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Terminal sedation: promoting ethical nursing practice.

A Gallagher1, P Wainwright

  • 1Kingston University, Kingston upon Thames, Surrey. a.gallagher@hscs.sgul.ac.uk

Nursing Standard (Royal College of Nursing (Great Britain) : 1987)
|May 24, 2007
PubMed
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Terminal sedation in end-of-life care has varied definitions. Using the term "palliative sedation" and understanding its ethical implications ensures patient dignity and autonomy in care.

Area of Science:

  • Medical Ethics
  • Palliative Care
  • Nursing Ethics

Background:

  • Terminal sedation is a complex aspect of end-of-life care with diverse interpretations.
  • Existing definitions of terminal sedation range from alignment with palliative care values to concerns about being 'euthanasia in disguise'.

Purpose of the Study:

  • To critically examine the ethical dimensions of terminal sedation in end-of-life care.
  • To propose 'palliative sedation' as a more appropriate and ethically sound term.
  • To evaluate the applicability and limitations of the 'doctrine of double effect' in supporting terminal sedation.

Main Methods:

  • Literature review to analyze definitions and ethical considerations of terminal sedation.
  • Critical examination of the 'doctrine of double effect' in the context of end-of-life care.

Related Experiment Videos

  • Use of illustrative vignettes to explore practical ethical dilemmas.

    • Main Results:

    • Inconsistent definitions of terminal sedation exist, leading to ethical ambiguity.
    • Palliative sedation, when properly defined and understood, is presented as an ethical and defensible practice.
    • The doctrine of double effect requires critical scrutiny when applied to terminal sedation.

    Conclusions:

    • Adopting the term 'palliative sedation' can enhance clarity and ethical practice in end-of-life care.
    • Nurses must maintain professional integrity, honesty, and respect for patient autonomy and dignity.
    • Critical evaluation of ethical principles like the doctrine of double effect is essential for responsible clinical practice.