Palliative sedation remains somewhat contentious, due to:
Many clinicians argue that palliative sedation does not necessarily mandate sedation to total unconsciousness and, instead, suggest there are variable degrees of sedation as well as duration of sedation.
Working definition of palliative sedation:
Palliative sedation may be more clearly defined and clinically characterized as the primary intention of deliberately inducing a temporary or permanent light-to-deep sleep, but not deliberately causing death, in patients with terminal illness and specific refractory symptoms.
Other common definitions of palliative sedation:
Intent v. Outcome
The intent of Palliative Sedation is the relief of intractable suffering caused by refractory symptom(s) and not to deliberately end the life of the terminally ill patient.
The specific outcome of palliative sedation is to intentionally sedate the patient to a point where the patient is unaware of the problematic symptom that was causing the intractable suffering.
In writing about this topic, U.S. Supreme Court Justice Sandra Day O’Connor, have endorsed the practice, arguing that “a patient who is suffering from a terminal illness and who is experiencing great pain has no legal barrier to obtaining medication, from qualified physicians, to alleviate that suffering, even to the point of causing unconsciousness and hastening death.”
Differentiating Palliative Sedation from Physician Assisted Suicide
Although palliative sedation is unquestionably a valuable and efficacious palliative intervention and was fundamentally sanctioned by the United States Supreme Court decision opposing a constitutional right to physician-assisted suicide (Rousseau 2001, Orentlicher 1997, Vacco v Quill 1997 Washington v Glucksberg 1997), its use remains somewhat nebulous, with a reported incidence ranging from 2% to 52% (Rousseau 2000, Quill 1997, Ventafridda 1990).
The wide variance in the use of palliative sedation is probably due to: