British Doctors Practising "Slow"
Euthanasia through Deep Sedation: BBC Report
A BBC report has revealed that physicians in the UK are increasingly
seeing and using "continuous deep sedation" as a form of "slow"
euthanasia. Adam Brimelow, BBC News health correspondent, writes that
the use of continuous deep sedation, also known as "terminal sedation"
is becoming more common in the UK and may be the way physicians are
skirting the law prohibiting direct euthanasia.
Research has shown that 16.5 percent of all deaths in the UK are
associated with continuous deep sedation until death, a number twice
that of Belgium and the Netherlands, both countries that already have
legalised direct euthanasia.
Deep sedation can be used intermittently or continuously until death,
and the depth of sedation can vary from a lowered state of
consciousness to unconsciousness. Under UK law, patients can give
a directive to medical staff that they refuse 'palliative care' or
'terminal sedation', or 'any drug likely to suppress respiration'.
Alex Schadenberg, the head of Canada's Euthanasia Prevention Coalition,
said that continuous deep sedation is a technique that can be used
ethically in cases of dying patients to alleviate intractable pain,
such as neuropathic pain that does not respond to morphine, but the
ethics depends upon the situation and the intention.
"It's important to make the distinction," Schadenberg told
LifeSiteNews.com, "between what we do with someone who is nearing death
and someone who is in pain but not dying." In some cases, he said,
patients who are not dying but may be suffering are put into deep
sedation, and then dehydrated to death - a use that is always unethical.
However, "if your patient is nearing death and is experiencing organ
failure, you really can't be putting food and fluid into a body that
can't use the fluids. When the body is shutting down, this is a natural
part of the dying process. But when they're not dying, like Terri
Schiavo, or someone who is experiencing great pain associated with
cancer, that is a different issue, because then we are talking about
causing that person's death.
"[Deep sedation] can be a backdoor route to euthanasia if it is used
unethically," he said. "The issue is intention. The intention must be
the alleviation of pain and suffering. Even a long-term sedation can be
ethical as long as the person is not being dehydrated to death. A good
palliative care physician won't use the technique very often."
Last year, Dutch researchers found that the use of continuous deep
sedation until death was becoming more widespread in the Netherlands
where direct euthanasia is already legal. In 2001, researchers found
that in six European countries deep sedation was used in 8.5 percent of
all deaths in patients with cancer and other diseases.
"The increased use of continuous deep sedation for patients nearing
death in the Netherlands suggests that this practice is increasingly
considered as part of regular medical practice," said lead researcher
Judith Rietjens, a postdoctoral researcher in the Department of Public
Health at Erasmus University Medical Center in Rotterdam.
"Also, the use of continuous deep sedation may in some situations be a
relevant alternative to the use of euthanasia for patients," Rietjens
Deep sedation is associated now with approximately 10 percent of all
deaths in the Netherlands, an increase that coincided with an increase
in public disquiet about the numbers of active euthanasia cases -
numbers that have since declined.
Schadenberg said that the answer to the puzzle is simple: "The
statistics of active euthanasia have gone down in the Netherlands
because they are simply resorting to deep sedation instead.
"But in fact this simply means that patients are being euthanised
slowly in conjunction with the withdrawal of fluids. It is why this is
being called 'slow euthanasia'. A lethal injection is quicker, but in
fact the ethics are no different. Both intend death."
Judith Rietjens confirmed this, saying, "We can see in our study that
those sub-groups where we saw an increase of continuous deep sedation -
just in those sub-groups - we saw a lowering of the frequency of
Contact: Hilary White
Date: August 18, 2009
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