Thursday, December 17, 2009

What's the Difference? Palliative Sedation and Aid in Dying.

A new paper from the conservative Center for Bioethics and Human Dignity works hard to explain the difference between palliative sedation (approved by the Religious Right) and aid in dying (what they call physician assisted suicide). There is a podcast of the paper at the link.

In the wake of Mark McConnell's oral arguments before the Montana Supreme Court in Baxter v. Montana in which he convincingly argues that there is "no bright line" between the two, I've seen a lot of attacks on such a premise. This is just the latest.

Here's the abstract:

The last presidential election saw Washington become the second state to legalize physician-assisted suicide (PAS). Pressure will increase for other states to follow suit so that those who are terminally ill can exercise the full scope of their “autonomy” and “die with dignity” through PAS if they so choose. Many concerned persons see trends toward legalizing PAS and the broad acceptance of euthanasia as not upholding the inherent dignity of human persons as is often claimed, but actually undermining it.

Christians engaged in palliative care have a responsibility to do what is permissible within theological, ethical, and legal boundaries to serve and treat their patients. Palliative sedation is thought to be an advance in palliative care that has alleviated the need for PAS when managing otherwise uncontrollable pain in the terminally ill. However, there is some question as to whether this procedure is sufficiently distinct from euthanasia and PAS. It may be argued that if there is no legitimate distinction, then PAS and other forms of euthanasia should be legal and legitimate end-of-life treatment options for patients along with palliative sedation. If this view is correct, then Christians who support the use of sedation in the terminally ill should have no problem with the practice of PAS.

This issue is important for health care professionals, pastors, Christian counselors, chaplains, and others, who may be called upon to support patients and their families concerning end-of-life treatment options. This paper argues that there is a legitimate moral distinction between these practices and that those who oppose euthanasia while maintaining the appropriateness of palliative sedation in certain situations are not acting inconsistently. Thus, palliative sedation in some circumstances, as a form of palliative care for the terminally ill, is morally permissible and does not violate the intrinsic dignity of vulnerable patients.

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