scholarly journals Continuous deep sedation and the doctrine of double effect: Do physicians not intend to make the patient unconscious until death if they gradually increase the sedatives?

Bioethics ◽  
2020 ◽  
Vol 34 (9) ◽  
pp. 977-983
Author(s):  
Hitoshi Arima
2010 ◽  
Vol 17 (1) ◽  
pp. 5-13 ◽  
Author(s):  
Livia Anquinet ◽  
Judith A. C. Rietjens ◽  
Lieve Van den Block ◽  
Nathalie Bossuyt ◽  
Luc Deliens

2017 ◽  
Vol 9 (2) ◽  
pp. 143-145 ◽  
Author(s):  
Takuya Shinjo ◽  
Tatsuya Morita ◽  
Daisuke Kiuchi ◽  
Masayuki Ikenaga ◽  
Hirofumi Abo ◽  
...  

ObjectivesVoluntarily stopping eating and drinking (VSED) could be regarded as a patients’ own non-treatment decision that hastens death, which involves patients voluntarily forgoing food and liquid until death. The aims of this study were to investigate the experience of home hospice physicians and palliative care specialists who care for patients during VSED in Japan, and their opinions on continuous deep sedation (CDS) as a means to relieve patient symptoms during VSED.Methods219 home hospice physicians and 695 palliative care specialists across Japan were surveyed by mail questionnaire in 2016.ResultsA total of 571 (62%) responses were analysed. A total of 185 (32%) had experience of patients who selected VSED. In response to questions about CDS to provide relief to patients during VSED, the number of physicians who replied that CDS was acceptable was 88 (15%).ConclusionsIn Japan, 32% of physicians surveyed replied that they had experience of caring for patients during VSED in a clinical setting and 15% considered CDS acceptable.


2021 ◽  
pp. 104973232110376
Author(s):  
Stijn Vissers ◽  
Lenzo Robijn ◽  
Sigrid Dierickx ◽  
Freddy Mortier ◽  
Joachim Cohen ◽  
...  

Physicians have been subject to increasing external control to improve their medical practice, and scholars have theorized extensively about their opposition to such control. However, little empirical attention has been paid to the views and reasoning that lie behind this opposition. An in-depth understanding is necessary for enhancing the effectiveness and efficiency of external controls, and continuous deep sedation until death (CDS) is an interesting case in this regard. This study aims to explore how physicians frame control measures for CDS. We conducted 47 semi-structured interviews with Belgian physicians in 2019. A qualitative framing analysis was performed to analyze their views and reasoning. This study reveals that physicians approach CDS practice and control measures with different emphases. Controlling by mechanisms of professional self-regulation and state governance are put forward as appropriate means to improve CDS practice. Policymakers should take into consideration physicians’ frames to develop sound control measures.


2014 ◽  
Vol 28 (6) ◽  
pp. 491-500 ◽  
Author(s):  
Evangelia (Evie) Papavasiliou ◽  
Kenneth Chambaere ◽  
Luc Deliens ◽  
Sarah Brearley ◽  
Sheila Payne ◽  
...  

2007 ◽  
Vol 2 (3) ◽  
pp. 133-138
Author(s):  
M Davie ◽  
A Kaiser

The management of an infant after a decision to withdraw active treatment creates dilemmas. Both lingering death and active killing are undesirable, but palliative interventions can hasten death. We investigated what staff on our neonatal unit thought were the limits of acceptable practice and why. We administered a structured interview to elucidate their views, and asked them to justify their answers. The interviews were analysed quantitatively and qualitatively. A total of 25 participants (15 nurses and 10 doctors) were recruited. 80% emphasized the importance of pain relief following withdrawal, 60% mentioned meeting parental needs at that time. 76% agreed that death can be a desired consequence of withdrawal, yet 52% felt that death should never be hastened. 96% felt that morphine is acceptable after withdrawal, and 72% would give a higher than normal dose if necessary. 56% would stop paralysis at extubation but not reverse it, while 24% would continue paralysis. 16% would consider a drug that ended life instantly in some cases. A wide variety of views emerged, but there were two main positions, a cautious majority, and a more proactive minority. Apparent contradictions within the majority position could be explained using the doctrine of double effect and the acts and omissions distinction.


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