Kasper Raus on Continuous Sedation vs. Physician-Assisted Suicide

New Hot Paper Commentary, November 2011

Kasper Raus

Article: Is Continuous Sedation at the End of Life an Ethically Preferable Alternative to Physician-Assisted Suicide?

Authors: Raus, K;Sterckx, S;Mortier, F
Journal: AM J BIOETH
Volume: 11, Issue: 6, Page: 32-40, Year: 2011
* Univ Ghent, Blandijnberg 2,Room 2-08, B-9000 Ghent, Belgium.
* Univ Ghent, B-9000 Ghent, Belgium.

Kasper Raus talks with ScienceWatch.com and answers a few questions about this month's New Hot Paper in the field of Social Sciences, general.

SW: Why do you think your paper is highly cited?

I think one of the strengths of our paper is that it relies heavily on empirical data to construct and support an ethical argument. This interplay between ethics and empirics makes the paper accessible to people from various disciplines.

Also, our paper is devoted to the question of whether continuous sedation at the end of life is always the preferable alternative to physician-assisted suicide. The paper therefore combines discussions on two hotly debated topics.

SW: Does it describe a new discovery, methodology, or synthesis of knowledge?

First we identified an argument first made by the US Supreme Court in the court decision Vacco v. Quill, and argued that this argument is frequently used under different forms in the international literature. The argument is, however, rarely identified and discussed and, as such, our article contributes to the knowledge of the debates surrounding continuous sedation and physician-assisted suicide.

"We do not argue for or against the legalisation of physician-assisted suicide, but argue that the existence of continuous sedation should not be used as an argument to do away with the debate on physician-assisted suicide."

Second, the validity of the argument in its different forms is tested and for this we relied heavily on available empirical research. So, although all data had been previously published this article provides a synthesis of knowledge by (1) combining all these data in one article; and (2) using the empirical data to support an ethical claim.

SW: Would you summarize the significance of your paper in layman's terms?

Some people doubt the relevancy of debating whether or not physician-assisted suicide should be legalized, by claiming that we have a better alternative for it, namely continuous sedation, i.e., reducing or taking away patients’ consciousness at the end of life. In this article we show that there seems to be no reason why continuous sedation would in itself be a preferable alternative to physician-assisted suicide. Although in some case continuous sedation could indeed be preferable to physician-assisted suicide, this is no argument for not having a debate on physician-assisted suicide.

SW: How did you become involved in this research, and how would you describe the particular challenges, setbacks, and successes that you've encountered along the way?

I got involved when I had to chance to start a Ph.D. in philosophy at Ghent University and became involved in an international study on continuous sedation in The Netherlands, Belgium, and the UK, called the UNBIASED study.

In working on the topic of continuous sedation I found it interesting that in Belgium there exists a unique situation since continuous sedation as well as euthanasia are legal, so doctors have the possibility to perform both these practices. In many other countries, however, while continuous sedation is legal, physician-assisted suicide is not. It therefore interested me which role the practice of continuous sedation played in the debates about whether or not physician-assisted suicide should be made legal.

SW: Where do you see your research leading in the future?

For this paper we relied on existing empirical data for the support of our ethical reasoning. I am, however, also involved in an international consortium—the UNBIASED consortium—and will gather qualitative data myself. The goal of this research is to gain insight into how continuous sedation is experienced by physicians, nurses, and relatives, and what the differences therein are between The Netherlands, Belgium, and the UK.

SW: Do you foresee any social or political implications for your research?

Our paper focuses on a topic of heated societal debate, namely the possibility of legalizing physician-assisted suicide. We do not argue for or against the legalization of physician-assisted suicide, but argue that the existence of continuous sedation should not be used as an argument to do away with the debate on physician-assisted suicide. It is therefore an argument for the open discussion on the drawbacks and advantages of legalizing physician-assisted suicide.End

Kasper Raus, MA
Ph.D. Student
Ghent University
Ghent, Belgium
Member of Bioethics Institute Ghent
Member of End of Life Care Research Group Ghent University & Vrije Universiteit Brussels



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