8mm
Posted on 03/26/2008 6:08:06 AM PDT by wagglebee
Editor's note: The following commentary from Alex Schadenberg comes in response to a study in the Netherlands which found that 1,800 people - 7.1 percent of all deaths in the Netherlands in 2005 - were drugged into so-called continuous deep sedation shortly before dying. This compares with 5.6 percent of cases in 2001. At the same time, the use of euthanasia fell from 2.6 percent of all deaths to 1.7 percent, representing a decrease of 1,200 cases.
The question of the use of deep sedation in the Netherlands as the alternative form of euthanasia is an important question.
In the case of deep sedation, a person is usually sedated and then fluids and food are withdrawn, resulting in an intentional death by dehydration or "slow euthanasia."
Intentionally killing someone by injection (or as Dignitas Clinic in Switzerland now does, with a plastic bag and helium) usually takes several minutes and usually not more than one hour.
To intentionally kill someone by dehydration usually takes 10 - 14 days.
The problem with the moral assessment of deep sedation is that not all acts of deep sedation are related to decisions to intentionally kill the person. Sometimes a person is very near to death and experiencing intractable pain. The person is sedated and dies within a few days. This is not euthanasia, but in fact good palliative care.
Deep sedation can also be used in other cases when someone is not near to death but also experiencing intractable pain. These people can be sedated for several days. Fluids and food, however, should be continued, and after the short period of time the person comes out of the sedated state. These people are sometimes relaxed from their time of sedation and can be effectively treated for pain and symptom management without re-sedating them.
The point is: deep sedation can be used as a form of "slow euthanasia" or it can be effectively used as a form of good palliative care.
We must point out that when deep sedation is used as a form of euthanasia, this is an abuse of medical ethics. Such sedation is often an imposed death, whereby the family is not informed that the reason for the deep sedation is to cause the death of their family member.
Like all acts of euthanasia, deep sedation can be abused and is a direct threat to the lives of the most vulnerable people in our society who are not given the care and respect that is due a human person.
Well said.
A voice of reason. Good post.
I agree with everything you wrote.In my sister’s case she wanted to be resuscitated so they could not begin hospice.I was asked many times to override her decision and get Power of Attorney to begin hospice but she had no pain.She did have some discomfort and she was given something for it.I was condemned by some people because of this.She was aware till the end and she did ask for help for pain.By then we had Power of Attorney and started hospice 8 hours before her death.She stopped eating on her own and her body could not handle any food or liquid.At the end she could barely talk but she put her hands together in prayer.We prayed till we were hoarse because she would know when we stopped.This was about 8 weeks ago.
Judith Anne, that was a very thoughtful post, and your points are valid. If someone is in pain, it would be cruel to deny pain relief.
But there is another story out there: Not all cancer patients have pain. My father was one of them. Yet, there is a tendency for hospitals and hospice to push narcotics onto those patients, anyway.
We’ve had many relatives and friends who have succumbed to cancer. One died from a morphine overdose. Others refused narcotics because drugs like morphine made them feel worse. Narcotics like morphine are especially damaging if your liver is compromised. Certain patients who receive narcotics will hallucinate and cannot rest at all. Like anyone, these patients have discomfort and pain during medical procedures, but otherwise they experience no pain.
My father would insist that he had no pain, yet hospital staff would insist he was in pain and try to administer narcotics to him. We had to watch them all the time. In the end, a doctor unfamiliar with his case did end up administering a narcotic to him - without even telling Dad what he was doing - which may have led to an earlier death.
We had a family friend with cancer who continually refused morphine, and his hospice nurses would argue with him over it. He held them off for months before finally giving in.
If a patient is asking for pain relief, it should not be denied them. The problem is, narcotics are being forced upon others who don’t want it. And that’s when euthanasia may be only parading as palliative care.
My condolences to you in the loss of your sister. I hope you feel comfort in knowing that you honored her wishes to the end. May she rest in peace.
I posted only minutes after you did before seeing your post. Our family, too, was condemned for refusing narcotics and requesting continued treatment for my father.
I send you warm and loving hugs. I am sure she is in the arms of the Redeemer, Who will, I pray, comfort you and all those who loved her.
Part of the “dignity” imperative is honoring the patient’s wishes, no matter if it is for more, or less pain relief.
Thank you for making that important point.
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Yes. One does wonder when the attitude is that the medical caregivers appear to know what is best for the patient, even beyond his or the families wishes.
I am so sorry about your sister Fatima.
I agree with everything you said.
When my grandfather was diagnosed with inoperable pancreatic cancer about a year and a half ago, he immediately decided that he wanted to go home where he was comfortable. Hospice came to the house every day and he was given pain medicine as he needed it, not based on any “normal” needs. He was so happy that he was able to spend his last three months surrounded by those he loved in a familiar setting. I truly believe that in a hospital he would have been miserable most of the time and it would have made everything worse.
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