Palliative sedation: Controversies and challenges

Abstract

Palliative sedation (PS) is used increasingly commonly for symptom management in terminally ill patients in the Western world. The main controversies involving PS are whether it is the same as euthanasia, whether the practice supports patient autonomy, whether sufficient safeguards are or could be in place to prevent its abuse and what its spread may mean for the future of palliative care. While other reviews consider them separately, here the legal, scientific, ethical, and pragmatic challenges to the practice are examined together to provide a broad context in which to assess the current state of the practice.

Keywords:

• Palliative sedation
• Ethics
• Autonomy
• Provider–family conflict
• Maleficence
• Beneficence