116

Callahan, D. (2004). Terminal Sedation and the Artefactual Fallacy. In: Tännsjö, T. (eds) Terminal Sedation: Euthanasia in Disguise?. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-2124-4_9

Brock, D.W. (2004). Terminal Sedation from the Moral Rights’ Perspective. In: Tännsjö, T. (eds) Terminal Sedation: Euthanasia in Disguise?. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-2124-4_7

Łuczak, J. (2009). Komentarz do artykułu N. Syksa „Zagadnienia związane ze schyłkowym okresem życia”. Medycyna Praktyczna. Onkologia, 3, 52–54.

Materstvedt LJ, Bosshard G. Deep and continuous palliative sedation (terminal sedation): clinical-ethical and philosophical aspects. Lancet Oncol. 2009;10(6):622-627. doi:10.1016/S1470-2045(09)70032-4

Carr MF, Mohr GJ. Palliative sedation as part of a continuum of palliative care. J Palliat Med. 2008;11(1):76-81. doi:10.1089/jpm.2007.0100

Battin MP. Terminal sedation: pulling the sheet over our eyes. Hastings Cent Rep. 2008;38(5):27-30. doi:10.1353/hcr.0.0057

Kuhse, H. (2004). Helga Kuhse. In: Tännsjö, T. (eds) Terminal Sedation: Euthanasia in Disguise?. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-2124-4_6

Gevers S. Terminal sedation: a legal approach. Eur J Health Law. 2003;10(4):359-367. doi:10.1163/157180903772757821

Baumann A, Claudot F, Audibert G, Mertes PM, Puybasset L. The ethical and legal aspects of palliative sedation in severely brain-injured patients: a French perspective. Philos Ethics Humanit Med. 2011;6:4. Published 2011 Feb 8. doi:10.1186/1747-5341-6-4

van Delden JJ. Terminal sedation: source of a restless ethical debate. J Med Ethics. 2007;33(4):187-188. doi:10.1136/jme.2007.020446

Peppin JF. Intractable symptoms and palliative sedation at the end of life. Christ Bioeth. 2003;9(2-3):343-355. doi:10.1076/chbi.9.2.343.30283

Downloads

  • PDF

Published

2024-02-22

How to Cite

1.
BEDNARSKI, Artur, KRUŻEL, Aleksandra, ZIAJOR, Seweryn, SAJDAK, Piotr, TOMASIK, Justyna, DĘBIK, Marika, STODOLAK, Marcel, SZYDŁOWSKI, Łukasz, ŻUROWSKA, Klaudia, TURSKI, Mikołaj and KŁOS, Kamil. Comparative Analysis of Palliative Sedation and Euthanasia - a literature review. Journal of Education, Health and Sport. Online. 22 February 2024. Vol. 62, pp. 182-198. [Accessed 27 December 2025]. DOI 10.12775/JEHS.2024.62.012.
  • ISO 690
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
Download Citation
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

Issue

Vol. 62 (2024)

Section

Medical Sciences

License

Copyright (c) 2024 Artur Bednarski, Aleksandra Krużel, Seweryn Ziajor, Piotr Sajdak, Justyna Tomasik, Marika Dębik, Marcel Stodolak, Łukasz Szydłowski, Klaudia Żurowska, Mikołaj Turski, Kamil Kłos

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0

Stats

Number of views and downloads: 778
Number of citations: 0

Search

Search

Browse

  • Browse Author Index
  • Issue archive

User

User

Current Issue

  • Atom logo
  • RSS2 logo
  • RSS1 logo

Information

  • For Readers
  • For Authors
  • For Librarians

Newsletter

Subscribe Unsubscribe

Tags

Search using one of provided tags:

palliative sedation, euthanasia, terminal state
Up

Akademicka Platforma Czasopism

Najlepsze czasopisma naukowe i akademickie w jednym miejscu

apcz.umk.pl

Partners

  • Akademia Ignatianum w Krakowie
  • Akademickie Towarzystwo Andragogiczne
  • Fundacja Copernicus na rzecz Rozwoju Badań Naukowych
  • Instytut Historii im. Tadeusza Manteuffla Polskiej Akademii Nauk
  • Instytut Kultur Śródziemnomorskich i Orientalnych PAN
  • Instytut Tomistyczny
  • Karmelitański Instytut Duchowości w Krakowie
  • Ministerstwo Kultury i Dziedzictwa Narodowego
  • Państwowa Akademia Nauk Stosowanych w Krośnie
  • Państwowa Akademia Nauk Stosowanych we Włocławku
  • Państwowa Wyższa Szkoła Zawodowa im. Stanisława Pigonia w Krośnie
  • Polska Fundacja Przemysłu Kosmicznego
  • Polskie Towarzystwo Ekonomiczne
  • Polskie Towarzystwo Ludoznawcze
  • Towarzystwo Miłośników Torunia
  • Towarzystwo Naukowe w Toruniu
  • Uniwersytet im. Adama Mickiewicza w Poznaniu
  • Uniwersytet Komisji Edukacji Narodowej w Krakowie
  • Uniwersytet Mikołaja Kopernika
  • Uniwersytet w Białymstoku
  • Uniwersytet Warszawski
  • Wojewódzka Biblioteka Publiczna - Książnica Kopernikańska
  • Wyższe Seminarium Duchowne w Pelplinie / Wydawnictwo Diecezjalne „Bernardinum" w Pelplinie

© 2021- Nicolaus Copernicus University Accessibility statement Shop