Is it morally justifiable not to sedate this patient before ventilator withdrawal?

In their case description and analysis, Barbara Springer Edwards and Winston M. Ueno provide a nice opportunity to examine the intersection of theory and practice in medical ethics, as well as to discuss the fine tuning of treatment decisions in the clinical setting. They raise the question: Is it morally justifiable to sedate an alert patient before his life-supporting ventilator is disconnected? Clearly they have a thorough understanding of their patient's legal and ethical entitlement to have his request for discontinuation of life-supporting treatment honored. They also recognize the principle of double effect in allowing large doses of medication to control pain even at the risk of accelerating death. My doubts lie in their specific application of the notion of beneficence, a principle that involves mainly two objectives: preservation of life and alleviation of suffering....