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Ethics of crisis sedation: questions of performance and consent
  1. Nathan Emmerich1,2,
  2. Bert Gordijn2
  1. 1 School of Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
  2. 2 Institute of Ethics, Dublin City University, Dublin, Ireland
  1. Correspondence to Dr Nathan Emmerich, School of Medicine, Australian National University, Canberra, ACT 2600, Australia; nathan.emmerich{at}anu.edu.au

Abstract

This paper focuses on the practice of injecting patients who are dying with a relatively high dose of sedatives in response to a catastrophic event that will shortly precipitate death, something that we term ‘crisis sedation.’ We first present a confabulated case that illustrates the kind of events we have in mind, before offering a more detailed account of the practice. We then comment on some of the ethical issues that crisis sedation might raise. We identify the primary value of crisis sedation as allowing healthcare professionals to provide some degree of reassurance to patients, their families and the professionals who are caring for them. Next we focus on the issue of informed consent. Finally, we ask whether continuous deep sedation might be preferable to crisis sedation in scenarios where potential catastrophic events can be anticipated.

  • palliative care
  • end of life care
  • care of the dying patient
  • attitudes toward death
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Footnotes

  • Contributors NE is the lead author of the paper. BG is the second author of the paper.

  • Funding This paper was written with the support of ENDCARE, an Erasmus+ funded project on ethics and care at the end of life. EU ERASMUS+ Programme Agreement No 2015-1-MT01-KA203-003728: Harmonisation and Dissemination of Best Practice–Educating and alleviating the concerns of Health Care Professionals on the proper practice of end of life care (ENDCARE).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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